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References 1. Morris C, Pardo-Villamizar C, Gause C, Singer H. Serum autoantibodies measured by immunofluorescence confirm a failure to differentiate PANDAS and Tourette syndrome from controls. J Neurol Sci. 2009; 276(1-2): 45-48. 2. Hirschtritt ME, Hammond CJ, Luckenbaugh D, Buhle J, Thurm AE, Casey BJ, et al. Executive and attention functioning among children in the PANDAS subgroup. Child Neuropsychol. 2008; 11(2): 1-16. 3. Derenne JL. Abrupt-onset obsessive-compulsive disorder (OCD) in a child with Crohn’s disease. Psycho-somatics. 2009; 50(4): 425-426. 4

of suicidal thoughts and ruminations but may not necessarily have an increased risk of suicide. Obsessive compulsive disorders and suicidality Obsessive compulsive disorders are common, often longterm disorders in the general population. The one month-prevalence was 1.1% in the British National Psychiatric Morbidity Survey of 2000 ( Torres et al. 2006 ). OCD may appear independently or comorbid with other mental health disorders, especially depression and anxiety ( Chaudhary et al. 2016 , Chui et al. 1996, Torres et al. 2006 ). Obsessive compulsive disorders are

April, 16, 2012, from http://www.ocdonline.com/definecbt.php http://www.ocdonline.com/definecbt.php Reed, S. K. (2010). Cognition: Theories and applications (8th ed.). Belmont, CA: Wadsworth, Cengage Learning. The Nemours Foundation. (2011). Obsessive-compulsive disorder. Retrieved April, 16, 2012, from http://kidshealth.org/kid/feeling/emotion/ocd.html# Thomas, A., Chess, S. & Birch, H. (1969). Temperament and behavior disorders in children. New York, NY: University Press. Tibell, L., A., E. & Rundgren, C. J. (2009). Characteristics and implications for

References: 1. Patel D. D., Laws K. R., Padhi A., Farrow J. M., Mukhopadhaya K., Krishnaiah R., Fineberg N. A. The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis. Psychological Medicine 2010; 40: 921–933. 2. Crino R., Slade T., Andrews G. The changing prevalence and severity of obsessive-compulsive disorder criteria from DSM-III to DSM-IV. American Journal of Psychiatry 2005; 162: 876-882 3. Frías A., Palma C., Farriols N., Becerra C., Álvarez A., Cañete J. Neuropsychological profile and treatment-related features among

Abstract

Introduction: Trichotillomania is a mental disorder characterized by a repetitive and compulsive hair pulling, classified in ICD-10 to a group of habit and impulse disorders, and in the DSM-5 to the group of obsessive-compulsive disorders.

Aim: The aim of the study is to present on the basis of case study:1). the importance of traumatic family experiences in releasing as well as maintaining the symptoms of Trichotillomania, 2). comprehensive medical care, the application of which has resulted in a beneficial therapeutic effect.

Results: In the described case of 16-year-old patient, Trichotillomania was triggered by traumatic events related to lack of support and family stabilization resulting from parental disputes and grandfather’s death, when she was 11 years old. The subsequent years of her life, in spite of the divorce of her parents and their separate residence, abounded in periods of turbulent quarrels between the parents in which she was involved. Each time this type of incident was associated with the recurrence of behavior associated with Trichotil-lomania, the course of which was more severe with the occurrence of self-harm and suicidal thoughts.

Conclusions: 1. In the described case, traumatic events and pathological relations of the immediate family members were not only thetriggering factor, but also maintaining the Trichotillomania symptoms. 2. In accordance with the guidelines of Trichotillomania Learning Center-Scientific Advisory Board (2008), the use of a comprehensive treatment including both the patient - individual psycho-therapy (especially cognitive-behavioral therapy) and pharmacotherapy, as well as her family (family psychotherapy, family mediation, workshops for parents), brought about positive therapeutic effects.

References 1. Antosik-Wójcińska A, Święcicki Ł, Bieńkowski P, Mandat T, Sołtan E. Objawy zespołu Otella po wszczepieniu stymulatora jądra niskowzgórzowego–psychiatryczne działania niepożądane DBS i metody postępowania w ich przypadku. Psychiatr. Pol. 2016; 50(2):323-327. 2. Del Casale A, Kotzalidis GD, Rapinesi C, Serata D, Ambrosi E, Simonetti A et al. Functional neuroimaging in obsessive-compulsive disorder. Neuropsychobiology. 2011; 64:61–85. 3. 3. Antosik-Wójcińska A, Święcicki Ł. Zastosowanie stymulacji DBS w zaburzeniach psychicznych–szanse i zagrożenia

approves implanted brain stimulator to control tremors. Retrieved October 18, 2006 5. Drobisz D., Damborská A. Deep brain stimulation targets for treating depression. Behav Brain Res, 2019; 359, 266-273, doi:10.1016/j.bbr.2018.11.004 6. Grat I., Figee M., Denys D. The application of deep brain stimulation in the treatment of psychiatric disorders 2017; 178-190. 7. Vicheva P, Butler M, Shotbolt P. Deep brain stimulation for obsessive-compulsive disorder: A systematic review of randomised controlled trials. Neuroscience & Biobehavioral Reviews 2020; 109; 129-138. 8

Surg 1994;37:109-13. 82. Glicenstein I, Costa R. Pachydermodactyly: a report of two cases. Chir Main 2004;23:205-7. 83. Al Hammadi A, Hakim M. Pachydermodactyly: case report and review of the literature. J Cutan Med Surg 2007;11:185-7. 84. Cartier H, Guillet MH, Schollhammer M, Guillet G. Pachydermodactilie de l adolescent expression d un mal-etre. Arch Pediatr 1996;3:1091-4. 85. Calikoglu E. Pseudo-knuckle pads: an unusual cutaneous sign of obsessive-compulsive disorder in an adolescent patient. Turk J Pediatr 2003;45:348-9. 86. Fathalla BM, Goldsmith DP

Abstract

Background: Fearful and anxious behaviour is especially common in children, when they come across new situations and experiences. The difference between normal worry and an anxiety disorder is in the severity and in the interference with everyday life and normal developmental steps. Many longitudinal studies in children suggest that anxiety disorders are relatively stable over time and predict anxiety and depressive disorders in adolescence and adulthood. For this reason, the early diagnostic and treatment are needed.

Researchers supposed that anxiety is a result of repeated stress. Additionally, some genetic, neurobiological, developmental factors are also involved in the aetiology.

Methods and subjects: The aim of this article is to summarize and to present our own results obtained with the assessment and treatment of different forms of anxiety disorders in children and adolescents such as: Posttraumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Dental anxiety, General Anxiety Disorder (GAD), and Anxious-phobic syndrome. Some results are published separately in different journals.

a) Post Traumatic Stress Disorder (PTSD) in 10 young children aged 9 ± 2, 05 y. is evaluated and discussed concerning the attachment quality.

b) The group with OCD comprises 20 patients, mean age 14,5 ± 2,2 years, evaluated with Eysenck Personality Questionnaire (EPQ), Child behaviour Checklist (CBCL), K-SADS (Schedule for Affective Disorders and Schizophrenia for School age children), Beck Depression Inventory (BDI), SCWT (Stroop Colour Word task), WCST (Wisconsin Card Scoring test).

c) Dental stress is evaluated in a group of 50 patients; mean age for girls 11,4 ± 2,4 years; for boys 10,7 ± 2,6 years, evaluated with (General Anxiety Scale (GASC), and Eysenck Personality Questionnaire (EPQ).

d) Minnesota Multiphasic Personality Inventory (MMPI) profiles obtained for General Anxiety Disorder in 20 young females and 15 males aged 25,7± 5,35 years, and a group with Panic attack syndrome N=15 aged 19,3±4,9 years are presented and discussed by comparison of the results for healthy people.

e) Heart Rate Variability (HRV) was applied for assessment and treatment in 15 anxious-phobic patients, mean age 12, 5±2,25 years and results are compared with other groups of mental disorder.

Results: Children with PTSD showed a high level of anxiety and stress, somatization and behavioural problems (aggression, impulsivity, non-obedience and nightmares), complemented by hypersensitive and depressed mothers and misattachment in the early period of infancy. Consequently, the explanation of the early predisposition to PTSD was related to be the non-developed Right Orbital Cortex. The later resulted from insecure attachment confirmed in all examined children.

The obtained neuropsychological profile of children with OCD confirmed a clear presence of obsessions and compulsions, average intellectual capacities, but the absence of depressive symptoms. Executive functions were investigated through Event Related Potentials on Go/NoGo tasks. Results showed that no significant clinical manifestations of cognitive dysfunction among children with OCD in the early stage of the disorder are present, but it could be expected to be appearing in the later stage of the disorder if it is no treated.

In a study of 50 children randomly selected, two psychometric instruments were applied for measuring general anxiety and personal characteristics. It was confirmed that there was presence of significant anxiety level (evaluated with GASC) among children undergoing dental intervention. The difference in anxiety scores between girls and boys was also confirmed (girls having higher scores for anxiety). Results obtained with EPQ showed low psychopathological traits, moderate extraversion and neuroticism, but accentuated insincerity (L scale). L scales are lower by increasing of age, but P scores rise with age, which can be related to puberty. No correlation was found between personality traits and anxiety except for neuroticism, which is positively correlated with the level of anxiety.

The obtained profiles for MMPI-201 in a group of patients with general anxiety are presented as a figure. Females showed only Hy peak, but in the normal range. However, statistics confirmed significant difference between scores in anxiety group and control (t= 2, 25164; p= 0, 038749). Males showed Hs-Hy-Pt peaks with higher (pathological) scores, related to hypersensitivity of the autonomic nervous system, as well as with manifested anxiety. Calculation confirmed significant difference between control and anxiety in men (t= 15.13, p=0.000).

Additionally, MMPI profiles for patients with attack panic syndrome are also presented as a figure. Control scales for females showed typical V form (scales 1 and 3) related to conversing tendencies. In addition, females showed peaks on Pt-Sc scales, but in normal ranges. Pathological profile is obtained in males, with Hy-Sc peaks; this profile corresponds to persons with regressive characteristics, emotionally instable and with accentuated social withdraw.

Heart rate variability (HRV) is a measure of the beat to beat variability in heart rate, related to the work of autonomic nervous system. It may serve as a psychophysiological indicator for arousal, emotional state and stress level. We used HRV in both, the assessment and biofeedback training, in a group of anxious-phobic and obsessive-compulsive school children. Results obtained with Eysenck Personality Questionnaire showed significantly higher psychopathological traits, higher neuroticism and lower lie scores. After 15 session HRV training very satisfying results for diminishing stress and anxiety were obtained.

References Abler, B., Kessler, H. (2009). Emotion Regulation Questionnaire – Eine deutsche Version des ERQ von Gross & John. Diagnostica; 55:144–152. Abramovitch, A., Dar, R., Schweiger, A., Hermesh, H. (2011). Neuropsychological impairments and their association with obsessive-compulsive symptom severity in obsessive-compulsive disorder. Archives of Clinical Neuropsychology, 26 (4), 364-376. Araújo, V. (2009). The person in relationship: What is our reference model? Journal for Perspectives of Economic, Political and Social Integration, Vol. XV, nº1-2. Bédard