title: A patient with autism and severe depression: medical and ethical challenges for an adolescent medicine unit.
abstract: An adolescent with autism and intellectual disability presented with severe depression related to menstruation. Because of the complex medical, psychiatric and ethical issues involved, her care was coordinated by a hospital-based adolescent medicine unit. After trials of other therapies over an extended period and interdisciplinary and intersectoral case conferencing, it was decided that hysterectomy was the most appropriate management. This case highlights the complexity of adolescent health care in a tertiary hospital, the importance of intersectoral cooperation between hospital and community, and the integral role of interdisciplinary care of adolescent patients with chronic conditions.
authors.affiliation: School of Paediatrics and Child Health, Princess Margaret Hospital for Children, GPO Box D184, Perth, WA 6840. rachels@ichr.uwa.edu.au
authors.forename: S Rachel
authors.initials: SR
authors.lastname: Skinner
authors.forename: Cindy
authors.initials: C
authors.lastname: Ng
authors.forename: Ann
authors.initials: A
authors.lastname: McDonald
authors.forename: Tamara
authors.initials: T
authors.lastname: Walters
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000941:ethics*; D001321:Autistic Disorder / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008599:Menstruation Disturbances / Q000209:etiology / Q000523:psychology / Q000628:therapy; D009771:Obsessive-Compulsive Disorder / Q000209:etiology / Q000523:psychology / Q000628:therapy; D011595:Psychomotor Agitation / Q000209:etiology / Q000523:psychology / Q000628:therapy; D013406:Suicide, Attempted; D013812:Therapeutics