High-Frequency Utilization of the Outpatient Messaging System in a Specialized Outpatient Catatonia Clinic for Individuals with Autism Spectrum Disorder

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Smith, J. R., Sengstack, D. G., McCoy, A. B., Lim, S., Marler, S., Williams, Z. J., Hossain, N., & Luccarelli, J. R. (2025). High-Frequency Utilization of the Outpatient Messaging System in a Specialized Outpatient Catatonia Clinic for Individuals with Autism Spectrum Disorder. Journal of Child and Adolescent Psychopharmacology, 35(7), 424-430. https://doi.org/10.1089/cap.2025.0034

Publication date: 30 Apr 2025 Added to AutiHub: 7 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
8
Publication authors identified as autistic
1 / 8 (12.5%)
  1. Joshua Ryan Smith
  2. Donald G. Sengstack
  3. Allison B. McCoy
  4. Seri Lim
  1. Sarah Marler
  2. Zachary J. Williams *
  3. Nausheen Hossain
  4. James Ryan Luccarelli

Abstract

Purpose:Catatonia is a highly morbid psychomotor disorder that impacts autistic adults and children. There is very little literature that describes outpatient catatonia management practices, none of which discusses the use of the electronic health record (EHR). Thus, we conducted this study to analyze patient messages in a specialized catatonia clinic. Methods:We conducted a retrospective analysis of messaging practices in the EHR for patients in a specialized clinic with autism and catatonia from July 1, 2021, to May 31, 2024. Catatonic symptom severity was recorded via the Bush Francis Catatonia Rating Scale (BFCRS), Kanner Catatonia Severity Scale (KCS), and Kanner Catatonia Examination (KCE). We conducted Spearman and Pearson correlation coefficients to determine whether a relationship exists between the frequency of patient messages, catatonic symptoms, and length of follow-up. Results:A total of 12,972 messages were sent to the health system or received by the patient or their family. Of those, 6375 (49.1%) messages were sent from the family to the health system. Relationships between message frequency to the health system and all baseline catatonia severity scores (BFCRS, KCS, KCE) were not statistically significant, although message frequency was strongly associated with length of follow-up (r = 0.65, p < 0.001). A total of 5555 (42.8%) messages were sent directly to or received from providers in the catatonia specialty clinic. The rate of messages to providers in the catatonia clinic was 2.9 messages/day. Conclusion:The frequency of patient messaging was high in this catatonia specialty clinic. Health systems should consider this possibility when planning for similar service lines.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 14:04.

Cited references
34
With a DOI
33
Without a DOI, from raw bibliography text
1
2 / 34 (5.9%) cited references include at least one author identified as autistic.
References with data to complete
1 / 34 (2.9%)
References with detected author names
34 / 34 (100.0%)
Without detected author names
0
Without a structured title
1
Without a stable identifier
1
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
240
From DOI or external metadata
240
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
68 / 240 (28.3%) names are linked to an author already present in AutiHub. 172 / 240 (71.7%) names are not yet linked.
Names linked to a person identified as autistic
3 / 240 (1.2%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 3 / 68 (4.4%). Distinct people identified as autistic: 3 / 184 (1.6%).
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