Jun 2026· International Journal of Research in Medical Sciences· Vol 14, pp. 3061-3064· 0 citations· 7 references
TL;DR
The paper discusses an adolescent male with ASD and complexities faced in diagnosing and treating secondary BD and showcases a 16 year old male with ASD with acute aggression, suicidal ideation, and severe school refusal.
Abstract
Autism spectrum disorder (ASD) is frequently associated with a variety of psychiatric comorbidities. Bipolar disorder (BD) is a mood disorder associated with ASD. The diagnosis and treatment of BD in the background of ASD presents unique difficulties in management of the patient in both diagnosis and management. Overlapping symptoms, inadequate communication of patient history and pharmacological limitations compromises treatment success. The paper discusses an adolescent male with ASD and complexities faced in diagnosing and treating secondary BD It showcases a 16 year old male with ASD with acute aggression, suicidal ideation, and severe school refusal. He was initially given a diagnosis of DMDD and GAD. His symptoms proceeded to a manic episode and a revised diagnosis of bipolar I disorder. Backed by strict parental monitoring and multidisciplinary school tracking, the patient achieved complete mood stabilization and extreme treatment compliance. The diagnostic process in the ASD-BD population is hindered by the lack of communication in history taking, masking of symptoms. Pharmacological management is complicated due to sensitivity to adverse events and limited treatment options. The comorbid ASD and BD require a highly targeted, multidisciplinary approach. There is a need for ASD specific diagnostic tools and specialized guidelines to prevent misdiagnosis and polypharmacy. The stabilization is achievable and requires tracking and tailored pharmacological strategy for optimal treatment.
This review systematically summarizes the conceptual definition and clinical phenotypes of profound autism and emphasizes the need to shift the intervention focus toward managing serious comorbidities and establishing augmentative and alternative communication systems.
Yang Xue, Fei-yong Jia· Zhongguo dang dai er ke za z...· 0 citations
A narrative review of papers published between 1 January 2015 and 16 February 2026 that were pertinent to comorbidity and autism finds how the variable risk of comorbidity mimics the heterogeneity present in autism, thus inviting further investigations.
E. Dando, Juergen Hahn, D. Geier et al.· Healthcare· 0 citations
Schizotypal Personality Disorder (SPD) is characterised by pervasive social and interpersonal deficits, cognitive–perceptual distortions, and eccentric behaviour, and is frequently misdiagnosed due to symptom overlap with schizophrenia, anxiety, and obsessive-compulsive symptoms. It occupies a distinct position across diagnostic systems, being placed within schizophrenia spectrum disorders in the International Classification of Diseases, 11th Revision (ICD-11), while the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies it under Cluster A personality disorders. This case describes a 25-yearold male who initially presented with social anxiety and ritualistic behaviours and was diagnosed with social anxiety disorder with obsessive-compulsive features. In subsequent visits, additional diagnoses of depression and psychosis were considered based on the evolving symptom profile. He responded poorly to treatment despite multiple trials of medications and inpatient care. On his fourth admission, a comprehensive evaluation with diagnostic psychometry was undertaken, incorporating birth and developmental history and thorough tracking of the longitudinal course of symptoms, which revealed an enduring pattern of eccentric behaviour, persistent odd beliefs, impaired interpersonal functioning, constricted affect, transient stress-related suspiciousness, and poor treatment adherence, leading to significant occupational and social impairment. The diagnosis was revised to SPD, and he was treated with psychotherapy and pharmacotherapy. The case highlights the importance of a Kraepelinian longitudinal approach to evaluation in psychiatry, which is often neglected in contemporary practice.
Amit Dattatraya Khune, S. Rajkumar, Anoop Jose Alappat et al.· Journal of Clinical and Diag...· 0 citations
There is an urgent need for prospective longitudinal studies to adequately map the aging trajectories of this population of older adults with ASD, which constitute a vulnerable population.
J. P. S. Gontijo, Marcelo H S S Martins, L. M. Alves· Trends in Psychiatry and Psy...· 0 citations
Schizotypal disorder is marked by pervasive social and interpersonal deficits, cognitive-perceptual distortions, and eccentric behaviors, often co-occurring with other psychiatric conditions. This case report presents a rare instance of schizotypal disorder comorbid with atypical anorexia nervosa and somatization disorder in a 19-year-old female. The patient, Ms. V, exhibited complex symptomatology including social withdrawal, odd beliefs, somatic complaints, and restrictive eating behaviors. Despite extensive medical investigations, her physical symptoms remained unexplained, leading to a psychiatric evaluation. She was diagnosed with schizotypal disorder, atypical anorexia nervosa, and somatization disorder per the International Classification of Diseases, Tenth Revision criteria. Initial treatment with risperidone was poorly tolerated, but she showed significant improvement with olanzapine, fluoxetine, and cognitive-behavioral therapy, resulting in better functioning and reduced somatic preoccupation. This case underscores the challenges of diagnosing and treating comorbid psychiatric disorders, particularly when presentations are atypical. A multidisciplinary approach proved essential for Ms. V’s recovery, offering insights into the management of complex psychiatric comorbidities.
Shruti Zunzunwala, Tanisha Pruthi, Anubhav Katyal et al.· Annals of Indian Psychiatry· 0 citations
Bipolar disorder (BD) in older adults is a signifi cant yet under-recognized mental health concern. The clinical presentation in this population often
diff ers from younger individuals, with increased cognitive impairment, comorbid medical conditions, and heightened sensitivity to medications.
Accurate diagnosis is frequently complicated by overlapping symptoms with neurodegenerative disorders and age-related mood changes. This
review examines epidemiology, clinical features, diagnostic challenges, and treatment strategies for older adults with bipolar disorder. Evidencebased pharmacological and psychosocial interventions are discussed, emphasizing the importance of individualized care to improve quality of
life and functional outcomes. Recognizing and addressing the unique needs of this population is crucial for eff ective management. Eff ective
management of bipolar disorder in older adults is multidimensional, requiring a balance between evidence-based pharmacological treatments,
psychosocial support, and careful attention to comorbidities and functional status. Individualized care plans, ongoing monitoring, and collaboration
among healthcare providers are essential to optimize outcomes and enhance quality of life.
