Psychotic depression with Turner’s syndrome and autism spectrum disorder

In the article, a patient with Turner’s syndrome diagnosed at the age of five years is described. Since early childhood she displayed inadequate behaviours and deficits in communication. Her parents related their daughter’s difficulties with TS, hypothyroidism, and coeliac disease. Cumulative difficulties persuaded caregivers to elaborate the diagnosis, which was done by a psychiatrist, a psychologist, and a special educational needs teacher. Based on the interview, clinical trials for autism, and mental state examination a diagnosis of atypical autism at the age of 18 years was made. Since the age of 17 years, the patient remained in psychiatric care because of mood fluctuations, impulsivity, and irritability. She was diagnosed with depressive episodes, and was prescribed antidepressant medication, with improvement in her mental state. At the age of 21 years, severe depression with psychotic symptoms and suicidal tendencies appeared, resulting in psychiatric hospitalisation. Gradual improvement was obtained by pharmacotherapy (clomipramine, lithium, clozapine). Psychotherapeutic interventions have been difficult because of unstable family engagement in the patient’s treatment