Depressive symptoms as a side effect of the sustained release form of methylphenidate in a 7-year-old boy with attention-deficit hyperactivity disorder

Introduction. Hyperkinetic disorder or attention-deficit hyperactivity disorder (ADHD) is a clinical entity consisting of a cluster of symptoms including hyperactivity, attention disorder and impulse control disorder group. In the context of ADHD etiology we may say that genetic, clinical and imaging studies point out a disruption of the brain dopamine system, which is corroborated by the clinical effectiveness of stimulant drugs, which increase extracellular dopamine in the brain. Basically, it is a biological and not psychological disorder, which is important both for the comprehension and therapeutical approach to this problem. Today, the best recommended approach regarding children with ADHD is a combination of two therapeutic modalities: pharmacotherapy and behavioral treatment. The first-choice drugs for this disorder belong to the group of sympathomimetics - psychostimulants and atomoxetine (more recently). As the firstchoice therapy, methylphenydate in sustained release form has numerous advantages. Like all drugs, methylphenidate has its unwanted side effects. Most common are: loss of appetite, weight loss, sleeping disorders, irritability, headache. These side effects are well-known and documented in the literature. By analysing the available literature we have found cases of psychiatric side effects such as: psychosis, mania, visual hallucinations, agitation, suicidal ideas. We have not found examples of ADHD in children who use increased dosage of sustained release of methylphenidate leading to depressive symptomatology. On the other side, methylphenidate may be prescribed for off-label use in treatmentresistant cases of depression. Case report. The case of a 7- year-old boy diagnosed with ADHD was on a minimal dose of sustained release form of methylphenidate. After initial titration of the drug, i.e. after raising the dose to the next level the boy developed clinical signs of depression. The treatment was ceased and depressive symptoms were withdrawed. Conclusion. Manifestation of depressive symptomatology after dose increasement of sustained release form of methylphenidate in a 7-year-old boy with ADHD represents an uncommon side effect. Precise drug activity mechanisms responsible for the appearance of these symptoms remains to be explained

Quality of life in childhood and adolescence: From concept to practice

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The family and an obese child

Obesity in children is a 'new' epidemic of the modern society, whose importance is far greater in terms of the consequences it creates than is the problem itself. The etiology of obesity is certainly complex and multifactorial. This paper studies the effects of the family on the occurrence of obesity in children and adolescents in the context of Bronfenbrenner's bioecological systems theory

Autism and autistic spectrum disorders in the context of new DSM-V classification, and clinical and epidemiological data

Autism is one of disorders from the autism spectrum, besides Asperger syndrome, atypical autism and pervasive developmental disorder not otherwise specified. They are classified as mental disorders as being manifested by a wide range of cognitive, emotional and neurobehavioural abnormalities. Key categorical characteristics of the disorder are clear impairments of the development of the child’s socialisation, understanding and production of verbal and non-verbal communication and restricted and repetitive patterns of behaviour. Demarcation boundaries are not clear, neither within the very group of the disorders from the autistic spectrum, nor with respect to the autistic behavioural features in the general population. For this reason, the term spectrum points out the significance of the dimensional assessment of autistic disorders, which will most likely be the basis of the new diagnostic classification of the disorders belonging to the current group of pervasive developmental disorders in the new DSM-V classification. The understanding, as well as the prevalence of the autistic spectrum disorders has changed drastically in the last four decades. From the previous 4 per 10,000 people, today’s prevalence estimates range from 0.6 to around 1%, and the increase of prevalence cannot be explained solely by better recognition on the part of experts and parents or by wider diagnostic criteria. The general conclusion is that the autistic spectrum disorders are no longer rare conditions and that the approach aimed at acknowledging the warning that this is an urgent public health problem is completely justified

ОРИГИНАЛНИ РАД / ORIGINAL ARTICLE � UDC: 616.89-008.441.42-07 Presence of Different Forms of Compensatory Behaviours among Eating Disordered Patients

Introduction Eating disorders indicate unhealthy habits in nutrition and/or behaviour in the feeding and maintaining of body weight. The main characteristic of these diseases is changed behaviour in nutrition, either as an intentional restriction of food, namely extreme dieting or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are the forms of compensator