Telehealth approaches to catatonia in autism spectrum disorder and intellectual disability: A case series

Catatonia requires in-person evaluation, but expansion of telehealth raises questions about virtual diagnosis and treatment. This case series examines outcomes of catatonia care delivered through telepsychiatry for patients with Intellectual Disability and other Neurodevelopmental Disorders. A retrospective chart review was conducted of patients seen through Ohio's Telepsychiatry Project (2009-present). Inclusion required diagnosis and treatment of catatonia via telehealth. Data collected included demographics, comorbidities, medications, and outcomes. Fourteen patients met inclusion criteria (ages 14-69; 87% male). All had Intellectual Disability; 60% also had autism spectrum disorder. Lorazepam was the primary treatment, titrated virtually, with clinical improvement in 71.4% of cases. Benefits included reduced aggression, self-injury, and regression, though a minority experienced worsening psychosis. Findings suggest telepsychiatry may be a feasible approach for diagnosis and management of catatonia in individuals with neurodevelopmental disorders. Structured assessment and ongoing monitoring remain essential. Future studies can address treatment response and outcomes of catatonia using telepsychiatry.