title: Childhood disintegrative disorder with seasonal total mutism: A rare clinical presentation.
abstract: Childhood disintegrative disorder (CDD) is a rare autistic-like clinical condition with unknown etiology, in that previously acquired age-appropriate language, social and adaptive abilities deteriorate significantly in 2-10-year-old healthy children, although physical and neurological evaluations display no observable abnormality. Our case is a 22-year-old female born of a consanguineous marriage, with the appearance of CDD symptoms in her fifth year of age following normal mental and physical development during her initial four years of life. Without any precipitating factor, she gradually lost her language abilities, social relational skills, affectionate behavior, adaptive capacities, peer play and meaningful interest in her surrounding, friends and family members over a period of 4 years, reaching a plateau in her ninth year of age. The unique special clinical symptom in this case is a seasonal total mutism, which after the beginning of her CDD symptoms is revealing every year covering the spring. As no additional physical or psychological change accompanies her total seasonal speech loss, it cannot be attributed to any mental condition known as having a seasonal pattern. Because in the literature CDD is presented mostly as case reports with lacking of advanced research data, describing any new case is recommended to improve the knowledge about this rare condition, especially if it displays some new unusual signs, not reported till now.
authors.affiliation: Mental Health Research Center, Tehran Institute of Psychiatry-School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Shirazi
authors.affiliation: Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Hosseinpoor
authors.affiliation: Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Seyyed Mohammad Mahdy
authors.initials: SM
authors.lastname: Mirhosseini
authors.affiliation: Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Bidaki
keywords: Childhood disintegrative disorder; mutism; seasonal; speech loss