Hallermann-Streiff Syndrome and Psychosis: A Case Report

Description Hallermann-Streiff syndrome is a rare genetic congenital disorder, with fewer than 200 cases reported to date, that is characterized by brachycephaly with frontal bossing, micrognathia, a "bird-like" beaked nose, microphthalmia with congenital cataracts, dental abnormalities, hypotrichosis, skin atrophy, and short stature. There is limited data on psychosis in individuals with Hallermann-Streiff syndrome; the information available depicts mania rather than psychosis. This case report reviews the presentation and treatment of psychosis in a 32-year-old male with Hallermann-Streiff syndrome who was involuntarily admitted to an inpatient psychiatric unit for persecutory delusions and hallucinations. The patient's psychosis responded well to risperidone with a resolution of psychosis and suicidal ideation in 6 days. Psychosis in individuals with Hallermann-Streiff syndrome appears to respond to a high-potency second-generation antipsychotic. Given this patient's early onset of psychosis and limited social/occupational impairment, it is unclear if psychosis is a component of Hallermann-Streiff syndrome or if he has comorbid schizophrenia or schizoaffective disorder, bipolar type.