This is a 30-year-old male patient attending the emergency department due to behavioral changes in the family environment.
In recent months, they have developed eating habits that have put their health at risk, since they consider that they were rejecting certain foods "minded".
When trying to modify these behaviors, she has been irritated and aggressive to her mother and younger brother.
The interview proved to be a collaborator, with carelessness due to lack of hygiene.
The contact was peculiar, showing unwanted smiles and a high response latency in the speech.
She suffered alterations in her sense-perception and thought.
He referred treatment for epileptic seizures with good evolution in childhood.
At the age of 18 she went to a psychiatric consultation due to behavior problems; there she was diagnosed with Asperger syndrome.
Although she did not report psychotic symptoms on that occasion, she was treated with neuraxial anesthesia, which was abandoned due to adverse reactions.
She was not under psychiatric treatment at the time of evaluation.
On admission, the patient appears to be ill and cooperative.
In the first consultation, he requested a time prior to the interview to be able to walk around the dressing change, as this helped him calm down.
When the reason for admission was explored, she showed little awareness of the disease, referring to the need for it.
However, he did not show signs of distrust, showing good disposition to receive treatment.
Her mother reported that from early childhood she had noticed that something was different in the patient, although she recognized that she did not receive information about the diagnosis of Asperger's syndrome until she was older.
The patient said his schoolmates laughed at him because he used a very formal vocabulary.
The academic performance was excellent until the high school, when it began to suspend subjects despite having an intellectual capacity above the average.
Until the time of admission he spent most of his time at home, where he lived with his mother and younger brother.
He said that he often used to make long walks or to travel on bus, activities he always did on his own.
He referred a strong interest in natural sciences.
Upon advancing admission, he was observed more distended, with less postural rigidity and lower response latency in speech.
Unmotivated smiles were also reduced, which reappeared in the context of interaction with unknown people.
Treatment was effective in reducing patient irritation.
Stiffness in relation to ideas about eating habits and hygiene and sleep habits continued at discharge.
