Missed diagnosis of psychosis in a patient with Autism Spectrum Disorder: A Case Report

Results

Mr S, a 24-year old Caucasian, was first brought to our hospital’s emergency services by the police for a possible case of unsound mind. Patient was travelling in Singapore, and he was noted to be behaving abnormally and shouting and disturbing others in public, and his mother was unable to manage his behaviour and hence patient was brought in by the police for assessment. Patient has a past medical history of Autism Spectrum Disorder for which he is on oral aripiprazole 2.5mg OM, and has only been partially compliant since coming to Singapore. Patient was admitted to the ward with the impression that patient’s behaviour is related to his autism spectrum disorder. Mother corroborated that patient has been behaving differently from his usual self in the past 1 week. Patient was noted to be paranoid towards phone scammers and police, and have been exhibiting more disruptive and potentially dangerous behaviour as well. During his admission, patient’s behaviour and mental state was closely monitored and he was noted to have grandiose and bizarre delusions that that he is a “Wing-Chun Master” and is the main lead actor and producer of a movie film in the ward. He also declined to be addressed by his name for fear of being captured by CCTVs in the ward. Diagnosis was then revised to brief psychotic disorder and he was treated accordingly.