Is There a Major Role for Undetected Autism Spectrum Disorder with Childhood Trauma in a Patient with a Diagnosis of Bipolar Disorder, Self-Injuring, and Multiple Comorbidities?. (26th May 2019)

• Record Type: Journal Article
• Authors: Carmassi, Claudia; Bertelloni, Carlo Antonio; Salarpi, Gianluca; Diadema, Elisa; Avella, Maria Teresa; Dell'Oste, Valerio; Dell'Osso, Liliana
• Other Names: Inada Toshiya Academic Editor.
• Is Part Of: Case reports in psychiatry. Volume 2019(2019)
• Publication Date: 2019-05-26
• Subjects: Psychiatry -- Periodicals; Psychiatry -- Case studies -- Periodicals; Mental Disorders; Psychiatry; Psychiatry; Periodicals; Case studies; Periodicals; 616.89
• DOI: 10.1155/2019/4703795
• Languages: English
• ISSNs: 2090-682X

Abstract

Abstract : This case report highlights the relevance of the consequences of trauma in a female patient with an undetected autism spectrum disorder (ASD) affected by bipolar disorder (BD) with multiple comorbidities. A 35-year-old woman with BD type II, binge eating disorder and panic disorder was admitted in the Inpatient Unit of the Psychiatric Clinic of the University of Pisa because of a recrudescence of depressive symptomatology, associated with increase of anxiety, noticeable ruminations, significant alteration in neurovegetative pattern, and serious suicide ideation. During the hospitalization, a diagnosis of ASD emerged besides a history of childhood trauma and affective dysregulation, marked impulsivity, feeling of emptiness, and self-harm behavior. The patient was assessed by the Autism-Spectrum Quotient (AQ), Ritvo Autism and Asperger Diagnostic Scale (RAADS-R), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), Trauma and Loss Spectrum (TALS-SR), and Ruminative Response Scale (RRS). Total scores of 38/50 in the AQ, 146/240 in the RAADS-R, 99/160 in the AdAS Spectrum emerged, compatible with ASD, 47/116 in the TALS-SR, and 64/88 in the RRS. We discuss the implications of the trauma she underwent during her childhood, in the sense that caused a complex posttraumatic disorder, a lifelong disease favored and boosted by the rumination tendency of high functioning ASD.