A 24-year-old male presented with behavioral disorders in the emergency department.
The family reported that the patient had been isolated for four years, abandoned his usual activities, changes in thinking content and sense-perception that have worsened in recent months.
At the beginning of admission the patient presented a high disorganization in the speech, in which lax associations prevailed.
He identified himself with an animated character ("Gru" of the film Gru, my favorite villain) and recognized some staff members as characters of the same film.
She looked deliriously at the casual gestures that were made in her presence, and referred to voces that transmitted messages with a mystical-religious or persecutory content.
The family interview, which was conducted with the parents and a maternal aunt, helped clarify the picture.
There were no difficulties in pregnancy or childbirth and, in relation to their psycho-development, the parents highlighted the patient's difficulties in language acquisition and socialization since early childhood.
They described it as a child who is very ill, ordered, with restrictive behavior patterns and marked difficulty in the social area that got worse during adolescence, keeping a restricted group of friends and few leaves.
His personal history included an evaluation in Mental Health at the age of 22 years due to the presence of anxious symptoms.
As a family history, she required a brief admission to the inpatient unit due to psychosis.
Their difficulties in social interaction got worse at the beginning of high school, when they were in a new environment without their school friends.
He remarked that he had difficulty understanding himself with his companions, not understanding the double senses or jokes, which he interpreted literally.
At 19 years of age he presented a picture of "generalized allergy" that led him to isolate himself at home for two years with little external contact, dedicated most of the time to view children's films and online content animation.
Due to the insistence of his parents, he successfully completed a training cycle of welding, with job adjustments in the company where he had carried out the practical training.
Their performance decreased when they had to face the change in their life cycle, from student to worker.
At six months he left this job and began another vocational training related to mental illness, which also proposed to abandon due to the anxiety that the relationship with his peers caused.
During admission, she was a collaborator in the interviews, although she avoided participating in group therapies, showing preference for solitary activities.
He defined himself as an antisocial person who did not need to be with others, as he referred not knowing what to say in social situations or not understanding what others said.
The evaluation was completed after hospital discharge.
In the Wechsler Adult Intelligence Scale (WAIS) (30) all subscales were within the normal range except for the "complete" subscale, which assesses social situations.
High punctuation obtained in the Spectrum A (AQ) Coefficient due to difficulties in the social area.
In the follow-up interviews she said that sometimes she participated in recreational group activities with her classmates, although after several hours she felt the need to withdraw with a high sense of anguish.
His explanation was repeated, "I don't know what to say.
I don't understand what they tell me".
This situation worsened when his companions made use of double senses or ironies he understood literally.
Upon returning to his academic activities, the patient presented anxious symptoms within the context of interaction with his classmates.
For this reason, I preferred to leave either with his family or alone.
Moreover, one of its usual activities consisted of walking several kilometers in full solitude.
Their mental rigidity and difficulty in understanding social messages lead them to misinterpretation when confronted with others, resulting in evading themselves in solitary activities.
