Trastorno por Déficit de Atención con Hiperactividad (TDAH) como posible factor mediador para intento suicida en niño de 10 años: Reporte de un caso

El propósito de este artículo es hacer la descripción de un caso clínico donde se observa una convergencia entre el diagnóstico de TDAH e intento suicida, en ausencia de otras enfermedades psiquiátricas comórbidas, describiendo los antecedentes y el proceso de evaluación. Se trata de un paciente de 10 años de edad, con diagnóstico de TDAH (de acuerdo a los criterios clínicos del DSM IV TR), quien es hospitalizado al presentar intento suicida de alta letalidad por ahorcamiento en ausencia de comorbilidad psiquiátrica alguna, evaluado clínicamente, usando múltiples fuentes de información y por medio de escalas clinimétricas. A pesar de que la tasa de TDAH es alta en poblaciones con ideación, intentos y suicidio completado, (casi el doble que los controles)(1), son relativamente pocas las investigaciones que se han realizado de dicha asociación y además suelen intentar explicar la suicidalidad mediante la psicopatología comórbida (Trastornos afectivos, de ansiedad, de personalidad, abuso de sustancias), sin cuestionar la relación TDAH-riesgo suicida como mecanismo explicativo de forma independiente. La disfunción ejecutiva que se presenta en el TDAH, particularmente, la impulsividad, pudiera estudiarse como un posible mecanismo mediador en el riesgo suicida

Association between bullying and major depressive disorder in a psychiatric consultation

Assess if there is a significant association between being bullied and presenting depressive symptoms. Materials and methods: In the March---October period of the present year, 8---16-year-old children and adolescents that attended psychiatric consultation for the first time in Dr. Eleuterio González Hospital were included in this study. Test Bull-S was used to determine the presence of bullying (Victim subtype); to evaluate depression 2 instruments were used according to age: Children’s Depression Rating Scale-Revised (CDRS-R) for 8---12-year olds and the Birleson Depression Self-Rating Scale (DSRS) for 13---16-year olds. A total of 147 clinical patients were studied (73 women and 74 men). Data were captured in excel and the Statistical Package for the Social Sciences (SPSS) program was used for statistical analysis. Results: A very significant association was found between being bullied and presenting depression (X2 = .289, p = .0004). Conclusions: These data are in agreement with national and international studies, therefore, reinforcing the evidence of such association. This is why we suggest inquiring about bullying in children and adolescents whose chief complaint is depressive symptomatolog

Severe Growing-Up Phobia, a Condition Explained in a 14-Year-Old Boy

We present the clinical case of a 14-year-old boy with gerascophobia or an excessive fear of aging, who felt his body development as a threat, to the point where he took extreme measures to stop or otherwise hide growth. He had a history of separation anxiety, sexual abuse, and suffering bullying. He presented with anxious and depressive symptoms and food restriction, criticized his body image, had negative feelings towards the maturation process, suffered at the thought of being rejected, and was preoccupied with certain physical characteristics. We conducted an analysis of biological, psychological, and environmental factors and their possible interactions and established treatment with psychotherapy and fluoxetine. Because of the favorable results, this approach could be considered a good option in such cases

Trastorno por Déficit de Atención con Hiperactividad (TDAH) como posible factor mediador para intento suicida en niño de 10 años: Reporte de un caso

The purpose of this article is to present a clinical case description in which there is an observable convergence between Attention Deficit Disorder with Hyperactivity (ADHD) and a suicide attempt, in the absence of other co-morbid psychiatric disorders. We describe the patient’s background and the evaluation process. We report the case of a 10 year old boy with an ADHD diagnosis, (as stipulated by DSM IV TR), who was hospitalized after a high-lethality suicide attempt by hanging, in the absence of any comorbid psychiatric diagnoses. The patient was evaluated through a clinical assessment, that took multiple sources of information and clinical rating scales into account. Although ADHD rates are high in suicidal groups (almost double the rate of controls) (1), there are relatively few investigations about such association, this has led to a tendency for explain suicidality in terms of comorbid psychopathologies (anxiety, affective, and substance abuse disorders), without analyzing the ADDH-suicide relationship as an independent explicative mechanism. Executive dysfunction that occurs in ADHD, particularly impulsivity, could be studied as a possible mechanism mediating in suicide risk.El propósito de este artículo es hacer la descripción de un caso clínico donde se observa una convergencia entre el diagnóstico de TDAH e intento suicida, en ausencia de otras enfermedades psiquiátricas comórbidas, describiendo los antecedentes y el proceso de evaluación. Se trata de un paciente de 10 años de edad, con diagnóstico de TDAH (de acuerdo a los criterios clínicos del DSM IV TR), quien es hospitalizado al presentar intento suicida de alta letalidad por ahorcamiento en ausencia de comorbilidad psiquiátrica alguna, evaluado clínicamente, usando múltiples fuentes de información y por medio de escalas clinimétricas. A pesar de que la tasa de TDAH es alta en poblaciones con ideación, intentos y suicidio completado, (casi el doble que los controles)(1), son relativamente pocas las investigaciones que se han realizado de dicha asociación y además suelen intentar explicar la suicidalidad mediante la psicopatología comórbida (Trastornos afectivos, de ansiedad, de personalidad, abuso de sustancias), sin cuestionar la relación TDAH-riesgo suicida como mecanismo explicativo de forma independiente. La disfunción ejecutiva que se presenta en el TDAH, particularmente, la impulsividad, pudiera estudiarse como un posible mecanismo mediador en el riesgo suicida