Rational Psychopharmacological and Psychotherapeutic Treatment of a 14-Year-Old Female with Functional Neurological Symptoms Disorder and Depression

Chief Complaint and Presenting Problem A. is a 14-year-old adolescent girl referred to the emergency department for involuntary psychiatric assessment for suicidal ideation with diagnoses of cluster B traits, obsessive-compulsive disorder (OCD), depression, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). Perpetuating factors include multiple previous psychotropic medication trials with recurrent intrusive suicidal thoughts, partial response to medications, medication adverse effects, and concurrent and recurrent PNES episodes. Protective factors include good social support from family, engagement and access to mental health treatment, and numerous hobbies/interests. Other laboratories completed during the hospitalization included triglycerides, calculated low-density lipoprotein, cholesterol, A1C, high-density lipoprotein, and point-of-care glucose,