ABSTRACT
Concerns about Mickey's inattentiveness and poor school performance prompted a psychological assessment at the end of second grade. At age 18, Mickey dropped out of his final year of high school, stating that he hated it there and always had. Before closing her practice, the previous family physician had tried Mickey on two different medications in an attempt to deal with aspects of his behaviour. This chapter introduces the possibility of a global neurochemical dysfunction possibly a neurotransmitter receptor malfunction compromising several parallel cortical basal ganglia thalamocortical circuits and leading to a variety of behavioural abnormalities including tics, obsessive-compulsive behaviours, rage attacks and so forth. Returning to the apparent conundrum that Mickey has symptoms that reasonably satisfy the criteria for four psychiatric diagnoses, people may ask whether three of the apparently discrete disorders may, in Mickey's case, be subsumed under the diagnostic umbrella of the fourth.
