Early Onset Psychosis in an Adolescent with Copper Metabolism Alterations: Primary or Secondary Psychosis?

Authors

  • Sofia Lemos Child and Adolescent Psychiatry Department, Hospital Dona Estefânia, Unidade Local de Saúde de São José https://orcid.org/0009-0005-0299-3346
  • Joana Coelho Genetics Department, Hospital Dona Estefânia, Unidade Local de Saúde de São José https://orcid.org/0009-0009-4151-4749
  • M. Margarida Venâncio Child and Adolescent Psychiatry Department, Hospital de São Francisco Xavier, Unidade Local de Saúde de Lisboa Ocidental https://orcid.org/0000-0002-3291-4638
  • Margarida Marques Child and Adolescent Psychiatry Department, Hospital Dona Estefânia, Unidade Local de Saúde de São José https://orcid.org/0009-0009-4712-4637

Keywords:

adolescent, copper metabolism, early-onset psychosis, psychiatry, psychosis

Abstract

Primary psychotic disorders in adolescents are uncommon in adolescence and require careful investigation of alternative etiologies. Wilson’s disease (WD) is one of the metabolic disorders that should be considered in the differential diagnosis. We report the case of a 15-year-old male who was admitted to an Inpatient Psychiatric Unit due to new-onset psychotic symptoms characterized by disorganized behavior and thought processes, psychomotor agitation and near-total insomnia. The patient was diagnosed with a brief psychotic disorder and later investigated for WD, based on an elevated urinary excretion of copper.  He had a Ferenci Score of 5, but after genetic investigation with both parents, the diagnosis was not confirmed. We discuss the hypothesis that abnormalities in copper metabolism may have played a role in the onset and persistence of the psychiatric symptoms, given the essential role of copper in central nervous system functioning, affecting different pathways that have been associated with a wide range of psychiatric disorders.

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References

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Published

2026-07-09

How to Cite

1.
Lemos S, Coelho J, Venâncio MM, Marques M. Early Onset Psychosis in an Adolescent with Copper Metabolism Alterations: Primary or Secondary Psychosis?. BGMJ [Internet]. 2026 Jul. 9 [cited 2026 Jul. 24];. Available from: https://revistas.rcaap.pt/bgmj/article/view/39336

Issue

Ahead of print

Section

Clinical Case Reports

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Copyright (c) 2026 Sofia Lemos, Joana Coelho, M. Margarida Venâncio, Margarida Marques

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