Diagnosis and Treatment in Pediatric Psychiatry

Mark the date!

Time: Tuesday, March 25, 6-7:30 PM

Place: CAMH, Russell Street site, 33 Russell Street, Room 2029

Dr Wachtel is an associate professor of child and adolescent psychiatry at the Johns Hopkins University School of Medicine and Medical Director of the Neurobehavioral Unit, Kennedy Krieger Institutte, Baltimore, MD.

Wachtel has a strong clinical and research interest in treating children and adolescents with concomitant autism, psychosis, and frequently self-injurious behaviour (SIB). In recent years, she has made a series of ground-breaking contributions to the clinical literature, first by identifying SIB as a form of catatonia and secondly by demonstrating that the condition responds well to standard anti-catatonic therapies, including high-dose benzodiazepines and electroconvulsive therapy.

Wachtel's clinical findings closely parallelled Shorter's investigation into the history of autism and catatonia, which found that the prevailing clinical understanding of these disorders was badly distorted.  Catatonia, a common psychiatric illness in both children and adults, had virtually disappeared from the discipline's radar; and the conventional view of autism ignored decades of work published before Leo Kanner "introduced" the concept in 1943. The children and adolescents who appeared in German and French-language literature in the 1920s had multiple catatonic symptoms in addition to being explicitly labeled "autistic." Yet this entire literature has been forgotten.

Shorter and Wachtel began a fruitful collaboration in the spring of 2012 with a conference presentation (since published in the Acta Psychiatrica Scandinavica) which introduced the concept of autism, catatonia and psychotic illness as an "iron triangle" of psychopathology in children and adolescents.  They have since published several further papers relating to this hypothesis.




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