Pediatric delirium in autism spectrum disorders. Clinical and genetic polymorphism, connection with ontogenetic epileptic encephalopathies, schizophrenia, bipolar disorder


  • I.A. Martsenkovsky SI “Research Institute for Psychiatry of the Ministry of Health of Ukraine”, Kyiv, Ukraine
  • I.I. Martsenkovska SI “Research Institute for Psychiatry of the Ministry of Health of Ukraine”, Kyiv, Ukraine
  • H.V. Makarenko SI “Research Institute for Psychiatry of the Ministry of Health of Ukraine”, Kyiv, Ukraine
  • T.O. Skrypnyk SI “Research Institute for Psychiatry of the Ministry of Health of Ukraine”, Kyiv, Ukraine
  • I.F. Zdoryk SI “Research Institute for Psychiatry of the Ministry of Health of Ukraine”, Kyiv, Ukraine



autism spectrum disorders, delirium, catatonic symptoms, epileptic encephalopathy


Psychotic symptoms are diagnosed in 3–16 % of adolescents and young adults with autism spectrum disorder (ASD) and arouse the discussion about their etiopathogenetic conceptualization. Within the 7th Framework Program: PsychGene “Copy Number Variation and Endophenotypes in Psychiatric Disorders, 2009–2012”, after GWAS by the deCODE Genetics’ laboratory (Iceland), more than 40,000 rare mutations were identified that are associated with an increased risk of manifestation of mental disorders in childhood. During 2009–2012, 25 children of preschool and primary school age (mean age 78.0 ± 36.3 months) with ASD with 1q21.1, 15q13.3, 15q24, 2q24.3, 2p16.3, 16p11.2, 7q31.32, 22q13.3, 17p13, 4q35 syndromes and NEXMIF mutations on the X chromosome and 38 children (mean age 48.0 ± 21.8 months) with variants of serotonin 2A receptor gene loci polymorphism (5HTR2A) and dopamine (DRD2) were selected for prospective research in the State Institution “Research Institute for Psychiatry of the Ministry of Health of Ukraine”. By March 2021 (mean duration of longitudinal observations 127.2 ± 12.8 months), 12 clinical cases of psychotic disorders/delirium in patients with ASD and epileptic seizures and 8 cases of ASD with individual psychotic symptoms without impaired consciousness and epileptic seizures were described and studied. The clinical phenotypes of SHANK3, NRXNT, NEXMIF encephalopathies, other complex variants of pervasive developmental disorders with psychotic symptoms, their causal relationships with epileptic encephalopathies, schizophrenia, bipolar disorder, attention deficit hyperactivity disorder have been investigated and described. From a prospective study, therapeutic strategies are discussed. Patients with epileptic encephalopathies do not tolerate therapy with phenytoin, phenobarbital, carbamazepine, and atypical antipsycho-tics. New evidence has been obtained of the possible effectiveness of therapy with lamotrigine, low doses of valproic acid salts, polytherapy with valproate with lamotrigine and lacosamide in such patients. In ASD with epileptic seizures resistant to antiepileptic drugs, delirium with catatonic symptoms, the use of benzodia-zepines (clonazepam) is recommended. When prescribing atypical antipsychotics, quetiapine and aripiprazole are recommended. These drugs are effective in children and young adults with ASD with psychotic symptoms without impairment of consciousness or catatonic symptoms.


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How to Cite

Martsenkovsky, I., Martsenkovska, I., Makarenko, H., Skrypnyk, T., & Zdoryk, I. (2021). Pediatric delirium in autism spectrum disorders. Clinical and genetic polymorphism, connection with ontogenetic epileptic encephalopathies, schizophrenia, bipolar disorder. INTERNATIONAL NEUROLOGICAL JOURNAL, 17(2), 44–58.



Original Researches