AI Article Synopsis
- A study observed 9 autistic children and adolescents with moderate to severe mental retardation displaying "waiting-for-instruction" behavior, indicating they needed prompts for daily activities.
- None of the participants could express feelings of depression, but all met the DSM-IV criteria for a major depressive episode.
- Treatment with fluvoxamine improved depressive symptoms in 7 out of 9 patients, while risperidone and valproate sodium were effective for those who didn't respond to fluvoxamine, suggesting potential bipolar II disorder diagnoses as well.
Article Abstract
We have seen 9 moderately to severely mentally-retarded autistic children and adolescents who waited for small-step instructions to perform previously acquired daily life activities (called "waiting-for-instruction" behavior). None of these patients were capable of expressing their depressive mood. All cases were considered to meet the criteria for major depressive episode described in DSM-IN. The "waiting-for-instruction" behavior was suggested to be a diagnostic key for depressive state in mentally retarded children and adolescents. GAF scales for depressive symptoms including the "waiting-for-instruction" behavior improved in 7 of these 9 cases with fluvoxamine. Risperidone and valproate sodium were useful for these symptoms in patients who were not responsive to fluvoxamine. Therefore, there is a possibility that they met the criteria for bipolar II disorder in DSM-IV.
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