Catatonia and Autoimmune Conditions in Children and Adolescents: Should We Consider a Therapeutic Challenge?
Catatonia as a result of autoimmune conditions offers new therapeutic opportunities for patients that child and adolescent psychiatrists should consider. However, the diagnosis is sometimes challenging when an autoimmune signature is not identified.



In this study, we aim to summarize seven cases from a 20-year series of 84 youths with catatonia, including three cases that represented a diagnostic challenge because of the absence of positive autoimmune testing.



Immunosuppressive/modulatory treatment improved catatonic and psychotic features in all cases.



To facilitate treatment decision-making, we propose a causality assessment score and a treatment algorithm, which may help clinicians consider whether an autoimmune condition is associated with catatonia.
1 Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HP, Paris, France .|2 Department of Child and Adolescent Psychiatry, Université de Rouen , Hôpital Charles Nicolle, AP-HR, Rouen, France .
Vladimir
V
Ferrafiat
1 Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HP, Paris, France .
Marie
M
Raffin
3 Department of Neuropediatrics, Université Paris XI , Hôpital Bicêtre, AP-HP, Paris, France .
Kumaran
K
Deiva
4 Departments of Child and Adolescent Psychiatry, Université de la Méditerranée , Hôpital St Marguerite, AP-HM, Marseille, France .
Xavier
X
Salle-Collemiche
5 Department of Neuropediatrics, Université de la Méditerranée , Hôpital La Timone, AP-HM, Marseille, France .
Anne
A
Lepine
1 Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HP, Paris, France .
Michel
M
Spodenkiewicz
6 Department of Pediatrics, Centre Hospitalier Universitaire (CHU) de Rouen , Rouen, France .
Isabelle
I
Michelet
7 Department of Internal Medicine, E3M Institute, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HR, Paris, France .
Julien
J
Haroche
7 Department of Internal Medicine, E3M Institute, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HR, Paris, France .
Zahir
Z
Amoura
2 Department of Child and Adolescent Psychiatry, Université de Rouen , Hôpital Charles Nicolle, AP-HR, Rouen, France .
Priscille
P
Gerardin
1 Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HP, Paris, France .|8 CNRS UMR 7222, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HP, Paris, France .
David
D
Cohen
1 Department of Child and Adolescent Psychiatry, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HP, Paris, France .|9 Groupe de Recherche Clinique, Abord dimensionnel des épisodes psychotiques de l'enfant et de l'adolescent: implications génétiques, métaboliques et auto-immunes, Université Pierre et Marie Curie , Hôpital Pitié-Salpêtrière, AP-HP, Paris, France .
Angèle
A
Consoli
D000293:Adolescent; D000465:Algorithms; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000188:drug therapy; D002389:Catatonia / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D002648:Child; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies
D007155:Immunologic Factors; D007166:Immunosuppressive Agents
acute psychotic episode; autoimmune condition; catatonia; immunosuppressive treatment; treatment algorithm