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Beyond what clinicians see: missed diagnosis and misdiagnosis of a woman with autism spectrum disorder
  1. Joana Isaac1,2,
  2. Daniela Jeremias1,
  3. Carolina Rocha Almeida1 and
  4. Rui Albuquerque1
  1. 1 Psychiatry, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  2. 2 Psychiatry, Hospital José Joaquim Fernandes, Beja, Portugal
  1. Correspondence to Dr Joana Isaac; joanaisaac{at}; Dr Daniela Jeremias; djeremias{at}


A young woman with autism spectrum disorder was admitted to the hospital via the emergency care unit. On being admitted, she was improperly diagnosed with a psychotic disorder due to her erratic behaviour and incomprehensible refusal to eat. As a result, the patient was hospitalised against her will. For accurate and correct diagnosis and treatment, it was necessary to collect the patient’s detailed clinical history, while being hospitalised.

  • Psychiatry
  • Psychotic disorders (incl schizophrenia)
  • Depressive disorder
  • Developmental paediatrocs

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  • Contributors JI and DJ are joint first authors and they conceptualised the idea, performed the literary review, and wrote the first draft and the multiple reviews of this case. JI and CA performed regular inpatient assessments and proposed the diagnosis. DJ and RPA followed the patient after being discharged from the ward. They also adequately informed and obtained a signed consent from both the patient and their family about the publication. CA and RPA supervised, edited and reviewed the last versions of the article prior to publication. All authors discussed and reviewed the final manuscript and agreed with it before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.