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Psychiatric comorbidity and treatment response in patients with tuberous sclerosis complex

Thomas K. Chung, MA

Departments of Pediatrics and Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Elizabeth R. Lynch, MS

Departments of Pediatrics and Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Cheryl J. Fiser, MSW, LISW-S

Division of Social Services, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Daniel A. Nelson, MD

Division of Child and Adolescent Psychiatry, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Karen Agricola, FNP

Departments of Pediatrics and Neurology, Tuberous Sclerosis Clinic and Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Cynthia Tudor, PNP

Departments of Pediatrics and Neurology, Tuberous Sclerosis Clinic and Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

David Neal Franz, MD

Departments of Pediatrics and Neurology, Tuberous Sclerosis Clinic and Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

Darcy A. Krueger, MD, PhD

Departments of Pediatrics and Neurology, Tuberous Sclerosis Clinic and Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

BACKGROUND: Behavioral and psychiatric comorbidity are common in tuberous sclerosis complex (TSC), but information regarding psychopharmacologic management is lacking.

METHODS: We reviewed clinical records of patients evaluated over a 20-month period at a large, quaternary referral center specializing in the comprehensive management of patients with TSC. Data were collected regarding psychiatric diagnoses, psychopharmacologic medications used to treat these disorders, and clinical response to treatment at follow-up.

RESULTS: There were 113 encounters by 62 pediatric and adult patients with TSC, which were included in the present analysis. Behavioral and anxiety disorders were most prevalent, as were autism spectrum disorders and attention-deficit/hyperactivity disorder. Antipsychotics, antidepressants, and anticonvulsants with mood-stabilizing properties were the most often prescribed psychoactive medications and were associated with an overall improvement or stabilization of psychiatric symptoms 65% of the time.

CONCLUSIONS: Psychiatric comorbidity, especially behavioral disorders, is very common among patients with TSC. Pharmacologic treatment can be very effective and should be considered for optimal disease management in affected individuals.

KEYWORDS: tuberous sclerosis complex, psychiatric comorbidities, behavior, treatment

ANNALS OF CLINICAL PSYCHIATRY 2011;23(4):263-269

CORRESPONDENCE: Darcy A. Krueger, MD, PhD, Division of Child Neurology, MLC 2015, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229 USA, E-MAIL: krueger_darcy@cchmc.org
Annals of Clinical Psychiatry ©2011 Quadrant HealthCom Inc.

 
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