title: Misdiagnosis and exacerbation of unusual obsessive-compulsive disorder presentation with risperidone and clozapine in an adolescent girl - A case report.
abstract: Obsessive-compulsive disorder (OCD) is a heterogenous disorder with different clinical presentations. The most common symptoms are those that involve contamination, possible harm, ordering/symmetry, aggressive/sexual/religious concerns and hoarding. A variety of less common symptoms have been described. Unusual OCD symptoms may lead to misdiagnosis, inappropriate treatment with possible serious side effects. In this report we present a case of an adolescent girl in which unusual OCD presentation and symptoms were misinterpreted to represent psychosis and exacerbation of OCD symptoms with risperidone and clozapine treatment. We discuss the possible pathophysiological mechanisms of OCD symptom exacerbation, clinical implications, and successful management of this case, with fluvoxamine therapy. This case may represent the first report of musical obsessions successfully managed with fluvoxamine therapy.
authors.affiliation: Psychiatric Hospital for Children and Youth, Zagreb, Croatia. vlatka.boricevic@zg.t-com.hr
authors.forename: Vlatka Boricević
authors.initials: VB
authors.lastname: Marsanić
authors.forename: Branka
authors.initials: B
authors.lastname: Aukst-Margetić
authors.forename: Neda
authors.initials: N
authors.lastname: Grgić
authors.forename: Enes
authors.initials: E
authors.lastname: Kusmić
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use*; D003951:Diagnostic Errors; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000188:drug therapy; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy; D018967:Risperidone / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine; D018967:Risperidone; D016666:Fluvoxamine