Prevalence of tic disorders among schoolchildren in Warsaw, Poland.

OBJECTIVE: To estimate the prevalence and to describe clinical characteristics of tic disorders in 12-15 year old Warsaw schoolchildren. METHOD: Children attending 24 randomly selected schools were screened by inquiring their parents and teachers. Children indicated as tic-positive by the screening procedure were investigated using semi-structured questionnaires and the Polish version of YGTSS scale. A validity study involved random selection and investigation of 130 non-indicated subjects. RESULTS: Out of 1,579 screened children, 104 met criteria for tic disorders, giving a lifetime prevalence of 9.9% (95% CI 7.1-12.6%) and a point prevalence of 6.7% (4.3-9.1%). Lifetime prevalence of ICD-10 tic disorders was 2.6% (95% CI 1.2-4.1%) for transient tic disorder (TTD); 3.7% (1.9-5.4%) for chronic tic disorder (CTD); 0.6% (0.2-0.9%) for Tourette disorder (TD); and 2.9% (1.2-4.6%) for non-specific tic disorder. Screening procedure had high sensitivity (92%) and low positive predictive value (18%). CONCLUSION: Tic disorders are common among Warsaw schoolchildren, have mild severity and form a continuum. The present study has confirmed numerous problems with studying neurobehavioral disorders in general population not referred to physicians, and stressed out the need to improve education on tic disorders in the general public.

Obsessive-compulsive disorder and acquired toxoplasmosis in two children.

Two children presenting symptoms of obsessive-compulsive disorder (OCD) and with acquired toxoplasmosis are described and the possibility of a previously rarely reported association between OCD and acquired toxoplasmosis is discussed. Case 1 is a 14-year-old boy with Tourette syndrome (TS), attention deficit hyperactivity disorder (ADHD) in partial remission and a three-year history of OCD referred to our department due to an acute deterioration of obsessive-compulsive (OC) symptoms. Case 2 is an 11-year-old boy referred to our department because of a two-year history of OCD. The OC symptoms were observed immediately following an infection. In both cases laboratory tests confirmed the diagnosis of acquired toxoplasmosis. The pharmacological therapy of T.gondi infection without any psychopharmacological treatment caused remission or significant improvement regarding OC symptoms.

[Obsessive-compulsive disorder in children and adolescents: a literature review. Part II]. / Zaburzenie obsesyjno-kompulsyjne u dzieci i mlodziezy--przeglad pismiennictwa. Czesc II.

This paper presents opinions about obsessive-compulsive disorder in children and adolescents. Washing, checking, repeating, touching, counting and scrupulosity are the most commonly seen rituals. Almost all patients reported a change in their principal symptom over time. There appear to be no significant intercultural differences in phenomenology. Childhood OCD seems to be associated with depression, eating disorders and anxiety disorders (in several cases the secondary diagnosis was mild), whereas there seems to be no convincing relation between OCD and schizophrenia. Follow-up studies of the course of OCD with a childhood onset are still very few in number. OCD is disabling disorder with bad prognosis for one third to one half of the patients. The behavior therapy is an effective treatment for childhood-onset OCD, while numerous systematic investigations have demonstrated the efficacy of clomipramine treatment. Fluoxetine and other drugs which inhibit serotonin reuptake also may be helpful.

Psychogenic seizures in obsessive-compulsive disorder with poor insight: a case report.

Psychogenic seizures or psychogenic nonepileptic seizures occur in various mental disorders. Obsessive-compulsive symptoms can also imitate epileptic partial seizures, but detailed observations of this phenomenon are rare in the literature. A girl of 13 years was referred to the Department of Child Psychiatry because of sudden falls that had occurred during a 1-year period, mainly at school. She had been diagnosed previously as having epilepsy or conversion seizures. After a fall, she demonstrated no response for periods up to 10 minutes, postictal somnolence had occasionally been observed. From the age of 10 years, the patient was reported to have had intrusive recurrent thoughts about dirt and contamination and had also demonstrated some signs of separation anxiety disorder. She was diagnosed as having obsessive-compulsive disorder with poor insight. The chronic falling disappeared completely when behavioral therapy was begun, but the girl still exhibits obsession and separation anxiety.

[Psychotherapeutic methods in the treatment of obsessive-compulsive disorder (OCD) in children and adolescents]. / Metody psychoterapeutyczne stosowane w leczeniu zaburzenia obsesyjno-kompulsyjnego u dzieci i mlodziezy.

The psychiatric and psychological literature was systematically reviewed for studies applying psychotherapeutic principles to young persons with obsessive-compulsive disorder. Abundant clinical and empirical evidence suggest that cognitive-behavioral psychotherapy, alone or in combination with pharmacotherapy, is an effective treatment for OCD in children and adolescents. Thirty-two investigations, most of them single case reports, showed some benefit for such kind of interventions. Graded exposure and response prevention form the core of treatment; anxiety management training and specific family interventions may play an adjunctive role.

[Obsessive-compulsive disorder in children and adolescents: literature review. Part I]. / Zaburzenie obsesyjno-kompulsyjne u dzieci i mlodziezy--przeglad pismiennictwa. Czesc I.

The literature on obsessive-compulsive disorder (OCD) in children and adolescents is reviewed. The disorder is characterized by obsessions (recurrent troublesome thoughts) and compulsions (ritualized thoughts or behaviors performed repetitively in response to an irresistible urge). OCD is far more common among children and adolescents than was previously believed. Good epidemiological studies from different parts of the world are still needed to determine if prevalence is equally high. Boys seem to have an earlier age of onset of OCD than girls. Male female ratio changed with age of onset, with males predominating in early onset and increasing numbers of females occurring during adolescence. Increasing evidence supports a neurobiological theory for etiology of OCD, specifically a frontal lobe--basal ganglia dysfunction.