Autism spectrum disorder, very-early onset schizophrenia, and child disintegrative disorder: the challenge of diagnosis. A case-report study.
autism spectrum disorder
case report
child disintegrative disorder
late regression
neurodevelopment
very-early onset schizophrenia
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2023
2023
Historique:
received:
26
04
2023
accepted:
14
07
2023
medline:
14
8
2023
pubmed:
14
8
2023
entrez:
14
8
2023
Statut:
epublish
Résumé
Autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) contains several disorders previously present as distinct diagnoses in the DSM Revised Fourth Edition (DSM-IV-TR). These include child disintegrative disorder (CDD). The latter presents typical features, such as a late regression of developmental acquisitions. However, it also shows symptoms similar to ASD, and psychotic symptoms, such as very-early onset schizophrenia (VEOS), are described in the literature. In this case report we deepen the case of P., a child who presents a late regression, at 7 years old, associated with psychotic symptoms in the absence of organic alterations. The child was treated with antipsychotic drug therapy and cognitive behavioral therapy. P. was diagnosed with ASD with acute and late regression associated with psychotic symptoms. During the follow-up, there was a gradual improvement in the clinical conditions. Improvements were possible due to therapeutic intervention (pharmacological and psychotherapeutic) and/or the natural course of the disorder. The diagnostic difficulty of this case reflects a clinical complexity in which it is not easy to distinguish between neurodevelopmental and psychiatric aspects. Clinical cases such as that of P. emphasize the theme of the neurodevelopment continuum model in which neurodevelopmental and psychiatric disturbances can be considered within a pattern of pathological continuity.
Sections du résumé
Background
UNASSIGNED
Autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) contains several disorders previously present as distinct diagnoses in the DSM Revised Fourth Edition (DSM-IV-TR). These include child disintegrative disorder (CDD). The latter presents typical features, such as a late regression of developmental acquisitions. However, it also shows symptoms similar to ASD, and psychotic symptoms, such as very-early onset schizophrenia (VEOS), are described in the literature.
Case report
UNASSIGNED
In this case report we deepen the case of P., a child who presents a late regression, at 7 years old, associated with psychotic symptoms in the absence of organic alterations. The child was treated with antipsychotic drug therapy and cognitive behavioral therapy. P. was diagnosed with ASD with acute and late regression associated with psychotic symptoms. During the follow-up, there was a gradual improvement in the clinical conditions. Improvements were possible due to therapeutic intervention (pharmacological and psychotherapeutic) and/or the natural course of the disorder.
Conclusion
UNASSIGNED
The diagnostic difficulty of this case reflects a clinical complexity in which it is not easy to distinguish between neurodevelopmental and psychiatric aspects. Clinical cases such as that of P. emphasize the theme of the neurodevelopment continuum model in which neurodevelopmental and psychiatric disturbances can be considered within a pattern of pathological continuity.
Identifiants
pubmed: 37575588
doi: 10.3389/fpsyt.2023.1212687
pmc: PMC10416439
doi:
Types de publication
Case Reports
Langues
eng
Pagination
1212687Informations de copyright
Copyright © 2023 Di Luzio, Guerrera, Pontillo, Lala, Casula, Valeri and Vicari.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Références
J Autism Dev Disord. 2013 Feb;43(2):265-71
pubmed: 22677931
Psychiatry Res. 2020 May;287:112922
pubmed: 32203749
J Autism Dev Disord. 2022 Apr;52(4):1495-1506
pubmed: 33934283
Lancet Psychiatry. 2020 Sep;7(9):788-800
pubmed: 32649925
Dialogues Clin Neurosci. 2020 Mar;22(1):65-72
pubmed: 32699506
JAMA. 2003 Jan 1;289(1):87-9
pubmed: 12503982
CNS Drugs. 2006;20(10):841-66
pubmed: 16999454
J Autism Dev Disord. 1994 Oct;24(5):659-85
pubmed: 7814313
J Clin Psychopharmacol. 2002 Oct;22(5):455-60
pubmed: 12352267
J Child Adolesc Psychopharmacol. 2006 Oct;16(5):541-8
pubmed: 17069543
J Psychopharmacol. 2002 Mar;16(1):93-101
pubmed: 11949778
Nat Med. 2020 Dec;26(12):1912-1918
pubmed: 33169016
World Health Stat Q. 1988;41(1):32-6
pubmed: 3376487
J Am Med Rec Assoc. 1988 Aug;59(8):suppl 1-34
pubmed: 10288257
Child Adolesc Psychiatr Clin N Am. 2020 Jan;29(1):71-90
pubmed: 31708054
J Am Acad Child Adolesc Psychiatry. 1995 Aug;34(8):1092-5
pubmed: 7665448
Trials. 2019 Jul 4;20(1):395
pubmed: 31272477
Front Psychiatry. 2021 Sep 16;12:662093
pubmed: 34603093
J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):806-814.e2
pubmed: 23880491
Indian J Psychiatry. 1997 Jan;39(1):85
pubmed: 21584052
Neurocase. 2022 Aug;28(4):369-374
pubmed: 36369699
J Clin Psychiatry. 2005;66 Suppl 10:3-8
pubmed: 16401144
J Autism Dev Disord. 2005 Dec;35(6):873-4
pubmed: 16283078
World Psychiatry. 2017 Oct;16(3):227-235
pubmed: 28941101
Drugs. 2011 Jan 22;71(2):179-208
pubmed: 21275445
Brain Dev. 2003 Jun;25(4):225-8
pubmed: 12767450
J Nerv Ment Dis. 1954 Jun;119(6):471-7
pubmed: 13201958
J Clin Psychopharmacol. 2014 Oct;34(5):624-6
pubmed: 25118082
J Psychiatry Neurosci. 2004 Jan;29(1):57-60
pubmed: 14719051
Schizophr Res. 2018 Feb;192:39-49
pubmed: 28526280
Eur Child Adolesc Psychiatry. 2022 Dec;31(12):1943-1951
pubmed: 34143303
Dev Med Child Neurol. 2019 May;61(5):503
pubmed: 30740653
J Autism Dev Disord. 1992 Dec;22(4):601-24
pubmed: 1483979
Dev Med Child Neurol. 2019 May;61(5):523-534
pubmed: 30548847
Am J Psychiatry. 2000 May;157(5):794-800
pubmed: 10784474