自闭症及其他神经发 育障碍中的紧张症
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当紧张症与自闭症和其他神经发育障碍同时发生时
紧张症是一种严重的但未被充分认识的疾病，它可能与自闭症和其他神经发育障碍同时发生。虽然通常可以治疗，但它经常未被诊断出来——尤其是在早期阶段——因为它的症状可能与已有的特征相似或重叠，逐渐出现，或者以不会引起立即关注的方式出现。
许多患者缺乏足够的语言或认知能力来描述自己的经历，而照护者本身就需要应对各种复杂的需求，可能难以察觉患者出现了新的行为或退行症状。临床医生也可能忽略这些迹象，因为大多数医学教育中对紧张症的讲解仍然不够充分。因此，早期症状常常被误解或忽视。
这种情况发生时，治疗可能会被延误，紧张症也可能继续发展，导致症状恶化、严重残疾，甚至危及生命的并发症。虽然早期识别可以改善预后，但即使紧张症已持续一段时间，治疗仍然有效。提高公众意识、加强教育并坚持寻求准确诊断至关重要——这样，在评估新的体征和症状时，就能将紧张症纳入鉴别诊断。
为家庭、学校和护理人员提供关于自闭症患者紧张症的基本且易于分享的信息
本信息表由 Carol Allread 编写，她是一位自闭症儿子的母亲，致力于通过以家庭为中心的洞察力来倡导自闭症健康公平。她与 Joshua Ryan Smith 博士、华盛顿大学神经发育及相关障碍领导力教育 (LEND) 项目、自闭症科学基金会和 SPACES 合作编写了本信息表。
我们很荣幸在此分享此资源，供家庭、教育工作者和护理团队使用。
注意到紧张症的最初迹象
认识到自闭症、其他神经发育障碍和紧张症之间的重叠之处至关重要，然而这一点却常常被忽视。由于紧张症的许多症状可能与自闭症或其他神经发育障碍的特征相似或加剧这些特征，因此早期迹象可能被认为是患者自身固有特征的一部分，或归因于压力、行为改变或发育波动。
因此，密切关注个体行为、情绪、精力或功能方面任何与以往不同的变化至关重要。即使是细微的变化也可能意义重大。最重要的不是这种行为本身是否是自闭症患者的常见表现，而是它是否代表着该个体自身的变化。此类变化可能预示着紧张症的发生，应立即进行评估。
虽然紧张症的表现形式多种多样，但需要注意的一些最重要变化包括：
整体行为、情绪或精力水平的变化
无端攻击行为
情绪变化，例如哭泣、易怒、社交退缩或自杀念头
突然感到头晕或不合时宜地大笑
重复性或自我刺激行为（“刺激行为”）的加剧
出现新的或加剧的自伤行为
反复出现或循环往复的念头，通常带有恐惧或厄运的意味。
出现新的或加剧的回声语言（重复词语或短语）
认知能力、功能技能或日常生活活动能力（ADL）出现退化
对食物兴趣减退、食量减少或体重明显下降
当被问及时，可能会出现缄默或言语反应减少的情况。
活动水平升高或无目标性运动（多动症）
目光呆滞或长时间凝视，眼球运动很少或眨眼次数减少
长时间保持不寻常或僵硬的姿势
血压或体温等生命体征的波动
任何突然或无法解释的变化——特别是无故攻击、自残行为或退行——都应引起重视，考虑是否患有紧张症，并及时进行临床评估。
如果照护者发现紧张症的迹象，他们该怎么办？
如果您发现任何突然或无法解释的变化——尤其是新的自伤行为或无故攻击行为——务必迅速采取行动。这些行为可能危及患者自身及他人安全，也可能是紧张症的早期征兆。紧张症会随着时间推移而加重，但即使症状已持续数月甚至数年，通过正确的评估和治疗，通常也能得到改善。
以下步骤将帮助您顺利完成为您的亲人安排合适护理的流程：
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记录您所爱之人的基本情况以及发生的变化。
描述一下在你注意到变化之前（基线），他们的典型情绪、行为、技能和活动水平是什么样的。
记录下发生的变化：何时开始、发生的频率以及现在的样子。
短视频片段可以帮助显示变化，尤其是在就诊期间没有出现这些行为的情况下。
虽然您可以保留详细的笔记以供自己记录，但请创建一份简明扼要的要点摘要，突出最重要的变更内容，并将其提供给医护人员。临床医生审阅信息的时间有限，因此简洁的格式有助于确保您的主要诉求得到充分理解。 点击此处查看示例。
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尽快进行全面的医学评估
联系您的初级保健医生、神经科医生或精神科医生，并清楚地描述您的担忧： “我担心我的亲人可能出现了紧张症的症状。”
请将您所爱之人的资料（基线数据、变化情况、视频片段、简要要点总结）带到预约地点。
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如果医护人员不熟悉紧张症
许多临床医生在识别紧张症方面接受的培训有限，尤其是在自闭症和其他神经发育障碍方面。
如果发生这种情况，请保持冷静并配合。你可以说： “我知道紧张症并不总是被重视，但我读到过它可能会发生在患有我亲人这种疾病的人身上，我想了解一下这种可能性。”
请携带打印版的同行评审文章、临床指南或教育材料（例如来自紧张症基金会的材料）以供分享。 点击此处查看近期文章。
询问他们是否愿意咨询一位在紧张症方面有专长的同事，或者将你转诊给一位专家。
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请考虑是否患有紧张症
要求将紧张症纳入鉴别诊断。
布什-弗朗西斯紧张症评定量表（BFCRS）是一种广泛使用的工具——询问是否可以进行评估。
如果合适，讨论是否可以将劳拉西泮激发试验作为诊断过程的一部分。
了解何时需要紧急或急诊护理。
如果您的亲人有自残或无故攻击行为，可能对自己或他人造成伤害，请立即寻求紧急医疗救助。
如果患者停止进食或饮水、无法动弹，或出现呼吸、心率或体温变化，也需要进行紧急评估。
倡导及时治疗
如果确诊或怀疑患有紧张症，请咨询一线治疗方案，例如劳拉西泮和/或电休克疗法。即使是长期病例，如果使用得当，这些疗法也可能有效。
请记住：您最了解您的亲人。您对他们健康状况的了解以及对变化的观察，对于指导临床医生做出正确的诊断和治疗至关重要——无论这些变化是近期发生的，还是已经持续了一段时间。
紧张症和神经发育障碍的倡导
When catatonia occurs in someone with a neurodevelopmental condition, timely recognition and treatment can be life-changing — but getting there often requires active, persistent advocacy. Many healthcare providers have little training in catatonia, especially when it presents in autism, intellectual disability, or other neurodevelopmental conditions.
As a result, families and caregivers often find themselves needing to bring up the possibility of catatonia as a potential diagnosis — doing so from an informed perspective — while also providing relevant information and advocating for a comprehensive evaluation.
Knowing when and how to advocate is essential
Advocacy may involve presenting clearly documented changes from baseline, requesting that catatonia be considered in the differential diagnosis, asking for specific assessments such as the Bush–Francis Catatonia Rating Scale, or suggesting referral to a clinician with experience in neurodevelopmental conditions and catatonia.
This is not an easy role to take on. It places an unfair burden on caregivers who are already navigating complex daily challenges, distressing behaviors, and sometimes rapid loss of skills in their loved one.
Advocating is challenging but necessary
Advocating for someone with a neurodevelopmental condition who may also have catatonia can be challenging and exhausting. Caregivers are often managing complex needs on a daily basis, and the added burden of ensuring catatonia is recognized and treated can feel overwhelming. Yet, timely and accurate diagnosis often depends on a caregiver’s ability to notice changes, communicate them clearly, and request appropriate evaluation.
The language you use is important
One key aspect of effective advocacy is choosing language that supports accurate diagnosis. The words you use can shape how a provider thinks about symptoms — sometimes in ways that unintentionally lead them away from considering catatonia. To increase the likelihood that catatonia is part of the differential diagnosis, describe behaviors factually and in detail, without defaulting to terms that imply another condition.
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Avoid diagnostic shortcuts – Instead of using terms that imply a psychiatric diagnosis (e.g., “mania” or “depression”), focus on observable signs.
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Be precise about changes from baseline – Quantify the change in behavior so providers can distinguish between longstanding traits and new or intensified signs.
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Provide context – Include when you first noticed the change, how long it has been occurring, and whether symptoms fluctuate over time.
例如：
不要用“躁狂症”，而要说： “他不停地动来动去，无法安静下来，一走就是几个小时。”
不要用“抑郁症”这个词，而要说： “她总是想着厄运，而且一天到晚都在哭泣。”
不要说“自我刺激行为增多”，而应该说： “以前每天有 30 分钟的自我刺激行为；现在这种行为持续不断，影响进食和睡眠。”
这种精确、客观的描述能够帮助医护人员更好地了解变化的范围和性质，从而使他们在评估中更有可能考虑紧张症。
来自紧张症基金会的资源
在紧张症基金会，我们深知倡导工作的必要性及其带来的压力。因此，我们开发了一系列资源，帮助您更有信心地应对这一过程：
你不应该独自承担这份责任——但当需要进行倡导时，拥有计划、正确的语言和可靠的资源可以起到至关重要的作用。
医疗服务提供者如何进行诊断
诊断患有神经发育障碍的个体是否出现紧张症可能具有挑战性。症状可能与基线行为重叠，逐渐变化，并随时间推移而波动——有时患者可能表现得躁动不安，而有时则可能表现得孤僻或昏睡。这些变化会使紧张症更难识别，尤其是在不同阶段出现不同症状的情况下。 在短暂的门诊就诊中，医生可能只能看到部分情况——特别是当症状在一天中波动或仅在特定情况下出现时。
对紧张症的全面评估可能包括以下内容：
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布什-弗朗西斯紧张症评定量表（BFCRS）
这是一种结构化的评估方法，用于测量紧张症症状的存在和严重程度。虽然应用广泛，但由于某些特征与既有行为重叠，因此在神经发育障碍中可能更难应用。医护人员应重点关注与患者基线不同的症状——例如症状强度更高、出现频率更高，或出现之前未观察到的症状。即便存在这些挑战，BFCRS 仍然为系统评估潜在的紧张症提供了一个框架。 点击此处了解更多关于 BFCRS 的信息。
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劳拉西泮挑战
这项测试会给患者服用小剂量劳拉西泮，观察症状是否暂时缓解。阳性反应可以支持紧张症的诊断，但需要注意的是，并非所有患者都会有反应，阴性结果也不能排除紧张症。 点击此处了解更多关于劳拉西泮挑战的信息。
实验室检查、影像学检查和脑电图可用于识别这些病因。识别并治疗潜在疾病可以改善治疗效果。对于照护者而言，询问医护人员是否已考虑过这些可能性，是争取进行全面评估的重要组成部分。
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潜在条件
医护人员可能需要评估患者是否存在可能诱发或加重紧张症的潜在内科和精神疾病。这些疾病可能包括：自身免疫性脑炎（例如抗NMDA受体脑炎）
感染（例如，尿路感染、肺炎）
代谢紊乱（例如，甲状腺疾病、电解质失衡）
神经系统疾病（例如，癫痫、中风）
药物副作用（包括戒断反应）
精神疾病（例如，情绪障碍）
治疗和管理
对于患有神经发育障碍的个体，一旦怀疑或确诊紧张症，就应尽快开始治疗，因为早期干预通常与更好的预后相关。在某些情况下，症状可能迅速恶化甚至危及生命，因此及时评估尤为重要。
由于紧张症在每个人身上的表现可能不同，而且症状可能会随着时间而变化，因此治疗通常需要个性化，并随着情况的发展而调整。
治疗可能包括药物治疗、电休克疗法 (ECT)、治疗潜在的内科或精神科疾病、支持性护理、持续监测和维护以及多学科方法， 如下所述。
Medication
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Benzodiazepines – Lorazepam is the most commonly used medication and is often highly effective, sometimes producing rapid improvement. Other benzodiazepines, such as diazepam or clonazepam, are sometimes used depending on the individual’s needs and the provider’s informed and educated clinical judgment. Treatment usually starts with a low dose that is increased gradually.
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Higher doses – Managing catatonia with lorazepam often requires higher doses than in other conditions. Published reports describe the use of doses up to, and in some cases, exceeding, 30mg per day to achieve symptom relief. These higher doses are typically well-tolerated by patients with catatonia. It is important that treatment is provided under the care of a physician who can carefully monitor response and adjust dosing as needed.
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Additional medications – In some cases, additional medications may be considered, particularly if benzodiazepines are only partially effective or not tolerated. Amantadine and memantine — both of which affect the brain’s glutamate system — are among the medications that have been used in certain situations under specialist guidance. Other medications may be used as well, either to target the symptoms of catatonia itself or to address underlying psychiatric or medical conditions contributing to the symptoms.
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IMPORTANT CAUTION – Certain medications — including some antipsychotics and other psychiatric drugs — can cause or exacerbate catatonia in some individuals and should be used with caution. Additionally, weaning medications too quickly can trigger or worsen catatonia, so any changes to medication should be done gradually and under close medical supervision.
Electroconvulsive Therapy (ECT)
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What is ECT – A medical procedure performed under anesthesia in which brief, controlled electrical stimulation is applied to the brain. ECT is often highly effective for catatonia, including in individuals with neurodevelopmental conditions, especially when benzodiazepines have not provided enough improvement. It is considered safe when performed by experienced providers.
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Safety of ECT – While ECT can sound intimidating, it is not painful, is done with full monitoring, and has been safely used in children, adolescents, and adults for decades.
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When might ECT be used earlier – Although often considered a second-line treatment, in cases of severe aggression, self-injurious behavior, or malignant catatonia, ECT may be used earlier to rapidly address life-threatening or dangerous symptoms.
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A family's story – To hear from a family whose son with autism and catatonia receives ECT treatment, click here
Addressing underlying causes
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If catatonia is related to a medical, neurological, or psychiatric condition, treating that underlying cause is essential.
支持性护理
营养和水分——患有紧张症的人可能会减少进食或饮水，这可能很快变得危险。监测并支持充足的摄入至关重要。
活动和体位调整——长时间保持静止不动会导致褥疮或血栓等并发症。可能需要轻柔地调整体位并进行活动范围练习。
环境支持——减少感官超负荷、保持平静的环境、提供安慰可以帮助降低神经系统的压力。
持续监测和维护
后续护理——即使治疗效果良好，紧张症的症状也可能反复发作。定期随访有助于医护人员调整药物、继续提供支持性护理，并及早发现任何复发迹象。
留意复发迹象——疾病复发是有可能的，因此及早发现变化有助于医护人员更有效地进行干预。在某些情况下，尤其是在患有神经发育障碍的个体中，这一点尤为重要。
维持性 ECT – 为了保持疗效，ECT 可能需要长期维持治疗。
多学科方法
医疗保健各学科之间的合作——将精神病学、神经病学、初级保健和其他专家聚集在一起——可以帮助确保健康的各个方面都得到解决。
让家人参与到护理团队中——家人和护理人员在这个过程中发挥着至关重要的作用，因为他们往往是第一个注意到症状细微变化的人，并且可以与护理团队分享宝贵的见解。
从儿科过渡到专科
成人护理
对于患有神经发育障碍和紧张症的患者，治疗和管理往往需要多年时间。随着青少年逐渐脱离儿科服务，他们及其家庭在过渡到成人护理时可能会面临新的挑战。
Potential challenges you may face in the transition process include:
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Limited provider expertise – There are often fewer adult psychiatrists, neurologists, and other specialists with direct experience in diagnosing and treating catatonia, particularly in individuals with neurodevelopmental conditions.
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Continuity of treatment – Long-term treatments such as maintenance ECT or ongoing medication management require careful handoff between pediatric and adult providers to avoid lapses in care.
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Consent and legal authority – Guardianship laws vary by state, and in some states guardians may not be able to consent to ECT for an adult. Understanding local regulations well before the transition is essential to prevent treatment delays. In some cases, it may be necessary to work with an attorney and petition the court for the authority to consent on behalf of an adult child.
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Shifts in care models – Pediatric care teams often work in a more integrated, family-centered way. Adult care systems may involve more fragmented services, requiring caregivers to coordinate across multiple providers and facilities.
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Access to specialized facilities – Not all adult hospitals or outpatient centers are equipped to manage catatonia in people with complex developmental and medical needs.
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Less frequent follow-up – Adult providers often see patients less frequently than pediatric teams, which means there may be fewer opportunities to address emerging issues — such as the need for medication adjustments or timely ECT treatments — before symptoms worsen.
提前规划可以使这一过程更加顺利。理想情况下，过渡计划应在患者达到儿科护理年龄上限之前就开始制定，以便有充足的时间确定成人医疗服务提供者、解决法律同意问题，并确保治疗方案和病历能够顺利转移。
获取支持服务
照顾患有紧张症和神经发育障碍的亲人，在体力、精神和情感上都是一种巨大的挑战。责任远不止于基本的照护——还包括应对严重的行为问题、协调医疗治疗、与医疗机构沟通以及确保安全。虽然你可能觉得除了你的亲友之外，没有人真正理解其中的艰辛， 但详细记录这一切可以帮助其他人——包括服务提供者、个案经理和决策者——了解所需的照护水平。
为什么这很重要—— 获得喘息服务、医疗补助资助和其他社区资源等服务，通常取决于您是否能充分展现您的照护责任范围。您越能清晰地说明您的日常工作量，就越容易获得有力的帮助。
如何记录您提供的护理水平：
写一份详细的每日护理日志——记录你为你的亲人所做的所有活动，从膳食和个人护理到药物管理、治疗支持和行为干预。
记录所花费的时间——记录每项任务花费的时间（分钟或小时）。
记录艰难时刻——记录每一次严重行为（攻击、自残、躁动）事件以及处理这些行为所花费的所有时间。
记录那些看不见的工作——包括协调预约、与学校或服务提供商沟通、管理保险或医疗补助文件以及争取服务所花费的时间。
优化格式，提升影响力——将笔记以清晰易读的格式呈现，例如表格或项目符号列表，并标明任务、频率和所需时间。这样可以让人一眼看出工作量的大小。
如需每日护理记录模板示例， 请点击此处
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下一步
拿到所需文件后，请与您的个案工作者、医疗补助服务协调员和其他相关专业人员分享。具体询问您可能符合哪些服务资格，例如：
喘息服务让您从照护工作中得到短暂休息。
居家支持人员或社区生活支持
行为支持服务
医疗补助豁免或其他州级项目
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探索和获取这些服务不是一种奢侈——它是你长期维持提供护理能力所必需的。
诊断和治疗的障碍
即使照护者识别出可能预示紧张症的症状变化，也常常存在诸多障碍阻碍及时有效的治疗。这 些障碍往往相互叠加，导致患者无法获得所需的诊断或治疗。
常见的挑战有哪些？
经验丰富的医护人员短缺——缺乏足够的临床医生具备识别和治疗紧张症的专业知识，尤其是在患有神经发育障碍的个体中。
专业意识和培训不足——许多医疗保健人员对紧张症缺乏或根本没有接受过正规教育。由于缺乏经验，一些细微或早期症状可能会被忽视。
症状误判——退行或行为改变常常被错误地认为是自闭症或其他神经发育障碍的“自然病程”的一部分。
医疗服务连续性存在缺口——住院和门诊医护人员之间的沟通常常不足。患者出院时可能没有精神科医生继续治疗，或者门诊医生可能将患者转诊至住院部，但缺乏有效的后续跟进或协调。
专科诊所寥寥无几——针对复杂或难治性病例的专科项目非常罕见。例如，密歇根大学设有难治性疾病诊所，但许多地区却没有类似的资源。
这些系统性缺陷意味着家庭经常要承担起安排护理、倡导适当评估以及确保治疗方案在不同机构中得到执行的重担。
What Families Can Do
While these obstacles are real and challenging, there are steps caregivers can take to improve the chances of getting effective treatment:
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Document thoroughly – Keep a clear record of changes in behavior, function, and mood compared to baseline, and present this in a concise, easy-to-read format for providers.
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Bring credible resources – Share peer-reviewed articles or reputable medical sources on catatonia in neurodevelopmental conditions with providers who may not be familiar with the condition. (See Advocacy and The Inside Scoop to Advocacy in Autism for recommended materials.)
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Clarify your language – Describe behaviors factually rather than labeling them with terms that may lead to misdiagnosis. (See Choosing Language That Supports Accurate Diagnosis for examples.)
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Seek specialized expertise – If possible, request referral to a provider or clinic with demonstrated experience in diagnosing and treating catatonia.
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Advocate for coordinated care – Encourage communication between inpatient and outpatient teams, and ask for a clear plan for follow-up after discharge
What The Catatonia Foundation Is Doing
The Catatonia Foundation is committed to addressing these obstacles through targeted initiatives, including:
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Raising awareness and educating providers – Offering educational materials, presentations, and training to increase recognition of catatonia across medical, psychiatric, and allied health disciplines.
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Exhibiting at annual conferences – In 2024-2025, The Catatonia Foundation has exhibited at annual meetings of the American Psychiatric Association (APA), International Society for ECT and Neuromodulation (ISEN), and American Academy of Child and Adolescent Psychiatry (AACAP).
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Educating the public – Providing families, caregivers, and community members with resources to recognize the signs and advocate effectively.
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Social media targeted campaigns – The Catatonia Foundation is active on LinkedIn, Instagram, Facebook, and X.
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Identifying and sharing provider expertise – Building a network of clinicians with experience in diagnosing and treating catatonia in neurodevelopmental conditions.
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Advocating for systemic change – Working with stakeholders to improve access, reduce diagnostic delays, and promote continuity of care between inpatient and outpatient settings.
一个家庭的故事：艾琳和戴维
艾琳是一名儿科康复科医生。她在医学培训中对紧张症的了解仅限于对典型表现的简要描述——患者一动不动地坐着，几乎不说话。她完全不知道，在自闭症患者身上，紧张症的表现可能截然不同。
她的儿子大卫患有自闭症，四岁时开始出现严重的运动性躁动，不停地跳跃、蹦跳、摇晃身体、做出刻板行为并大笑。11岁时，情况发生了显著变化。运动性躁动依然存在，但情绪却从“快乐爱笑的大卫”转变为“我要杀了你，大卫”。攻击性取代了欢笑。
当大卫14岁时被确诊为紧张症时，艾琳震惊不已。她甚至不知道紧张症会与自闭症同时出现。幸运的是，她设法将大卫送进了一家专治紧张症的医院。在那里，她得知，对于一个发育正常的儿童来说，住院电休克治疗（ECT）通常需要12次疗程才能减轻症状；但对于神经多样性儿童来说，所需的疗程可能要多得多——通常需要18次住院治疗。对大卫来说，“神奇的数字”是36——18次住院治疗和18次门诊治疗——之后他的紧张症症状才显著减轻。
治疗结束后，大卫的状态恢复到了一个新的水平：他变得更加平静，不再躁狂或具有攻击性。治疗并没有消除他的自闭症，但让他重新获得了摆脱持续躁动和无端攻击行为的能力。
自最初接受电休克治疗（ECT）以来，大卫一直在接受维持性ECT治疗。在他18岁时，他的家人不得不申请监护权。不幸的是，密歇根州的监护权制度不允许监护人代表大卫同意ECT治疗。大卫的父母不得不聘请律师，并向法院提出申请，请求允许他们代表大卫同意ECT治疗，因为如果没有这种治疗，大卫的攻击性会再次严重发作。幸运的是，他们的申请获得了成功。维持性ECT治疗显著降低了大卫的攻击性，虽然偶尔仍会出现一些棘手的情况，但他现在大部分时间都处于更加平静、稳定的状态。
点击此处了解他们的故事
资源
ECT: Disrupting the Stigma, Video from University of Michigan (2022)
Catatonia and Severe and Challenging Behaviors SIG, Six part webinar series, Autism Science Foundation (2025)
Catatonia in Pediatric and Neurodiverse Populations by Dr. Joshua Ryan Smith | TN NCSA Webinar, 2024
Cure SYNGAP1 Webinar – Catatonia in Neurodevelopmental Conditions like SYNGAP1 (Joshua Ryan Smith, MD): broader NDD context.
AARC Webinar – Catatonia and Autism (research overview; includes Down syndrome): accessible talk for families and clinicians.
Florida BH Center (Guidelines site) – Video lectures include Catatonia (Politte, MD) within ASD/IDD series.
Emerging Co-occurring Disorders with ASD - Catatonia and DMDD 2020
自闭症科学基金会每周科学播客——“没有人谈论紧张症” （与医学博士 Martine Lamy 对话）：症状、追踪和治疗。
PsychEd（多伦多大学）——第 67 集：紧张症，主讲人：Patricia Rosebush 医学博士：临床基础；适合有一定基础的非专业听众和医护人员。
精神病学和心理治疗播客——“儿童和青少年紧张症” （与 Joshua Ryan Smith 医学博士一起）：儿科识别、BFCRS、治疗。
让我们来谈谈紧张症，自闭症科学基金会，嘉宾是约书亚·瑞安·史密斯医学博士和扎卡里·威廉姆斯
Amy SF Lutz —《我每天都更喜欢它：自闭症、电休克疗法和我们最残疾儿童的治疗》（范德比尔特大学出版社）：一位家长对紧张症、电休克疗法决定和护理导航的描述。
Amy SF Lutz — 我们同行：与重度自闭症共存的生活（康奈尔大学出版社）：关于重度自闭症的生活、系统导航和伦理的散文。
《自闭症中的紧张症、崩溃和崩溃：心理生态学方法》， 作者阿米塔·沙阿博士。这是一本开创性的、以临床经验为基础的指南，结合了真实的案例和专门针对经历紧张症或崩溃状态的自闭症患者的管理策略。书中包含一个全新的临床框架（ACE-S）。
Electroconvulsive therapy in autism spectrum disorders: an update to the literature. Curr Opin Psychiatry, 2025.
Systematic Review of Symptoms of Catatonia in Autism Spectrum Disorder — Journal of Autism and Developmental Disorders, May 6, 2025. Identifies six symptom clusters in ASD catatonia (including features not in ICD-11), useful for earlier recognition and more precise differential.
A Cross-National Reliability Study of Catatonia in Individuals with Neurodevelopmental Disorders — JADD, Apr 16, 2025 (open access). Shows only 75% initial agreement among expert clinicians; stresses documenting change from baseline and using structured scales (e.g., BFCRS).
Catatonia in Autistic Adults in a Tertiary Inpatient and Outpatient Neurodevelopmental Service: A Retrospective Review — JADD, May 3, 2025. Prevalence ~11% in a specialized service; common signs were initiation difficulty, posturing, freezing; authors recommend specific tools (e.g., Wing & Shah criteria) to improve diagnostic accuracy.
Catatonia in ASD: Analysis of Clinical Characteristics, Stressful Life Events, and Validation of the Attenuated Behavior Questionnaire (ABQ) — Psychiatry Research, online ahead of print Jul 13, 2025. Validates ABQ for ASD catatonia; reports screening and diagnostic cut-offs (39.5; 92.5) and links catatonia with late regression and recent stressors—practical for screening and diagnosis.
Catatonia and Autism Spectrum Disorder: A Common Comorbid Syndrome or a Core Feature? — World Journal of Psychiatry, May 19, 2025 (open access). Narrative review focused on how to differentiate ASD traits from superimposed catatonia; emphasizes detecting pattern/severity changes.
Longitudinal Symptom Burden and Pharmacologic Management of Catatonia in Autism With Intellectual Disability — Autism Research, Feb 2025 (PMCID listed). Though treatment-oriented, it uses BFCRS/KCS/KCE serially—helpful exemplars for structured diagnosis and monitoring in ASD.
SHANK3 as risk factor for early-onset catatonia. Int J Neuropsychopharmacology, 2025.
Identifying and Treating Catatonia in Children With Neurodevelopmental Disorders — J Can Acad Child Adolesc Psychiatry. 2024 Nov 1;33(3):215–222.
Neurodevelopmental Disorders Including Autism Spectrum Disorder and Intellectual Disability as a Risk Factor for Delayed Diagnosis of Catatonia — J Dev Behav Pediatr. 2024 Mar-Apr;45(2):e137-e142.
Catatonia in ASD: Prevalence, functional impact, and diagnostic insights — Psychiatry Research, 2024. Highlights subtle catatonic behaviors in ASD — useful cues for early recognition before full syndrome emerges.
The effectiveness of the lorazepam challenge test in pediatric catatonia: A multisite retrospective cohort study. Schizophrenia Research, 2024 (pediatric catatonia; includes neurodivergent patients).
Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single-Site Retrospective Analysis. J Autism Dev Disord, 2024 (co-author).
Symptoms of Catatonia Observed in Down Syndrome Regressive Disorder. J Autism Dev Disord, 2024. (NDD—DS regression.)
Another Option for Aggression and Self-Injury: Alternative Benzodiazepines for Catatonia in Profound Autism. J Child Adolesc Psychopharmacol, 2023.
Catatonia in Neurodevelopmental Disorders: Assessing Catatonic Deterioration From Baseline — Lancet Psychiatry, Mar 2023. Influential diagnostic framework proposing “personalized baseline” and “deterioration from baseline” concepts—now commonly referenced in ASD catatonia diagnostics.
Evidence-Based Consensus Guidelines for the Management of Catatonia (BAP) — J Psychopharmacol, Apr 2023 (diagnosis section). Standard reference covering diagnostic criteria, recommended rating scales (e.g., BFCRS), exclusion of mimics, and benzodiazepine challenge as a diagnostic/therapeutic probe; applicable to ASD presentations.
Early-onset catatonia associated with SHANK3 mutations: looking at the autism spectrum through the prism of psychomotor phenomena. Frontiers in Psychiatry, 2023.
Catatonia in ASD: Systematic Review & Meta-analysis. Shows pooled catatonia prevalence ~10.4% in ASD; highlights common motor disturbances. Cambridge University Press, 15 December 2021
Catatonia in autism and other neurodevelopmental disabilities. High-level review across NDDs; differential points and management overview Npj Ment Health Res. 14 September 2022
Maintenance ECT is an essential, Medical Treatment for Patients With Catatonia: A COVID-19 Related Experience. Frontiers in Psychiatry (2021). Argues mECT is often necessary and safe to prevent relapse in catatonia linked to ASD/ID.
Catatonia: A Common Cause of Late Regression in Autism. Frontiers in Psychiatry, 2021.
Use of ECT in Autism. 2020 Review supporting safety/effectiveness of ECT for catatonia in youth with autism. J Child Adolesc Psychopharmacol.
Catatonia in Patients with ASD. 2020. Practical review: motor, speech, behavioral domains; emphasizes benzodiazepines and ECT as evidence-based treatments and the need for timely recognition. Child & Adolescent Psychiatric Clinics.
Treatment of catatonia in autism spectrum disorders (review). Acta Psychiatr Scand, 2019.
The multiple faces of catatonia in autism spectrum disorders. Eur Child Adolesc Psychiatry, 2019.
Catatonia in Down syndrome; a treatable cause of regression. Neuropsychiatr Dis Treat, 2015.
ECT for Malignant Catatonia in an Autistic Adolescent. 2010. Case report illustrating rapid, robust response when other treatments failed. Autism.
Maintenance ECT in Autistic Catatonia: Case Series Review. Argues for maintenance ECT to prevent relapse after acute response. Prog Neuro-Psychopharmacol Biol Psychiatry, 30 May 2010
Catatonia and Autism: A Historical Review, With Implications for Electroconvulsive Therapy. J ECT, 2009.
The effectiveness of the lorazepam challenge test in pediatric catatonia: A multisite retrospective cohort study Schizophr Res., 2024.
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