Catatonia and autism spectrum disorder: A common comorbid syndrome or a core feature?

Table 3 Summary of the Diagnostic and Statistical Manual of Mental Disorders-5 and Diagnostic and Statistical Manual of Mental Disorders-5-TR diagnostic criteria for autism spectrum disorder

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the current or by history	Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following
(1) Deficits in nonverbal communicative behaviors used for social interaction, ranging from poorly integrated verbal and nonverbal communication to abnormalities in eye-to-eye contact and body language, or deficits in understanding and use of gesture, to total lack of facial expression and nonverbal communication	(1) Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys, or flipping objects, echolalia, idiosyncratic phrases)
(2) Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties in behavior to suit various social contexts, difficulties in sharing imaginative play or making friends, to the absence of interest in peers	(2) Insistence on sameness, inflexible adherence to routine, ritualized patterns, or verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take the same route, or eating daily)
(3) Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts, to difficulties in sharing imaginative play or making friends, to an absence of interest in peers	(3) Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to preoccupation with unusual objects, excessively circumscribed or perseverative interests)
	(4) Hyper-reactivity or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)