{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T12:50:20Z","timestamp":1782305420136,"version":"3.54.5"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:00:00Z","timestamp":1672358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Ricerca Corrente 2021"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Catatonia is a complex neuropsychiatric syndrome, occurring in the context of different psychiatric and neurodevelopmental disorders, in neurological and medical disorders, and after substance abuse or withdrawal. The relationship between Autism Spectrum Disorder (ASD), Schizophrenia Spectrum Disorders (SSDs) and catatonia has been previously discussed, with the three disorders interpreted as different manifestations of the same underlying brain disorder (the \u201cIron Triangle\u201d). We discuss in this paper the diagnostic, clinical and therapeutic implications of this complex relationship in an adolescent with ASD, who presented an acute psychotic onset with catatonia, associated with mixed mood symptoms. Second-generation antipsychotics were used to manage psychotic, behavioral and affective symptoms, with worsening of the catatonic symptoms. In this clinical condition, antipsychotics may be useful at the lowest dosages, with increases only in the acute phases, especially when benzodiazepines are ineffective. Mood stabilizers with higher GABAergic effects (such as Valproate and Gabapentin) and Lithium salts may be more useful and well tolerated, given the frequent association of depressive and manic symptoms with mixed features.<\/jats:p>","DOI":"10.3390\/children10010077","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T04:17:38Z","timestamp":1672633058000},"page":"77","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Neurodevelopmental Disorders, Schizophrenia Spectrum Disorders and Catatonia: The \u201cIron Triangle\u201d Rediscovered in a Case Report"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5492-8929","authenticated-orcid":false,"given":"Pamela","family":"Fantozzi","sequence":"first","affiliation":[{"name":"IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56018 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Del Grande","sequence":"additional","affiliation":[{"name":"Azienda Usl Toscana Nord-Ovest, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital \u201cSanta Chiara\u201d, 38122 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Berloffa","sequence":"additional","affiliation":[{"name":"IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56018 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Tolomei","sequence":"additional","affiliation":[{"name":"IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56018 Pisa, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Salluce","sequence":"additional","affiliation":[{"name":"IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56018 Pisa, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3996-3827","authenticated-orcid":false,"given":"Antonio","family":"Narzisi","sequence":"additional","affiliation":[{"name":"IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56018 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Salarpi","sequence":"additional","affiliation":[{"name":"Azienda Usl Toscana Nord-Ovest, Department of Mental Health, Pontedera, 38122 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Capovani","sequence":"additional","affiliation":[{"name":"Azienda Usl Toscana Nord-Ovest, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital \u201cSanta Chiara\u201d, 38122 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7770-926X","authenticated-orcid":false,"given":"Gabriele","family":"Masi","sequence":"additional","affiliation":[{"name":"IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56018 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1136\/jnnp.49.9.991","article-title":"The syndrome of Karl Ludwig Kahlbaum","volume":"49","author":"Barnes","year":"1986","journal-title":"J. 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