Acute psychosis with attention-deficit/hyperactivity disorder and oppositional-defiant disorder comorbidities

Area of Science:

• Psychiatry
• Neuroscience

Background:

• An 18-year-old male with a history of attention-deficit/hyperactivity disorder (ADHD), oppositional-defiant disorder, and mild intellectual delay presented with acute behavioral changes.
• The patient exhibited a one-week history of paranoia and bizarre behavior, leading to emergency room admission.

Observation:

• Upon admission, the patient was incoherent, agitated, and uncooperative, requiring psychiatric inpatient care.
• Initial treatment involved low-dose risperidone, which resulted in significant symptom improvement within days.
• Nursing staff noted the patient's restlessness and agitation, but family confirmed this was his baseline behavior.

Findings:

• Risperidone effectively managed acute psychotic symptoms in an adolescent with pre-existing neurodevelopmental disorders.
• The case underscores the importance of differentiating acute exacerbations from baseline behavior in psychiatric assessments.

Implications:

• This case suggests that risperidone can be a valuable therapeutic option for managing acute behavioral disturbances in adolescents with complex psychiatric histories.
• Further research may explore the long-term efficacy and safety of antipsychotic use in similar patient populations.