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Recognition of psychiatric manifestations of Wilson's disease (WD) has diagnostic and therapeutic implications.

To describe the clinical features and psychopathology of patients with WD who had initial or predominant psychiatric manifestations.

Records of 15 patients with WD (M:F: 11:4), from a large cohort of 350 patients, with predominant psychiatric manifestations at onset were reviewed. Their initial diagnosis, demographic profile, family history, pre-morbid personality, clinical manifestations, treatment and outcome were recorded.

Their mean age at diagnosis was 19.8±5.8 years. Six patients were born to consanguineous parentage and two patients each had family history of WD and past history of psychiatric illness. Diagnosis of WD was suspected by detection of KF rings (all), observing sensitivity to neuroleptics (n=2), history of jaundice (n=2 …