Abstract

Psychiatric conditions often have variable presentations, especially as many of these disorders have similar symptoms and significant comorbidity. Multiple psychiatric disorders occurring concurrently are often mistaken as a single disease process. In this case, an adolescent patient’s initial diagnosis was bipolar disorder with mixed features, and he was referred for electroconvulsive therapy (ECT). Upon reevaluation, he was found to have Attention-Deficit/Hyperactivity Disorder (ADHD), depression, and concerns for pervasive developmental disorder - likely Autism Spectrum Disorder. This patient had been receiving treatment for bipolar disorder for two years, and had suffered from many adverse medication effects. Had the patient’s differential diagnoses been expanded to include co-morbid conditions, this might have been avoided. Improvements in screening recommendations could result in more accurate assessments and more precise treatments.