Self-injurious behaviour in children: A treatable catatonic syndrome

摘要

There is an excellent reason for publishing a paper on an unusual paediat-ric syndrome — self-injurious behaviour (SIB) - in a general psychiatry journal: it is among the few paedi-atric conditions that are highly treatable. The repetitive stereotypic catatonic movements in children with autism and intellectual disabilities, which can have such injurious consequences, respond readily to such standard treatments of catatonia as benzodiazepines and electroconvul-sive therapy (ECT). The authors of this paper have discovered this in their respective domains of inquiry: Lee Wachtel, leading a neurobehav-ioural service in a paediatric hospital, and Edward Shorter, who ascertained that in many historical accounts of paediatric SIB other symptoms of catatonia were present as well, reinforcing Wachtel's hypothesis of SIB as a form of catatonia. This hypothesis thus has two important pillars of support: the readiness with which SIB responds to anti-catatonic remedies in the clinic today, and the historical evidence that SIB fits in with larger syndromes of catatonia.