The effect of stuttering on symptoms of depression and social anxiety in adolescents.

OBJECTIVE: This study aims at examining the relationship between the severity of stuttering, which makes it difficult to speak and communicate, and the symptoms of depressive and social anxiety disorders during adolescence. PATIENTS AND METHODS: A total of 65 children between 14 and 18 years old, diagnosed with stuttering, were included in the study, regardless of gender. Stuttering Severity Instrument, Beck Depression Scale, and Social Anxiety Scale for Adolescents were administered to all participants. RESULTS: The mean age of the 65 patients was 15.41±0.93. Out of them, 36 (55.4%) were female and 29 (44.6%) were male. In terms of stuttering levels, 25 participants (35.8%) had mild stuttering, 20 (30.8%) showed moderate stuttering, and 20 (30.8%) had severe stuttering. Depression levels of individuals diagnosed with stuttering increased significantly in parallel with the severity of stuttering (p<0.001). The social anxiety scale total score and subscale scores of individuals diagnosed with stuttering also increased significantly in parallel with stuttering severity (p<0.01). CONCLUSIONS: The symptoms of depression and social anxiety disorders increase with the severity of stuttering in adolescent patients who applied to the child psychiatry clinic presenting stuttering.

Multiple organ failure and severe bone marrow dysfunction in two 18 year-old Caucasian patients: Epstein-Barr virus and the haemophagocytic syndrome.

Haemophagocytic lymphohistiocytosis secondary to viral infection is an unusual but well recognised cause of bone marrow dysfunction and multiple organ failure in young patients. Two 18 year-old patients were admitted to a tertiary liver unit with features of acute liver failure, cardio-respiratory collapse and pancytopenia. Serological tests and bone marrow examination with in-situ hybridisation revealed severe acquired haemophagocytic lymphohistiocytosis secondary to acute Epstein-Barr virus infection. Both patients died despite full supportive therapy; the first due to pulmonary haemorrhage, the second due to acute respiratory distress syndrome refractory to high frequency oscillatory ventilation. The clinical spectrum, diagnostic features and current evidence based recommendations for treatment of this condition are explored. The diagnosis of haemophagocytic lymphohistiocytosis should be considered in young patients with marked bone marrow dysfunction and multiple organ failure. Further research into appropriate therapy for patients with acute severe forms of the disease who require intensive organ support is required.