Angioedema and Urticaria Associated with Fluoxetine in a Preadolescent Boy

Angioedema is defined as increased permeability and dilatation of the capillaries in the deep dermis or subcutaneous or submucosal tissues leading to localized swelling, often affecting the upper respiratory and gastrointestinal tracts. It can also be observed as a rare adverse effect of selective serotonin reuptake inhibitors, as is the case with many other drugs. Here, we report a 10-year-old boy who had urticaria with fluoxetine use, showed recovery after cessation of the drug, and manifested with urticaria and angioedema after re-prescription. In the literature, there are two previous case reports of angioedema with fluoxetine. One case of angioedema accompanied by urticaria and showed a flu-like presentation 2 days after ingestion of high-dose fluoxetine. The other case, reporting angioedema with 10 mg/day, was without urticaria and thought to be a pseudoallergic reaction. We assume that our case is unique in this respect for that angioedema developed with therapeutic doses and thought to be allergic

The social, emotional and behavioral difficulties in thalassemic adolescents and psychopathology in their parents

Giriş ve Amaç: Bu çalışmada, beta-globin sentezinde defekt nedeniyle ortaya çıkan azalmış eritrosit sentezi, anemi ve demir birikimiyle karakterize kalıtsal bir kronik hastalık olan beta-talasemili ergenlerde sosyal, duygusal ve davranışsal güçlüklerin ve ebeveynlerinde psikopatoloji yaygınlığının değerlendirilmesi amaçlanmıştır. Yöntem ve Gereçler: 24 Beta-talasemili ergen ve ulaşılabilen ebeveyn hasta grubu; daha önce fiziksel ve mental hastalık öyküsü bulunmayan, yaş ve cinsiyet açısından eşleştirilmiş 20 ergen ve ulaşılabilen ebeveyn de kontrol grubu olarak çalışmaya dahil edilmiştir. Ergenlerde işlevsellik Güçler-Güçlükler Anketi (GGA) ile değerlendirilmiştir. Ebeveynlerde psikopatolojiyi değerlendirmek için 90 itemlik bir özbildirim ölçeği olan Ruhsal Belirti Tarama Listesi 90-R (RBTL 90-R) kullanılmıştır. Bulgular: Talasemili ergenlerde GGA yaşıt ilişkileri, emosyonel semptomlar ve total güçlük subskorları, bu alanlarda soruna işaret eder şekilde anlamlı olarak daha yüksek bulundu. Ebeveynlerde, hasta grubunda yüksek çıkan obsesif-kompulsif skalası hariç, tüm RBTL 90-R alt skorları ve genel semptom indeks skoru her iki grupta normal sınırlarda olsa da, ailede ikinci bir talasemili çocuk varlığı ile ebeveynlerde anksiyete düzeyi arasında anlamlı bir ilişki saptandı. Benzer şekilde, çocukta dismorfi varlığında tüm alt skorlar ve genel semptom indeksi skoru anlamlı olarak artmaktaydı. Tartışma ve Sonuç: Hastalığın kronik ve ölümcül oluşu, tedaviye bağlı zorluklar ve demir birikimine bağlı ortaya çıkan ikincil rahatsızlıklar nedeniyle hasta çocukta ve ebeveynlerde psikolojik ve sosyal sorunlar görülebilmektedir. Bu nedenle tıbbi tedavinin psikososyal destekle kombine edilmesi, çocukaileyi bir bütün olarak ele almak ve olası psikopatolojilerin tanısı ve tedavisi bir gerekliliktir.Introduction: The aim of this study is to investigate the social, emotional and behavioral difficulties in adolescents and the prevalance of pyschopatology in parents of adolescents with βeta-thalassemia, a chronic disease which is a hereditary blood disorder characterized by reduced or absent beta globin chain synthesis, resulting in decreased red blood cell production, anemia and subsequent secondary diseases as a result of iron loading. Methods: For this aim, 24 adolescents with Beta-thalassemia and accessible parent, as the study group and 20 adolescents without any physical or mental problems and accessible parent, as the control group were recruited. Functionality of adolescents was assessed with Strengths and Difficulties Questionnaire (SDQ) and psychopatology in parents was assessed with The Symptom Checklist 90-R (SCL 90-R), a self-report questionnaire consists of 90 items. Results: In thalassemic adolescents, SDQ subscores in peer relations, emotional symptoms and total difficulties were significantly higher, indicating problems in these areas. In both groups, all SCL 90-R subscale scores and general syptom index score were in normal range, but obsesive-compulsive score was statistically higher in thalassemia group. There was a significant correlation between the anxiety subscores of parents and presence of dismorfism in the thalassemic child. In the presence of a second child with thalassemia in the family also correlated with the overall psychopathology in parents. But contrary to expectation, in the presence of thalassemia complication(s), no correlation was found. Discussion and Conclusion: Because of the the chronic and fatal nature of the disease, difficulties about the treatment and secondary diseases due to the iron overload, psychological and social problems can be seen in the patients and their parents. In this respect, it’s a necessity to combine the medical treatment with psychosocial support, handle the child and the family as a whole and ensuring the identification and treatment of any possible psychopathologies

Can gestation be considered as trauma in adolescent girls: post-traumatic stress disorder in teen pregnancy

Although post-traumatic stress disorder (PTSD) in adolescent pregnancy has been reported at high rates in the limited research in this area, no studies have evaluated gestation as trauma in teens. This study, aimed to evaluate PTSD in this high risk group. All pregnant adolescents who presented to our obstetrics and gynaecology clinics in a one-year period were invited to participate in the study. Adolescents with a history of domestic or dating violence, rape, and sexual abuse were excluded. PTSD was rated using the Child Post-Traumatic Stress Disorder-Reaction Index. When the pregnant adolescents and control group were compared, various severities of PTSD were observed in nearly two-thirds of the study group. Although there was clinically significant PTSD among 23.3% of the controls, PTSD was more frequently seen in adolescents with pregnancy compared with their healthy peers. Educating adolescents about birth control methods and preventing child marriages will be protective in this respect.Impact statement What is already known on this subject? Teen pregnancy has significant psychosocial and economic impacts for adolescents, their offspring, and the community in terms of education and employment, increased risk of abuse and neglect, and the physical and emotional well-being of the offspring. Pregnancy and birth-related risks are also higher than in adults. In this context, pregnancy itself may be accepted as trauma for adolescents. What do the results of this study add? There has been limited research on PTSD in pregnant teens and is mainly associated with traumatic childhood events. This is the first study to examine pregnancy-related PTSD and related conditions in this group. What are the implications of these findings for clinical practice and/or further research? The prevalence of pregnancy related-PTSD in pregnant teens can be considered high and alarming, considering the fact that most of them had never been treated for it at all. Healthcare providers serving this population need to be trained to recognise the core symptoms of PTSD, and should direct adolescents for professional assistance if needed. Strategies such as higher quality sexual health education and greater access to reproductive health services to reduce adolescent pregnancy and marriage are also imperative

Problematic internet use in the psychiatric sample compared community sample

Amaç: Çalışmanın amacı psikiyatrik bozukluğu olan ve olmayan ergenlerde internet kullanım özelliklerinin ve Problemli İnternet Kullanımının (PİK) araştırılmasıdır. Yöntemler: Çalışmaya 12-18 yaşında 884 ergen katılmıştır. Psikiyatrik örneklem (PÖ) ve Toplum örnekleminin (TÖ) her birinde yaş/cinsiyet eşlenmiş 442 ergen bulunmaktadır. PÖ’de yer alanlar Çukurova - Mersin - Akdeniz Üniversitesi Çocuk Psikiyatrisi Polikliniklerine başvuran hastaları içermektedir. PİK internette bilimsel durum ölçeği (İBDÖ) ile değerlendirilmiştir. Bulgular: PÖ’de en sık tanı dikkat eksikliği hiper aktivite bozukluğudur (DEHB; n:260); bunu kaygı bozuklukları (KB; n:96) duygudurum bozuklukları (DDB; n:55) ve diğer bozukluklar (DB; n:31) izlemektedir. PÖ’de yer alan ergenlerin %23.3’ü haftada 8 saatten fazla internet kullandığını bildirirken, TÖ’de bu oran %10.6’dır (p=0.0001). PÖ’de yer alan ergenlerin İBDÖ ortalaması TÖ’de yer alanlardan yüksektir (p=0.0001). En yüksek İBDÖ ortalamalarının DEHB grubunda gözlenmiştir ve TÖ’den anlamlı biçimde farklıdır (p=0.0001). Sonuç: Bu çalışma ergenlerde psikopatoloji ve PİK ilişkisini desteklemektedir ve bu ilişki DEHB’li ergenler için daha belirgindir.Objective: The aim of this study is to determine the characteristics of internet use and Problematic Internet Use (PIU) in adolescents with and without psychiatric disorder. Methods: The present study was performed on 884 adolescents, who were in the age group of 12 to 18 years. Each o psychiatric sample (PS) and community sample (CS) included 442 age/gender matched adolescents. PS were patients at the child and adolescent psychiatry departments of Cukurova, Mersin and Akdeniz Universities. Online Cognition Scale (OCS) was used for PIU. Results: The most common diagnoses in PS were attention deficit hyperactivity disorder (ADHD; n: 260), followed by anxiety disorders (AD; n: 96), mood disorders (MD; n: 55), and other disorders (OD; n: 31, 7.0%). 23.3% of participants in PS and 10.6% in CS reported use of internet for more than 8 hours/week (p=0.0001). Additionally, mean OCS scores of participants in PS were significantly higher than those in CS (p=0.0001). The highest OCS score average was observed in the ADHD group and it was significantly higher than that in CS (p=0.0001). Conclusion: This study has supported the relationship between PIU and psychopathology among adolescents which is more pronounced in adolescents with ADHD