Dell'Osso Liliana, Conversano Ciro, Corsi Martina, Bertelloni Carlo A, Cremone Ivan M, Carpita Barbara, Carbone Manuel G, Gesi Camilla, Carmassi Claudia
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Case Rep Psychiatry. 2018 Feb 22;2018:1547975. doi: 10.1155/2018/1547975. eCollection 2018.
This case report draws attention to the potential relevance of undetected autism spectrum symptoms in a bipolar patient with high work functioning showing a peculiar addictive profile with impulsive and antisocial behaviors. A 23-year-old man with a diagnosis of Bipolar Disorder (BD) and Substance Use Disorder (SUD) was hospitalized at the Psychiatric Clinic of the University of Pisa for diuretics and -2 adrenergic agonist abuse in a remission phase of benzodiazepines and substance abuse. He reported a history of behavioral addictions in the framework of a global high work functioning with particular skills in computer science. When assessed for adult autism spectrum symptoms, despite not fulfilling a DSM-5 diagnosis of Autism Spectrum Disorder (ASD), he reported a score of 93/240 at the Ritvo Autism and Asperger Diagnostic Scale (RAADS-r) and of 88/160 at the Adult Autism Subthreshold Spectrum (AdAS Spectrum), both indicative of ASD. We argue the possible role of adult subthreshold autism spectrum features, generally disregarded in adult psychiatry, in the peculiar addictive profile developed by this patient with BD that may deserve appropriate treatment.
本病例报告提请注意，在一名工作能力较高的双相情感障碍患者中，未被发现的自闭症谱系症状可能具有相关性，该患者表现出具有冲动和反社会行为的特殊成瘾模式。一名诊断为双相情感障碍（BD）和物质使用障碍（SUD）的23岁男性因在苯二氮䓬类药物和物质滥用缓解期滥用利尿剂和β-2肾上腺素能激动剂，在比萨大学精神病诊所住院。他报告在整体工作能力较高且在计算机科学方面有特殊技能的背景下存在行为成瘾史。在评估成人自闭症谱系症状时，尽管未达到《精神疾病诊断与统计手册》第5版（DSM-5）自闭症谱系障碍（ASD）的诊断标准，但他在里特沃自闭症及阿斯伯格诊断量表（RAADS-r）上的得分为93/240，在成人自闭症亚阈值谱系量表（AdAS Spectrum）上的得分为88/160，两者均表明患有ASD。我们认为，成人亚阈值自闭症谱系特征在该双相情感障碍患者所形成的特殊成瘾模式中可能发挥的作用，而这在成人精神病学中通常被忽视，可能值得进行适当治疗。
