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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0267

Early-onset schizophrenia following obsessive-compulsive disorder: a case report

EARLY-ONSET SCHIZOPHRENIA FOLLOWING OBSESSIVE–COMPULSIVE DISORDER: A CASE REPORT

In a case that began with obsessive-compulsive symptoms at age eleven and progressed to treatment-resistant early-onset schizophrenia in adolescence, cognitive functions remained largely preserved despite progressive psychomotor deterioration.

The aim was to present the clinical course, pharmacoresistance, and treatment challenges in an adolescent who developed early-onset schizophrenia following obsessive-compulsive disorder (OCD), with preserved cognitive functioning. The first mental obsessive-compulsive symptoms emerged at age 11 as counting up to specific numbers during various activities. The initial assessment included laboratory investigations (ASO titer), EEG, brain magnetic resonance imaging, and psychological assessment; antidepressant treatment followed by antipsychotic treatments failed to produce clinical improvement. A comprehensive pediatric neurological evaluation, including lumbar puncture for cerebrospinal fluid analysis to investigate autoimmune encephalitis, extensive metabolic screening, pharmacogenetic testing, and molecular karyotyping (aCGH) were performed. During follow-up, progressive deterioration, particularly in psychomotor functioning, and semi-catatonic symptoms affecting activities ranging from routine tasks to basic physiological needs were observed. Suspected dissociative phenomena impaired academic and social functioning, while cognitive functions remained largely preserved. The patient requires confirmation of their actions or body position, accompanied by intense anxiety, and is becoming completely dependent on caregivers. Pharmacogenetic testing revealed CYP2D6 intermediate metabolizer status, intermediate ABCB1 activity, high 5-HTTLPR activity, and very high DAT1 VNTR activity; aCGH identified a 16p13.11 microduplication inherited from the clinically healthy father. The patient is currently being treated with risperidone, aripiprazole, clozapine, and lorazepam, and clinical improvement is awaited. This rare and challenging presentation in adolescence requires ongoing multidisciplinary follow-up and comprehensive psychosocial support addressing the patient's social and academic needs and support for the family.

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