ABSTRACT
A higher incidence of depression has been described in adults with primary oxidative phosphorylation disease. We evaluated the psychological characteristics of eighteen non-retarded pediatric patients diagnosed with a disorder of the oxidative phosphorylation. We found significantly higher rate of withdrawn, depressive behaviour compared to population norm scores, to children with other types of inborn errors of metabolism and also in comparison to patients with Sotos syndrome. The occurrence of depressive behaviour showed no correlation with the degree of mitochondrial dysfunction. These findings support the hypothesis that mood disorders could be associated to abnormal cerebral energy metabolism.
Subject(s)
Depression/epidemiology , Mitochondrial Diseases/complications , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Incidence , Infant , Interview, Psychological , Male , Oxidative PhosphorylationABSTRACT
Although in the past there were objections against the use of selective serotonin reuptake inhibitors (SSRIs) for the treatment of depression in children and adolescents, recent studies have shown that SSRIs, in particular fluoxetine, are effective against depression in this age group. Cognitive behavioural therapy has a questionable effect in children and adolescents with severe depression. Other unequivocally effective treatment options are not available. More suicidal behaviour was reported in children and adolescents using sertraline or venlafaxine, but fluoxetine did not clearly enhance this behaviour. Children with severe depression or a depression not responding to psychological therapy can be treated with SSRIs. Fluoxetine is the treatment of first choice.
Subject(s)
Depressive Disorder, Major/drug therapy , Risk Assessment , Selective Serotonin Reuptake Inhibitors/therapeutic use , Suicide/statistics & numerical data , Adolescent , Antidepressive Agents, Second-Generation/therapeutic use , Child , Cyclohexanols/adverse effects , Cyclohexanols/therapeutic use , Fluoxetine/therapeutic use , Humans , Sertraline/adverse effects , Sertraline/therapeutic use , Venlafaxine HydrochlorideABSTRACT
A 68 year old woman is described with persisting muscular rigidity of the left lower leg together with transient myoclonic jerking in the left quadriceps muscle. Six weeks after onset a small cell carcinoma of the lung became manifest. With radiotherapy and chemotherapy complete remission was achieved. Segmental muscular spasm improved at the same time. Necropsy revealed loss and degeneration of alpha-motor neuron cells at one side of the anterior horn of the lumbar enlargement. This case may represent another manifestation of paraneoplastic subacute motor neuronopathy.
