Autism Spectrum Disorder (ASD) is defined by the copresence of two core symptoms: alteration in social communication and repetitive behaviors and/or restricted interests. In ASD children and adults, irritability, self-injurious behavior (SIB), and Attention Deficit and Hyperactivity Disorders- (ADHD-) like symptoms are regularly observed. In these situations, pharmacological treatments are sometimes used. Selective Serotonin Reuptake Inhibitors- (SSRI-) based treatments have been the subject of several publications: case reports and controlled studies, both of which demonstrate efficacy on the symptoms mentioned above, even if no consensus has been reached concerning their usage. In this article four clinical cases of children diagnosed with ASD and who also present ADHD-like symptoms and/or SIB and/or other heteroaggressive behaviors or irritability and impulsivity treated with low doses of fluoxetine are presented.

Catatonia is a complex identifiable clinical syndrome characterized primarily by psychomotor symptoms. In recent decades, some authors have considered that catatonia can be presented as a catatonic syndrome in several pathologies such as bipolar disorder, schizophrenia and other psychotic disorders and not only in schizophrenia. Prior to DSM 5, there were two conceptions of catatonia: one in which clinical characterization seemed to play a determining role (a categorical view) and another in which a dimensional perspective advocated the existence of catatonia as a clinical entity in its own right, detached from the underlying pathology. Although there are no definitive consensus guidelines for the treatment of catatonia, some studies show that in the schizophrenic form of catatonia, benzodiazepines are partially effective, as well as treatment with ECT. We present the case of a 24-year-old man with severe catatonia and psychotic symptoms, resistant to lorazepam treatment, who achieved complete remission with clozapine treatment according to our diagnostic hypothesis of schizophrenia.

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Body dysmorphic disorder is described in the DSM-IV as a single clinical entity, but an additional diagnosis of delusional disorder, somatic type, is allowed when the preoccupation concerning an imaginary defect in appearance is held with delusional intensity. The existence of two clinical forms is implicitly recognized, depending on the presence or absence of psychotic symptoms. Several studies have suggested that these two forms make up a single illness, characterized by different degrees of insight. This supposition is supported by the fact that the symptomatology and the clinical response to the SSRIs are thought to be similar for the two forms. Moreover, certain authors have suggested that categorical nosography (as used by the DSM-IV) should not be the point of reference and that a ‘dimensional’ point of view is preferable, meaning that the presence of psychotic symptoms would constitute merely a simple phenomenon or state of the same illness.