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Stressor-related disorders in tuberous sclerosis

Susana Boronat, MD

Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA, Department of Pediatric Neurology, Vall d’Hebron Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain

Agnies M. Van Eeghen, MD

Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA

Julianna E. Shinnick, 

Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA

Peter Newberry, MD

Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA

Elizabeth A. Thiele, MD, PhD

Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA

Background: Patients with tuberous sclerosis complex (TSC) have high rates of psychiatric comorbidity, including mood and anxiety disorders. The aim of this study is to identify patients with stressor-related disorders such as posttraumatic stress disorder (PTSD) or adjustment disorder (AD) and to describe their clinical picture in the setting of TSC.

Methods: Retrospective review of medical charts of TSC patients referred for a stressor-related disorder to a TSC psychiatric clinic.

Results: We identified 7 females and 2 males (3 PTSD, 6 AD), including 4 children. Two patients with severe intellectual disability presented with aggression and the remaining patients presented with avoidance. The mean duration of symptoms at the time of the study was 21 months (range: 7 to 48 months) and 7 of the 9 patients still were having trauma-related symptoms. All the patients who received an initial diagnosis of AD had their diagnosis changed to another category because their symptoms lasted >6 months. In most cases, selective serotonin reuptake inhibitors improved the symptoms.

Conclusions: Stressor-related disorders in TSC frequently linger beyond 6 months and may appear with triggering events that typically are not viewed as trauma in a normal population.

Keywords: adjustment disorder, anxiety, seizures, posttraumatic stress disorder, trauma, tuberous sclerosis

ANNALS OF CLINICAL PSYCHIATRY 2013;25(4):243-249

CORRESPONDENCE: Elizabeth A. Thiele, MD, PhD Pediatric Epilepsy Program Massachusetts General Hospital 175 Cambridge Street, Suite 340 Boston, MA 02114 USA E-MAIL: ethiele@partners.org
Annals of Clinical Psychiatry ©2013 Quadrant HealthCom Inc.

 
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