Child obsessive-compulsive disorder presenting with catatonic-like features: Case presentation

Abstract

IntroductionAlthough catatonia was conceptualized as a subtype of schizophrenia, it is now recognized to occur most commonly in the course of other psychiatric disorders, in drug-induced disorders [1] or neurologic conditions [2]. Catatonia is rarely seen together with OCD and there are a limited number of case reports in the literature [3,4].ObjectiveWe describe the case of a 12 year boy who presented in our clinic with mutism, negativism, immobility, social withdrawn, rigid posture, refusal to eat.MethodWe performed a thorough psychiatric diagnostic assessment of the child as well as laboratory tests and MRI of the brain.ResultsThe child's first symptoms appeared 2 years ago: initially the child became socially withdrawn, spent most of time at his room, and became preoccupied with rituals of hand washing, walking back and forth, preoccupations with food contamination, became aggressive if someone would interrupt what he was doing, stopped going at school, and stopped calling his parents “mother” or “father”. Brain MRI showed lateral ventricular asymmetry and suboccipital cyst.ConclusionsThe child was put on therapy with lorazepam and sertraline. His obsessive-compulsive symptoms improved, and the apparent catatonic like features resolved and did not return over follow-up.DiscussionCatatonia is not uncommon among children and adolescents, and the relationship between OCD and catatonia is still misunderstood, but it may be an indicator of the severity of the OCD.Disclosure of interestThe authors have not supplied their declaration of competing interest.