Co-occurrence of Autism, Psychosis and Catatonia: A Scoping Review.
When autism, psychosis and catatonia overlap, assessments are messy and treatments hit or miss.
01Research in Context
What this study did
Nyrenius et al. (2025) looked at 17 papers about people who have autism, psychosis and catatonia at the same time.
They mapped how doctors figure out the three diagnoses and what treatments were tried.
The team did a scoping review, so they charted patterns rather than testing one drug or therapy.
What they found
Most reports did not use a clear step-by-step assessment plan.
Treatments ranged from ECT to clozapine to behavior plans, with very mixed results.
The authors say we still lack a common roadmap for telling these conditions apart and picking care.
How this fits with other research
Hasan et al. (2025) give us part of that roadmap. Their 2025 review lists six catatonia signs in autism, showing that current guides miss key clues like tics or sudden silence.
Davison et al. (1991) warned that catatonia in autism often signals a separate medical or mood problem. Johan’s findings echo this: when teams skip full work-ups, outcomes swing wildly.
Petkova et al. (2022) and Walley et al. (2005) each report single-case success—clozapine in two teens, ECT in one adolescent. Johan’s wider scan shows such wins are exceptions, not rules, underlining the need for better screening before leaping to these steps.
Why it matters
If a client with autism stops talking, sits frozen, or shows odd movements, you may face all three conditions at once. Use a checklist approach: rule out medical causes, chart mood symptoms, and track catatonia signs Syeda highlighted. Share the full picture with the psychiatrist before trialing heavy meds or ECT. Your data could become the clear report this field still lacks.
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02At a glance
03Original abstract
PURPOSE: Autism, psychosis and catatonia were once considered part of schizophrenia. While both autism and catatonia have been "detached" from schizophrenia, co-occurrence of the three conditions may be suspected in some cases, because of overlapping features, leading to challenges in diagnosis and treatment. This review provides an overview of the literature regarding the co-occurrence of autism, psychosis and catatonia. METHODS: A scoping review of peer-reviewed original research articles that simultaneously described all the three diagnostic constructs (autism, psychosis and catatonia) was performed. Using PRISMA-ScR guidelines, the review was based on MedLine, Scopus, PsycInfo and Cinahl databases. Studies included patients of all ages, races and both genders. A Qualitative Content Analysis (QCA) of the contents of the articles was also performed. RESULTS: Seventeen articles (n = 17) out of a total of 752 (after removing duplicates) met inclusion criteria, most of which (65%) were case reports/case series. Overall, majority of the studies lacked description of diagnostic procedures regarding psychosis - especially while describing co-occurrence of psychosis and catatonia in patients with autism. Reports of treatment outcomes showed considerable variations. Major themes identified in the QCA involved uncertainty, particularly in the differential diagnostic and treatment considerations. CONCLUSION: The results of this scoping review underscore a need for undertaking larger studies using structured diagnostic approaches for developing better methods to differentiate between autism, psychosis and catatonia. Our findings also point to a need for conducting treatment trials and developing treatment algorithms for mixed presentations when there is co-occurrence of autism, psychosis and catatonia.
Journal of autism and developmental disorders, 2025 · doi:10.1186/s13256-023-03903-3