We report the case of an adolescent male who presented with
mutism, immobility,
catalepsy, and mannerisms. The patient was admitted to our hospital with suspected
catatonic schizophrenia; however, he was subsequently diagnosed with
catatonia due to
Asperger's disorder. The patient was a 16-year-old male. More than six months before presentation, his grandfather displayed bizarre and violent behavior. Subsequently, he began to experience
catatonia, which eventually led to hospitalization. Treatment with
diazepam improved his condition and, as no causal disorders other than
Asperger's disorder were identified, he was diagnosed with
catatonia. The patient had experienced persistent abuse by his mother during childhood; therefore, it is important to consider
reactive attachment disorder (DSM-IV-TR) as a differential diagnosis. Among child and adolescent psychiatrists,
catatonia is considered to occur at a high frequency among patients with
autistic spectrum disorders. In contrast, general psychiatrists tend to consider
catatonia as related to
schizophrenia, which may be the reason why the diagnosis of our patient was difficult. We assume that the pathogenesis of
catatonia in this case was death mimicry due to the subjective perception of a life-threatening situation. For the treatment of
catatonia with
autistic spectrum disorders, the efficacy of
benzodiazepines and electroconvulsive therapy has been established. When a patient with an
autistic spectrum disorder presents with motor functional disturbances, it is important to consider these disturbances as
catatonia. Furthermore, it is also important to begin the treatment mentioned above even in the presence of definite psychogenic or situational factors.