Aslı Sürer Adanır

Methylphenidate treatment for binge-eating disorder in a 12-year-old boy

ABSTRACT Binge-eating disorder (BED) is defined as frequent episodes of binge eating, and the subjective feeling of loss of control over food intake, in the absence of inappropriate compensatory behaviours. Although it is one of the most common eating disorders in adults, it is less common in childhood and adolescence, and literature about its diagnosis and treatment in children and adolescents is limited. Here, we report a 12-year-old boy, with BED, who had not responded to conventional therapies, and showed recovery with methylphenidate therapy. He had lost his mother a year ago, and had depression symptoms since then, and binge-eating episodes for the last 3 months. His depression symptoms were ameliorated in a month with fluoxetine 20 mg, but his binge-eating episodes continued with the same frequency and severity, despite the drug and cognitive behavioural therapy. Twice daily short-acting methylphenidate (Ritalin 10 mg.) was added then, and with ritalin, his binge-eating episodes were dramatically decreased in frequency. Over the years, various strategies and guidelines for treatment have been proposed for BED, especially in adults, including pharmacological and psychotherapeutic strategies. Stimulants were also used for BED. Lisamfetamine has been shown to reduce the frequency of exacerbations in adults with binge-eating disorders. There are case reports about methylphenidate use for bulumia nervosa (but not for BED) in adults, but to our knowledge, to date, there is not a case reported methylphenidate use for BED in children and adolescents in the literature. In conclusion, data from these reports suggest a possible benefit of using psychostimulants in the treatment of children respond poorly to conventional therapies. Clinical trials are needed to fully evaluate the efficacy and tolerability of psychostimulants in this respect.

The relationship between physical restraint and the diagnosis and drug use in the patients receiving inpatient treatment in a child and adolescent psychiatry clinic

Objective: The aim of this study is to evaluate the characteristics such as the diagnosis and medication of the physically restrained patients in our inpatient unit, which is one of the few inpatient units for children and adolescents in Turkey, and the effect of the physical restraint on the treatment of them. Methods: The medical records of 102 inpatients treated in our mental health hospital during the year 2016 had been retrospectively reviewed. Patients who were restrained at least once during the hospitalization period were compared with patients who were not, in terms of diagnosis, medication, presence of comorbidity, duration of hospitalization and the way of discharge Results: Comparing the groups that were restrained and not restrained, it was found that multiple drug use was more common in the restrained group. The use of antipsychotics, anxiolytics and mood stabilizer drugs and haloperidol-biperiden injections were found to be significantly higher in the restrained group. The rate of multiple psychiatric diagnoses was significantly higher and major depression, conduct disorder, bipolar disorder and self-injurious behaviors were more frequent in the restrained group. Although the duration of hospitalization for both groups was similar, discharge with the request of the family or caregivers before the end of treatment was more frequent in the restrained group. Clinical global improvement scores were lower in the restrained group. Discus-sion: There are many differences in terms of diagnosis, medication and the way of discharge between the re-strained and non-restrained groups. More strategies are needed to reduce the restriction rates.

Psychopathology in pediatric bone marrow transplantation survivors and their mothers

Bone marrow transplantation (BMT) is used to treat various hematologic, oncologic and metabolic diseases. While the treatment is lifesaving, it is also associated with anxiety, post‐traumatic stress disorder, depression and psychosocial problems both in children and parents.

Increased Hyperacusis with Risperidone in an Autistic Child

Autistic spectrum disorder is a neurodevelopmental disorder characterized by qualitative impairment in social interactions and communication skills. In addition to these core features, sensory processing abnormalities such as auditory hypersensitivity have been frequently reported. Although the cause of auditory hypersensitivity remains unknown, it is thought to be associated with decreased inhibitory processing, possibly resulting from an abnormal sensory gating system or dysfunction of inhibitory interneurons. Its relation to drugs has not been well documented to date. In the literature, there is only one case on hyperacusis that worsened with risperidone in a 5-year-old girl with autism. Here we represent the case of an 11-year-old boy with autism, in whom hyperacusis worsened with risperidone, decreased after the discontinuation of the medication, and re-occurred after the prescription of the drug again. Although auditory hypersensitivity tends to affect the childs daily life negatively and is found to be correlated with behavioral problems in autistic patients, we still know very little about its etiology, treatment, and conditions related to it. There is a great need for conducting further studies in this regard.