The paradox of hypersociality and social maladjustment in a clinical case of a patient with Williams syndrome

Timirbulatov I. F.
MD, Dr. Sci. (Med.), Associate Professor, Head of Department¹, Chief Physician²

Evdokimova T. E.
MD, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Psychiatry and Medical Psychology³, Head of the Outpatient Department, Branch «Center for Mental Health, Vidnoe City»²
ORCID: 0000-0002-2722-2979

Kraskov G. V.
MD, Psychiatrist, Branch «Center for Mental Health, Vidnoye City»²

Surbas N. B.
MD, Clinical Psychologist, Branch «Center for Mental Health, Vidnoye City»²

Martynova V. O.
MD, Psychiatrist, Branch «Center for Mental Health, Vidnoye City»²

Mylkovskaya O. V.
MD, Head of the Branch «Center for Mental Health, Vidnoye City»²
ORCID: 0009-0004-3196-6358

Nadezhdin A. V.
MD, PhD (Med.), Associate Professor, Psychiatrist, Branch «Center for Mental Health, Vidnoye City»²
ORCID: 0000-0003-3368-3170

1Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Health of Russia
2State Budgetary Healthcare Institution of the Moscow Region «F. A. Usoltsev Central Clinical Psychiatric Hospital»
3Federal State Autonomous Educational Institution of Higher Education «Patrice Lumumba Peoples' Friendship University of Russia»

Nadezhdin Alexey Valentinovich; e-mail: aminazin@inbox.ru

The study had no sponsorship.

The authors declare no conflict of interest.

Williams syndrome (WS) is a rare multisystem genetic disorder caused by a deletion at locus 7q11.23. WS presents with specific somatic anomalies and a unique neurocognitive profile. Key features include intellectual disability, marked hypersociability, and a high prevalence of anxiety disorders. To illustrate the typical manifestations of Williams syndrome in adulthood and discuss the challenges of its lifelong management using the clinical case of patient B., 24 years old. A detailed case description is provided, including history, somatic, neurological, and mental status examinations, and results of a pathopsychological study. The patient exhibits a classic WS phenotype. Mild intellectual disability (IQ=56) was identified, with severe deficits in abstract-logical thinking and social intelligence, combined with preserved initiative speech. Traits of «hypersociability» are pronounced: excessive friendliness, talkativeness, lively eye contact. Somatic status includes heart defects (valvular pulmonary artery stenosis) and neurological anomalies (Arnold-Chiari malformation). Behavior is characterized by anxiety and motor restlessness. The key paradox of this case is the discrepancy between outward communicativeness and profound social naivety, creating a high risk of victimization in adulthood. This case clearly demonstrates the complexity of the neurocognitive profile in WS. Despite successful formal socialization (obtaining several professions, having hobbies), the patient remains vulnerable due to impaired social intelligence and judgment. This underscores the necessity for lifelong multidisciplinary support focused on socio-occupational adaptation and protection from social risks.

Williams syndrome, Williams-Beuren syndrome, 7q11.23 deletion, hypersociability, intellectual disability, clinical case

10.29234/2308-9113-2025-13-4-130-138

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