ROLE OF PSYCHIATRIC DISORDERS AND AUTOIMMUNE DISORDERS

Recently the Washington Post had an article about a woman named April who after a traumatic event had suddenly become psychotic and unresponsive being diagnosed with catatonia [a condition often associated with schizophrenia often with severe withdrawal from human contact, odd behaviors and often being nonresponsive. Then twenty years later still unresponsive she began to be able to interact with others and have aspects of her old self return after she had begun to be treated for neuro systemic lupus erythematosis [SLE] which is an autoimmune disorder where the immune system attacks it's own tissues oncluding the brain. Brain symptoms include behavior changes, clouded thinking, confusion and impaired memory. 

So what is the role of neuro SLE [NSLE] in development of catatonia? Is there a role for traumatic experiences or is it the nature of the brain damage from NSLE or ? 

I have seen psychotic symptoms after traumatic events that then will subside when their traumatic memory symptoms are successfully treated. This is without an underlying psychotic disorder like schizophrena. 

Regarding April, she apparently did not show any early symptoms related to schizophrenia and functioned very well until the traumatic event that was not specifed and then she became noncommunicative and started having psychotic symptoms. After 20 years of being unresponsive she began to have her recently diagnosed neuro SLE treated. This treatment involved repeated IV steroids for five days and then a single dose of cyclophosphamide a strong immunosuppressive medication. This was followed by treatment with rituximub [a targeted cancer medication called a myoclonal antibody that targets proteins on the surface of cancer cells] initially used to treat lymphomas. She had six rounds of these treatments needing a month in between to recover. April improved dramatically.

Questions remain regarding the role of traumatic events and autoimmune disorders [especially NSLE] in the develoopment of catatonic disorders. Regardless, there is the possibility that some people with catatonia have autoimmmune disorders caused at least in part by traumatic events and treating these disorders can lead to amazing improvement in the catatonic symptoms that even look like this disorder may be able to be cured. 

I have had people who have come to me for help who have been diagnosed with an autoimmune disorder and when I have been able to help them to very significantly lower their anxiety related to past traumatic experiences have not had any more symptoms of their autoimmune disorder.