Diagnostic and Therapeutic Challenges of Comorbid ASD, ADHD and Psychosis: A Case Report.

IF 2.8 3区 经济学 Q2 REGIONAL & URBAN PLANNING Journal of Planning Education and Research Pub Date : 2022-10-06 DOI:10.3390/bs12100382
Veronica Scarselli, Melania Martucci, Maria Novelli, Serena Galosi, Maria Romani, Carla Sogos
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Abstract

Autism Spectrum Disorder (ASD) and attention deficit hyperactivity disorder (ADHD) comorbidity is common in clinical practice and it seems to be related to shared etiological mechanisms and genetic susceptibility. Moreover, occurrence of psychosis can further complicate these complex clinical pictures. Here, we discuss the case of a nine-years-old boy presenting with an episode of abnormal sustained posture of the upper limbs, resembling dystonia, at the age of 3. At this time, auditory and visual hallucinations, as well as obsessive thoughts and attentional lability were also present and a diagnosis of "Early onset psychosis" was initially made. Due to the worsening of clinical picture, several hospitalizations were necessary and pharmacological treatment with carbamazepine, risperidone and aripiprazole was carried out. Extensive clinic evaluation revealed a past medical and personal history of toe walking, weak social skills and stereotyped behavior observed and ADOS-2 Module 2 administration revealed severe Autism scores. Moreover, signs of attention and hyperactivity were consistent with ADHD diagnosis. This work highlights the importance of a complete diagnostic assessment in patients with complex presentation, suggesting the possible overlap diagnosis of ADHD and Autism even in presence of psychotic-like symptoms.

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并发 ASD、ADHD 和精神病的诊断和治疗难题:病例报告。
自闭症谱系障碍(ASD)和注意缺陷多动障碍(ADHD)并发症在临床上很常见,这似乎与共同的病因机制和遗传易感性有关。此外,精神病的发生也会使这些复杂的临床表现更加复杂。我们在此讨论的病例是一名 9 岁男孩,他在 3 岁时出现上肢持续姿势异常,类似肌张力障碍,当时还伴有幻听、幻视、强迫观念和注意力不集中,最初被诊断为 "早发型精神病"。由于临床症状不断恶化,患者不得不多次住院治疗,并接受了卡马西平、利培酮和阿立哌唑等药物治疗。广泛的临床评估显示,该患儿既往有脚趾行走的病史和个人史,社交能力弱,行为刻板。此外,注意力和多动的迹象与多动症的诊断一致。这项研究强调了对表现复杂的患者进行全面诊断评估的重要性,表明即使存在类似精神病的症状,也有可能被重叠诊断为多动症和自闭症。
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来源期刊
CiteScore
7.40
自引率
4.50%
发文量
71
期刊介绍: The Journal of Planning Education and Research (JPER) is a forum for planning educators and scholars (from both academia and practice) to present results from teaching and research that advance the profession and improve planning practice. JPER is the official journal of the Association of Collegiate Schools of Planning (ACSP) and the journal of record for North American planning scholarship. Aimed at scholars and educators in urban and regional planning, political science, policy analysis, urban geography, economics, and sociology, JPER presents the most vital contemporary trends and issues in planning theory, practice, and pedagogy.
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