Probable emergence of symptoms of trichotillomania by atomoxetine: a case report

Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood. Atomoxetine is the first nonpsychostimulant agent approved by the Food and Drug Administration for the treatment of ADHD. Trichotillomania (TTM) is an obsessive-compulsive and related disorder characterized by a long-term urge that results in the pulling out of one’s hair from any part of his/her body. Studies have implicated dopaminergic and serotonergic dysfunction in the aetiology of TTM. We report a male patient with ADHD developing of symptoms of TTM following atomoxetine use. Atomoxetine indirectly affects dopamine levels in the mesolimbic dopamine system, similarly to methylphenidate/amphetamine, and can thus lead to hair pulling behaviour. Further studies concerning the potential adverse effects of atomoxetine, such as the development of TTM, are now needed

School Refusal Developıng In The Older Of Two Sıblıngs After Theır Beıng Assıgned To Dıfferent Classes: A Case Report

İlk kez İngiltere'de ortaya atılan 'okul reddi' terimi, duygusal zorluklar nedeniyle okula gitmeyen çocukların sorunlarını tanımlamak için kullanılır. Okul reddi bir belirtidir ve çeşitli psikiyatrik bozukluklara (anksiyete bozukluğu, yıkıcı davranış bozukluğu ve duygudurum bozukluğu gibi) eşlik edebilir. Okul reddi, psikolojik rahatsızlıkları olan ebeveynlerin çocuklarında sık görülür. Bu, okul reddi gelişiminde genetik ve çevresel faktörlerin rol oynadığı fikrini desteklemektedir. Her vaka için ayrı bir terapötik protokol, çocuklarla ilgili, aileyle ilgili ve sosyal çevre ve okulla ilgili faktörlerin ayrıntılı değerlendirmesi yoluyla oluşturulmalıdır. Okul reddi 5, 6, 10 ve 11 yaşlarındaki çocuklarda daha sık görülmektedir. Tedavide amaç en kısa sürede okula geri dönüş sağlamaktır. Okul reddi, Zihinsel Bozuklukların Teşhis ve İstatistik El Kitabı, Beşinci Basım'a göre klinik bir bozukluk olarak görülmemekle birlikte, çeşitli psikiyatrik bozukluklarla ilişkili olabileceği vurgulanmaktadır. Bu nedenle, okul reddi olan gençlerin bir ruh sağlığı uzmanı tarafından değerlendirilmesi gereklidir. Aynı sınıfta okula başlayan, ancak daha sonra farklı sınıflara atanan bir yaş farkı olan iki kardeşin yaşı büyük olanın da okul reddi olgusunu tartışıyoruz. Bu raporun amacı, ikizlerde olduğu gibi, yakın yaşlardaki kardeşlerin de farklı sınıflarda okula başlamasının önemini vurgulamak ve bunun farkındalığını artırmaktır.The term ‘school refusal,’ which first originated from Great Britain, is used to describe problems in children not going to school because of emotional difficulties. School refusal is a symptom and may be accompanied by several psychiatric disorders (such as anxiety disorder, disruptive behavior disorder and mood disorder). School refusal is common in the children of parents with psychological disorders. This supports the idea of genetic and environmental factors being involved in the development of school refusal. A separate therapeutic protocol must be established for each case through the detailed assessment of child-related, family-related and social environment and school-related factors. School refusal is more common in children 5, 6, 10 and 11 years of age. The aim of treatment must be to ensure a return to school as early as possible. Although school refusal is not a clinical disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, it can be associated with several psychiatric disorders. Therefore it is necessary that youths who are school refusing receive an evaluation by a mental health professional. We discuss a case of school refusal in the older of two siblings with an age difference of 1 year who started school in the same class but who were subsequently assigned to different classes. The purpose of this report is to emphasize the importance of siblings of a similar age starting school in difference classes

Hyperprolactinaemia and menstrual irregularity emerging in association with risperidone use and treated with aripiprazole in an adolescent diagnosed with schizophrenia: a case report

Risperidone is one of the most commonly used antipsychotic agents in the treatment of psychosis in children and adults. However, it can lead to hyperprolactinaemia by blocking dopamine D2 receptors in the anterior pituitary. This can result in galactorrhea, menstrual irregularity, amenorrhoea and gynaecomastia and can impact adversely on medication compliance and quality of life. Very few data are available in the literature concerning the management of hyperprolactinaemia developing in association with antipsychotics in children and adolescents. This report describes improvement with the addition to treatment of low-dose aripiprazole in hyperprolactinaemia and menstrual irregularity emerging as side effects of risperidone therapy in an adolescent girl diagnosed with schizophrenia

A case of an 11-year-old girl diagnosed with OCD developing giggle incontinence following addition of aripiprazole to treatment

Giggle incontinence (GI) is characterized by involuntary and generally unpredictable release of urine during giggling or laughter. It has been suggested that GI may be a centrally mediated disorder and may share a common pathophysiology with narcolepsy and cataplexy. The fact that methylphenidate reduces some symptoms suggests that the condition may be a cataplexy. While alpha 1 and dopamine D2 antagonists exacerbate cataplexy, alpha 1 and dopamine D2 agonists produce a marked improvement. Aripiprazole, frequently used to augment treatment of obsessive compulsive disorder, may have exhibited an alpha 1 and D2 receptor antagonist effect and have caused GI. We describe a case of GI occurring following aripiprazole use in an 11-year-old female obsessive compulsive disorder patient resistant to treatment

The relation between serum Toxoplasma gondii IgG antibody in children and ADHD and its severity

AIM: The purpose of our study was to investigate the relation between serum Toxoplasma gondii IgG antibodies in children and attention deficit hyperactivity disorder (ADHD) and its severity. METHOD: 214 subjects, consisting of 107 children aged 6–18 and diagnosed with ADHD and 107 children with no ADHD or psychiatric pathology were included. Subjects underwent a detailed psychiatric examination based on DSM-V-TR diagnostic criteria, using a data form, the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL) for School-Aged Children (6–18), the DuPaul ADHD Rating Scale, Parent Rating Scale, the Conners Teacher Rating Scale (CTRS), and the Conners Parent Rating Scale (CPRS). Blood anti-Toxoplasma IgG antibody levels were investigated. The data obtained were then subjected to statistical analysis. RESULTS: T. gondii IgG antibodies were positive in 8 (7.47%) of the case group and positive in 3 (2.8%) of the control group. No statistically significant difference was determined between the case and control groups in terms of T. gondii IgG positivity (p = .215). Higher levels of severe ADHD were determined in Toxoplasma IgG positive patients in the ADHD group compared to Toxoplasma IgG negative subjects, the difference being statistically significant (p = .005). CONCLUSION: No significant differences were determined between the case and control groups in terms of T. gondii IgG positivity and ADHD. However, correlation was determined between ADHD severity and T. gondii IgG positivity