22.2 LESSONS LEARNED FROM AN OUTPATIENT CATATONIA CLINIC

Abstract

Objectives: This session aims to provide an overview of an outpatient approach to the diagnosis and treatment of catatonia in individuals with Down syndrome and unexplained regression in the Down Syndrome Psychiatric Specialty Clinic at the Indiana University Neuroscience Center. Methods: This session will: 1) review 2 cases of patients with Down syndrome and unexplained regression, illustrating the proposed “tiers” for medical workup and treatment algorithm based on current literature and clinical practice among providers in the Down syndrome medical community;2) discuss the creation of a Down syndrome and pediatric catatonia outpatient specialty clinic, and modifications made for evaluation and treatment via telehealth during the COVID-19 pandemic;and 3) review how collaboration with pediatrics, pediatric subspecialties, and psychiatry led to improved catatonia awareness, and improved access to ECT for pediatric patients with and without neurodevelopmental disorders. Results: Recognition of unexplained regression and catatonia in Down syndrome leading to formal medical workup and treatment improved with the development of a dedicated specialty psychiatric clinic, institutional and community education, and ongoing coordination between pediatrics, pediatric subspecialties, psychiatry, and child and adolescent psychiatry. Conclusions: It is important to create bridges between pediatrics, pediatric subspecialties, psychiatry, and child and adolescent psychiatry to provide increased awareness of unexplained regression and catatonia in Down syndrome, which facilitates appropriate diagnosis and treatment of catatonia in both neurodevelopmental and pediatric populations. GS, ID