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Differential diagnosis of auditory hallucinations in teenagers. Assessment and difficulties: Case report of a 13 year old patient

Published online by Cambridge University Press:  13 August 2021

C. Pastor Jordá ,
P. Carroll ,
D. Bender  and
R. Tumuluru
C. Pastor Jordá*
Affiliation:
Child And Adolescent Psychiatry, Alicia Koplowitz Foundation, Madrid, Spain
P. Carroll
Affiliation:
Child And Adolescent Psychiatry, UPMC Western Psychiatric Hospital, Pittsburgh, United States of America
D. Bender
Affiliation:
Child And Adolescent Psychiatry, UPMC Western Psychiatric Hospital, Pittsburgh, United States of America
R. Tumuluru
Affiliation:
Child And Adolescent Psychiatry, UPMC Western Psychiatric Hospital, Pittsburgh, United States of America
*
*Corresponding author.

Abstract

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Introduction

Learning from a case of a 13 year old patient with auditory hallucinations for 2 months, admitted to the hospital due to suicidal ideation. Her mother had been diagnosed with Lupus and OCD. Her mood had been low for several months, probable mild intellectual disability.

Objectives

Learn how to assess auditory hallucinations and possible new onset psychotic symptoms in teenagers. Learn about different levels of care involved. Discuss differential diagnosis and future directions and treatment.

Methods

Description of the case. Differential diagnosis: Obsessive compulsive disorder, Major depressive disorder with Psychotic features, schizophrenia spectrum disorder, epilepsy or other neurologic disease, autoimmune disease, post-traumatic stress disorder… Tests and consults conducted by Neurology team Psychopharmacology description.

Results

Differential diagnosis: Obsessive compulsive disorder, Major depressive disorder with Psychotic features, schizophrenia spectrum disorder, epilepsy, autoimmune diseases like Lupus, post-traumatic stress disorder etc. Video EEG: normal. Brain MRI: normal Blood work unremarkable with positive ANA (titer 1:80). Work up, including lumbar puncture with autoimmune encephalitis and MS panels was negative. Psychopharmacology: Fluoxetine up to 40mg, and Aripiprazol up to 20mg without a good response. Possible sexual trauma was disclosed in a second hospitalization, months later.

Conclusions

Recommendation of assessing new onset of psychotic symptoms in detail to get a good diagnosis. Psychotic symptoms in young teenagers may occur as part of different presentations and it is important to provide a good follow up of the patient in order to provide the most accurate treatment.

Conflict of interest

Alicia Koplowitz Foundation

Keywords

HallucinationsTeenagers
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S233 - S234
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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