DOI: 10.1177/10401237261463741 ISSN: 1040-1237

Autonomic Dysfunction in Psychiatric Disorders: Illustrative Clinical Cases

Alfred Chabbouh, Yara El Frenn, Roua Abbas, Maya Bizri, Rita Khoury

Background

Autonomic dysfunction is a potentially life-threatening condition that is frequently underrecognized in psychiatric and neuropsychiatric settings. Failure to identify autonomic features may delay diagnosis and appropriate management, leading to increased morbidity.

Objective

To illustrate the diagnostic and clinical relevance of autonomic dysfunction in psychiatric patients through representative clinical cases encountered on the consultation-liaison psychiatry service.

Methods

We report the clinical presentations of 4 patients evaluated on the consultation liaison service at a tertiary care center in Lebanon between July 2023 and December 2025, through a retrospective chart review. Each case highlights a distinct neuropsychiatric syndrome in which autonomic dysfunction played a central role in diagnosis and management.

Results

The cases included autonomic dysfunction associated with neurodegenerative disease, malignant catatonia, benzodiazepine withdrawal, and Neuro-Sweet Syndrome. For each syndrome, we summarize the causes, recommended investigations, and treatment approaches, offering a practical framework for psychiatrists.

Conclusion

This overview highlights the importance of evaluating autonomic dysfunction in specific psychiatric populations to guide timely and targeted interventions.

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