P-1059 - A diagnosis dilemma

Abstract

A debate of differential diagnosis and possible presentations of anorexia nervosa, autistic spectrum disorder, simple schizophrenia, obsessional slowness, catatonia in an adolescent patient. Study case, close and thorough observation and monitor of the patient while an inpatient on a CAMHS ward, being involved a multidisciplinary team and literature search. Description of symptoms and management plan. A multiple and very rare psychopathology in adolescents. Only four similar cases have been described in the literature. The case is based on a study case of a 14 year old patient from a CAMHS ward. The patient has a 5 year history of deterioration of mental state, initially presenting with anorexic symptoms, which gradually developed into a full picture of obsessive - compulsive disorder, simple schizophrenia with right sided body neglect, catatonia, psychomotor retardation, bizarre behaviour (walking in circle, smearing of faeces). The patient was closely monitored and assessed by psychologists, speech and language therapists, neurologists, endocrinologists. The catatonic symptoms had a very good response to Lorazepam, but unfortunately on discharge patient had residual obssessional slowness and obssessive compulsive disorder like symptoms, which gives a dilemma to the diagnosis and treatment.