The study of pediatric catatonia supports a home of its own for catatonia in DSM-5

The study of pediatric catatonia has not received much attention. During the last few years, progress has been made in delineating this syndrome in children and adolescents across a wide range of disorders. Catatonia is a potentially life-threatening but treatable syndrome that also occurs in children and adolescents with autistic, developmental, and tic disorders, and in its idiopathic form. In many of these cases, catatonia cannot be accounted for by an associated psychotic, affective, or medical disorder. These findings are imminently relevant for classification where catatonia is currently restricted to sections of the psychotic, affective, or medical disorders. Catatonia should always be the primary diagnosis in children, adolescents, and adults, as specific treatments for catatonia, i.e., benzodiazepines and electroconvulsive therapy, lower risk of worsening catatonia or precipitating Neuroleptic Malignant Syndrome when antipsychotic medications are used as first-line or sole treatment. The creation of a separate diagnostic class for catatonia is the safest approach to ensure proper diagnosis and treatment of this syndrome in patients of all ages and the best approach to promote research.