title: A boy with conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), borderline intellectual disability, and 47,XXY syndrome in combination with a 7q11.23 duplication, 11p15.5 deletion, and 20q13.33 deletion.
abstract: BACKGROUND
  This is a case with multiple chromosomal aberrations which are likely etiological for the observed psychiatric phenotype consisting of attention deficit hyperactivity and conduct disorders.
  
  
  METHODS
  We report on an 11 year-old boy, admitted to the pediatric hospital for behavioral difficulties and a delayed neurodevelopmental trajectory. A cytogenetic analysis and high-resolution microarray comparative genomic hybridization (CGH) analysis was performed. The cytogenetic analysis revealed 47,XYY syndrome, while CGH analysis revealed an additional duplication and two deletions. The 7q11.23 duplication is associated with speech and language delay and behavioral symptoms, a 20q13.33 deletion is associated with autism and early onset schizophrenia and the 11p15.5 microdeletion is associated with developmental delay, autism, and epilepsy. The patient underwent a psychiatric history, physical examination, laboratory testing, and a detailed cognitive, psychiatric, and occupational therapy evaluation which are reported here in detail.
  
  
  CONCLUSIONS
  In the case of psychiatric patients presenting with complex genetic aberrations and additional psychosocial problems, traditional psychiatric and psychological approaches can lead to significantly improved functioning. Genetic diagnostic testing can be highly informative in the diagnostic process and may be applied to patients in psychiatry in case of complex clinical presentations.
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, 3015 CN Rotterdam, The Netherlands.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Kolaitis
authors.affiliation: Department of Psychiatry and Department of Clinical Genetics, Erasmus University Medical Center, 3015 CN Rotterdam, The Netherlands.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Bouwkamp
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Alexia
authors.initials: A
authors.lastname: Papakonstantinou
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Otheiti
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Belivanaki
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Styliani
authors.initials: S
authors.lastname: Haritaki
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Terpsihori
authors.initials: T
authors.lastname: Korpa
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Zinovia
authors.initials: Z
authors.lastname: Albani
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Elena
authors.initials: E
authors.lastname: Terzioglou
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Apostola
authors.affiliation: Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Skamnaki
authors.affiliation: 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 11527 Athens, Greece.
authors.forename: Athena
authors.initials: A
authors.lastname: Xaidara
authors.affiliation: Department of Medical Genetics, Medical School, National and Kapodistrian University of Athens, Athens, 11527 Greece.
authors.forename: Konstantina
authors.initials: K
authors.lastname: Kosma
authors.affiliation: Department of Medical Genetics, Medical School, National and Kapodistrian University of Athens, Athens, 11527 Greece.
authors.forename: Sophia
authors.initials: S
authors.lastname: Kitsiou-Tzeli
authors.affiliation: Department of Medical Genetics, Medical School, National and Kapodistrian University of Athens, Athens, 11527 Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tzetis
keywords: 11p15.5 deletion; 20q13.33 deletion syndrome; 47,XYY syndrome; 7q11.23 Williams–Beuren syndrome region micro duplication; ADHD; ASD; Conduct disorder