Catatonia and diagnostic challenges in transition-age youth: lessons from Central Asia for LMIC psychiatry

Catatonia remains under-recognised in many low- and middle-income countries, particularly in transition-age youth (15–25 years). This is especially relevant in parts of Central Asia, where diagnostic traditions have historically emphasised schizophrenia. Drawing on clinical observations and existing literature, this paper highlights how limited recognition of adult autism and catatonia may contribute to diagnostic uncertainty and missed treatment opportunities. Catatonia is frequently treatable yet insufficiently incorporated into psychiatric training and service development in resource-limited settings. Strengthening of diagnostic precision, training in catatonia assessment and research in transition-age populations would represent achievable steps towards improving mental health in low- and middle-income country settings.