Community Habilitative Support in the Case of an Adult with Growth-Hormone Deficiency Dwarfism (Panhypopituitarism), Multiple Psychiatric Disorders, Law Violating Behavior, and Life Threatening Self-Injury

Community Habilitative Support in the Case of an Adult with Growth-Hormone Deficiency Dwarfism (Panhypopituitarism), Multiple Psychiatric Disorders, Law Violating Behavior, and Life Threatening Self-Injury

This case report describes the psychiatric and treatment history of a 36-year old man with growth-hormone deficiency dwarfism who engaged in persistent health-threatening, self-harming, and law-violating behaviors. Diagnosed with Tourette's disorder, depression, obsessive–compulsive disorder, a...

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Bibliographic Details
Published in:Journal of developmental and physical disabilities Vol. 16; no. 3; pp. 287 - 296
Main Authors: Sperry, James M., Luiselli, James K., Goldman, Sarah R., Abbe, Karen J., Hauser, Mark J.
Format: Journal Article
Language:English
Published: New York Springer Nature B.V 01-09-2004
Subjects:
Aversive
Behavior
Boarding schools
Community mental health services
Compulsions
Deprivation
Dwarfism
Electric shock
Ethanol
Government agencies
Health behavior
Health services
Healthy food
Injuries
Law
Life threatening
Mental disorders
Mental health
Obsessive compulsive disorder
Patients
Physical restraints
Polydipsia
Schizophrenia
Self destructive behavior
Self injury
Tourette syndrome
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Summary:This case report describes the psychiatric and treatment history of a 36-year old man with growth-hormone deficiency dwarfism who engaged in persistent health-threatening, self-harming, and law-violating behaviors. Diagnosed with Tourette's disorder, depression, obsessive–compulsive disorder, and schizophrenia, his life-long involvement with the mental health system included repeated psychiatric hospitalizations and additional challenges such as pseudoseizures, polydipsia, ethanol abuse, and physical maltreatment. We trace the patient's care within secure settings, a residential school that employed aversive interventions (food deprivation, mechanical restraint, electric shock), and a community-based center where he was maintained effectively with pharmacologic and behavior support therapies. Although he adjusted positively at the community level, an administrative decision by the state agency responsible for his care returned the patient to a former secure environment, where he was subjected once again to invasive treatment. The unique features of this case are discussed.
ISSN:1056-263X
1573-3580
DOI:10.1023/B:JODD.0000032303.97384.a6