A case of young diabetes and parasuicide

BMJ Case Rep. 2018 Sep 18:2018:bcr2018225839. doi: 10.1136/bcr-2018-225839.

Abstract

Wolfram syndrome is a rare monogenic cause of juvenile onset diabetes mellitus. It is a non-autoimmune, insulin-deficient state with concurrent or consequent optic atrophy. Here we depict the case of a 16-year-old young girl afflicted with this condition, who presented with parasuicide on a background of depressive disorder. The aetiology of this presentation was attributable to multiple physical ailments and a genetic predisposition conferred by the disease-causing mutation for which she tested positive. She was managed with intensive insulin therapy and specific psychotherapy. Her case highlights the importance of recognising and addressing these comorbidities associated with Wolfram syndrome, so as to curtail disastrous consequences.

Keywords: child and adolescent psychiatry; diabetes; genetic screening / counselling; suicide (psychiatry).

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Depressive Disorder / complications
  • Depressive Disorder / etiology*
  • Depressive Disorder / psychology
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / psychology
  • Diagnosis, Differential
  • Female
  • Humans
  • Insulin / therapeutic use
  • Membrane Proteins / genetics
  • Psychotherapy / methods
  • Suicide, Attempted / psychology*
  • Treatment Outcome
  • Wolfram Syndrome / complications
  • Wolfram Syndrome / diagnosis*
  • Wolfram Syndrome / drug therapy
  • Wolfram Syndrome / genetics

Substances

  • Insulin
  • Membrane Proteins
  • wolframin protein