Josephine: a case report of a polymorbid patient with ADHD

ADHD symptoms in adulthood may not be the patient's only problem; it may be overshadowed by other clinically significant serious psychiatric syndromes. Differential diagnosis of episodes of affective disorder accompanied by a later detected psychotic illness and differentiation of the primarily based core ADHD symptoms is quite possible provided that a detailed data of patient's clinical history are obtained. In the pharmacotherapy of such a patient it is useful to set individual therapeutic priorities which are not always the same for each and everyone. Treatment can be similarly complicated as polymorbidity, where monotherapy is seldom sufficient. It is also necessary to take the occurrence of adverse events into account including the less frequent ones, such as high sensitivity to the undesired effects of medication occuring even at usual therapeutical doses.

Keywords: ADHD, comorbid disease, bipolar affective disorder, psychotic disorder, cognitive deficit, differential diagnosis, lithiotherapy, lithium toxicity, thymostabilizers, metabolic effects of antipsychotics.