Therapie electroconvulsive pour la catatonie chez des patients autistes et non autistes : une etude observationnelle sur l evolution, l efficacite, l agressivite et les issues d automutilation

Titre original en anglais : Electroconvulsive Therapy for Catatonia in Autistic and Non‐Autistic Patients: An Observational Study on Course, Efficacy, Aggression, and Self‐Injury Outcomes

Cette publication est incluse dans le projet « Contributions académiques de personnes autistes sur l’autisme ». un auteur·ice de cette publication est identifié·e comme autiste dans le projet.

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Smith, J. R., Bonnee, M., Marler, S., Lim, S., Fuchs, D. C., Tamargo, R., Baldwin, I., Maley, C., VanHaverbeck, A., Hamilton, C., Adegoke, T., Xu, H., Liu, J., Williams, Z. J., Wilson, J. E., & Luccarelli, J. (2026). Electroconvulsive Therapy for Catatonia in Autistic and Non‐Autistic Patients: An Observational Study on Course, Efficacy, Aggression, and Self‐Injury Outcomes. Autism Research, e70362-e70362. https://doi.org/10.1002/aur.70362

Date de publication: 08/09/2026 Ajout dans AutiHub: 10/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
16
Auteur·ices de la publication identifié·es comme autistes
1 / 16 (6,2 %)
  1. Joshua Ryan Smith
  2. Maria Bonnee
  3. Sarah Marler
  4. Seri Lim
  5. D. Catherine Fuchs
  6. Rafael Tamargo
  1. Isaac Baldwin
  2. Christopher Maley
  3. Ashley VanHaverbeck
  4. Courtney Hamilton
  5. Timothy Adegoke
  6. Haozheng Xu
  1. Jinyuan Liu
  2. Zachary J. Williams *
  3. Jo Ellen Wilson
  4. James Luccarelli

Résumé

RESUME La catatonie survient de maniere disproportionnee chez les personnes autistes et peut repondre a la therapie electroconvulsive (ECT), bien que des rapports anterieurs suggerent une charge therapeutique plus importante dans cette population. Nous avons compare l utilisation longitudinale de l ECT, la securite et les resultats cliniques entre des patients autistes et non autistes atteints de catatonie. Cette cohorte observationnelle monocentrique comprenait 110 patients traites de mai 2022 a avril 2026, dont 43 patients autistes et 67 patients non autistes. Les scores de la Bush-Francis Catatonia Rating Scale (BFCRS), de la Clinical Global Impression-Improvement (CGI-I), de la Clinical Global Impression-Severity (CGI-S) et de la Kanner Catatonia Severity and Examination ont ete enregistres au cours du traitement aigu et du traitement d entretien. Comme les cohortes differaient selon l age, le sexe biologique et la deficience intellectuelle, la charge therapeutique a ete evaluee a l aide de modeles ajustes sur les covariables et tenant compte de la censure, avec une variable de groupe clinique a trois niveaux comprenant la non-autisme, l autisme avec deficience intellectuelle et l autisme sans deficience intellectuelle. Les patients autistes ont recu davantage de seances d ECT que les patients non autistes (mediane, 35 contre 14) au cours de periodes de traitement observees plus longues (mediane, 342 contre 97 jours). Apres ajustement, cette difference refletait un maintien plus long dans l ECT d entretien plutot qu un taux de traitement plus eleve et etait concentree chez les patients autistes ayant une deficience intellectuelle (rapport de risques de Cox, 0,21). Une amelioration clinique a ete observee dans les deux cohortes : une reponse selon la CGI-I est survenue chez 100,0 % des patients autistes et 89,1 % des patients non autistes, une reduction de la BFCRS d au moins 50 % est survenue chez 76,9 % et 75,4 %, et une amelioration de la CGI-S d au moins 1 point est survenue chez 85,0 % et 70,8 %, respectivement. Les scores totaux de Kanner ont diminue de maniere significative, et la prevalence de l automutilation a diminue de 42,9 % a 17,1 % chez les patients autistes. L attitude combative s est amelioree dans les deux cohortes, et les evenements indesirables documentes etaient peu frequents. L ECT a ete associee a une amelioration clinique substantielle chez les patients autistes et non autistes atteints de catatonie. Les patients autistes, en particulier ceux ayant une deficience intellectuelle, ont connu des traitements d entretien plus longs plutot qu un traitement plus intensif, soulignant l importance d un acces durable au traitement.

ABSTRACT Catatonia occurs disproportionately in autistic individuals and may respond to electroconvulsive therapy (ECT), yet prior reports suggest greater treatment burden in this population. We compared longitudinal ECT utilization, safety, and clinical outcomes between autistic and non‐autistic patients with catatonia. This single‐center observational cohort included 110 patients treated from May 2022 through April 2026, comprising 43 autistic and 67 non‐autistic patients. Bush‐Francis Catatonia Rating Scale (BFCRS), Clinical Global Impression‐Improvement (CGI‐I), Clinical Global Impression‐Severity (CGI‐S), and Kanner Catatonia Severity and Examination scores were recorded across acute and maintenance treatment. Because the cohorts differed in age, biologic sex, and intellectual disability, treatment burden was evaluated using covariate‐adjusted, censoring‐aware models with a three‐level clinical‐group variable comprising non‐autism, autism with intellectual disability, and autism without intellectual disability. Autistic patients received more ECT sessions than non‐autistic patients (median, 35 vs. 14) over longer observed treatment courses (median, 342 vs. 97 days). After adjustment, this difference reflected longer retention in maintenance ECT rather than a higher treatment rate and was concentrated among autistic patients with intellectual disability (Cox hazard ratio, 0.21). Clinical improvement was observed in both cohorts: CGI‐I response occurred in 100.0% of autistic and 89.1% of non‐autistic patients, BFCRS reduction of at least 50% occurred in 76.9% and 75.4%, and CGI‐S improvement of at least 1 point occurred in 85.0% and 70.8%, respectively. Kanner total scores decreased significantly, and self‐injury prevalence declined from 42.9% to 17.1% among autistic patients. Combativeness improved in both cohorts, and documented adverse events were uncommon. ECT was associated with substantial clinical improvement in autistic and non‐autistic patients with catatonia. Autistic patients, particularly those with intellectual disability, experienced longer maintenance courses rather than more intensive treatment, underscoring the importance of sustained treatment access.

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Références citées
83
Avec un DOI
76
Sans DOI, à partir du texte brut de la bibliographie
7
1 / 83 (1,2 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
2 / 83 (2,4 %)
Références avec noms d’auteurices détectés
81 / 83 (97,6 %)
Sans nom d’auteurice détecté
2
Sans titre structuré
2
Sans identifiant stable
7
Références avec noms bruts d’auteurices restant à vérifier
0
Références avec problème de récupération des métadonnées externes
0
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Noms d’auteurices détectés dans la bibliographie citée
474
À partir du DOI ou de métadonnées externes
474
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
0
65 / 474 (13,7 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 409 / 474 (86,3 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
1 / 474 (0,2 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 1 / 65 (1,5 %). Personnes distinctes identifiées comme autistes : 1 / 397 (0,3 %).
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