As a psychiatrist with an interest in rare disorders, including DCC, I see adult patients with emotional and mental health issues that are associated with a range of brain disorders. My interest in DCC started when I became interested in mental health neuroimaging research, and became aware of the link between DCC and psychotic illness – a rare disorder where individuals may experience hallucinations or false beliefs and paranoia.

However, this type of mental health illness is still rare, and is rare in patients with DCC. What is much more common in the adult patients I see is significant anxiety (a high level of worry, which may progress to extreme periods of anxiety known as panic episodes), and difficulties managing social relationships. Reassuringly, anxiety is one of the more treatable mental health issues in adults, and often responds well to particular types of psychological therapy and to antidepressant medication.

Difficulties with social cognition are often present to varying degrees in patients with DCC, but can be one of the more problematic difficulties that patients face, particularly in adolescence and early adulthood when peer relationships, and later intimate relationships, become central parts of our emotional lives. Some patients may find they struggle with the reading of emotions in others or situations, or understanding the more complex interpersonal dynamics that can occur – particularly within groups, such as school or workplaces.

The good news is that with a good understanding of how DCC affects you, these issues can usually be managed. I generally recommend that some form of neuropsychological assessment, which includes measures of social cognition, is essential as it provides a roadmap to your strengths and weaknesses in a range of brain functions, from basic to more advanced or higher-level. This can then allow for guidance as to how to manage specific difficulties with exercises, training or “workarounds” to manage these situations, particularly in friendship groups or occupationally. Ensuring that anxiety is also managed is important, as ongoing high levels of anxiety can act as a “magnifier” for these

problems. But with you, and your doctor or therapist, understanding your own “roadmap” of cognitive or thinking strengths and weaknesses, you can work on finding a way to manage these components of the illness to ensure that you can function at your best.

A/Professor Mark Walterfang – AusDocc Adult Advisor