Adolescent obsessive compulsive disorder heralding chorea-acanthocytosis.
We describe one male and one female patient who each developed childhood/adolescent obsessive-compulsive disorder as a prelude to the development of a typical picture of chorea-acanthocytosis (ChAc). In each patient, the caudate nucleus showed dramatic atrophy. The role of the caudate in compulsive phenomena, and the predilection for neurological disorders with onset in adolescence to present as major mental illness, is discussed. On the basis of the current evidence and previous findings, we suggest that ChAc can be understood as a disorder whose clinical presentation reflects an interaction between the disease process and the individual's neurodevelopmental stage with both initial interrupted neurodevelopment, and supervening neurodegeneration.
Walterfang
Mark
M
Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia. mark.walterfang@mh.org.au
Yucel
Murat
M
Walker
Ruth
R
Evans
Andrew
A
Bader
Benedikt
B
Ng
Ashley
A
Danek
Adrian
A
Mocellin
Ramon
R
Velakoulis
Dennis
D
D000050:Acanthocytes; D000328:Adult; D001284:Atrophy; D002421:Caudate Nucleus / Q000473:pathology; D002819:Chorea / Q000209:etiology* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D009771:Obsessive-Compulsive Disorder / Q000150:complications*