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Subglottic cysts are rare causes of stridor in infancy and should be suspected in the case of intubation. A 15-month-old male presented with recurrent stridor and respiratory distress. Prematurity and intubation were present in his history. Two subglottic cysts below the glottis were diagnosed. The cysts were ruptured by flexible bronchoscopy. The child's stridor and other symptoms disappeared thereafter. Early diagnosis of subglottic cysts is important since the obstruction can be relieved by rupturing the cysts with bronchoscope, whereas development of a fibrotic stenosis may require a tracheotomy, with its attending morbidity.

The aim of this study was to test if children with group A beta hemolytic streptococcal infection (GABHS) are more likely to develop neuropsychiatric symptoms or the syndrome of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS) compared to children with GABHS-negative throat cultures. Children aged 8 to 12 years (n = 81) with upper respiratory tract infection were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version, Children's Yale Brown Obsession Compulsion Scale, Yale Global Tic Severity Scale, Child Behavior Checklist for Ages 4-18, Conners Parent Rating Scale, and State-Trait Anxiety Inventory for Children at baseline and six weeks later. One case of PANDAS was diagnosed and no other differences were observed between groups and time points. It was suggested that GABHS infection may be a triggering factor for PANDAS in some genetically prone individuals.

In this study we attempted to investigate the outcome of encopresis and to determine factors affecting prognosis. The sample consisted of 52 boys (77.6%) and 15 girls (22.4%) diagnosed as encopresis according to DSM IV diagnostic criteria. These patients were evaluated six years after their initial examination in the Department of Child Psychiatry. Clinical and demographical data were compared between initial and follow-up interviews and between patients with complete recovery and others. Fifty-six patients (83.6%) recovered completely and 11 (16.4%) continued to be encopretic after six years. Good school performance (p<0.005), high levels of parental education (p<0.005) and absence of constipation (p<0.05) were associated with favorable outcome. In addition, secondary encopretics who were diagnosed within a year from onset of the symptom recovered significantly earlier (p<0.001). Encopresis is a chronic disorder and complete recovery rates tend to increase with time. Families and primary health care providers should be informed about the treatment possibilities of encopresis for early intervention.

Although encopresis is a common and complex disorder, relatively few studies have evaluated the comorbid psychiatric disorders in this condition. This study was performed to investigate the comorbid psychiatric disorders in encopresis. One hundred and sixty boys (79.6%) and 41 girls (20.4%) fulfilled the diagnostic criteria for encopresis according to DSM-IV. There was at least one comorbid diagnosis in 149 (74.1%) patients. The most frequent comorbid diagnosis was enuresis (55.2%). Clinical and demographical data were compared between patients with comorbid disorders and others. Primary encopresis was significantly more frequent in patients with comorbid disorders, and the mean age at admission was lower in these patients. The mean interval between the onset of symptoms and the diagnosis was significantly shorter in secondary encopretic patients with comorbid disorders. Furthermore, there were significantly more psychiatric disorders in the first-degree relatives of patients with comorbid disorders. Encopresis is frequently accompanied with a psychiatric disorder. Clinicians need to inquire about symptoms of other psychiatric disorders in patients who present with encopresis and vice versa.

The purpose of this study was to examine the efficacy and safety of fluoxetine for short-term and long-term treatment in children and adolescents with obsessive-compulsive disorder (OCD). Twenty-three children and adolescents (mean age 12.0, SD = 2.3) treated with fluoxetine for OCD with or without Gilles de la Tourette's syndrome were the subjects of this study. The design was an open-label trial for 20 weeks of fixed-dose fluoxetine (20 mg/day). OCD symptom severity was measured with the Maudsley OCD scale and with Clinical Global Impression Scale (CGI). All of the patients were followed-up after discontinuation of the drug for 24 months. Patients with OCD showed a significant decrease in the severity of their OCD symptoms according to Maudsley OCD scores (p < 0.001) and CGI scores (p < 0.001). Fluoxetine was generally well tolerated, and side effects were relatively mild. Ten patients (43.5%) with OCD who responded to fluoxetine relapsed in the follow-up period, but responded well to fluoxetine. These results indicate that fluoxetine is effective and safe for short-term and long-term treatment of OCD in children and adolescents.

This study was performed to investigate the clinical outcome of childhood masturbation. For this purpose 50 children (mean age = 48.7 +/- 24.5 months, 34 girls females and 16 boys males) with masturbation symptoms were examined at first visit to the Department of Child Psychiatry and two years thereafter with psychiatric interviews. The mean masturbation frequency at the initial interview was significantly decreased after two years. It was noted that 39 children (78%) were completely recovered and 11 children (22%) continued to masturbate after two years. Children who did not recover were significantly younger, began to masturbate earlier and masturbated more frequently than others at the time of initial evaluation. It was concluded that the findings about the beneficial effect of sedative drugs in combination with parental guidance, education and means for behavior modification were promising.

The aim of this study was to determine some of the demographical and clinical characteristics of conversion disorder in children and adolescents and to ascertain comorbidity with depressive and anxiety disorders. For this purpose 51 children and adolescents (mean age: 13.2 +/- 1.9, range: 9-16 years) who met DSM-IV criteria for conversion disorder were compared with a control group. The subjects of this study were mostly postpubertal girls, and pseudoseizure was the most frequent presentation. Misdiagnoses were frequent among these patients. Eight (15.7%) patients received a comorbid diagnosis of major depression and 19 (37.2%) patients had comorbid anxiety disorders according to DSM-IV diagnostic criteria. Significant differences between the two groups on depression and anxiety scales supported the clinical findings. It was concluded that clinicians should screen every patient with conversion disorder for major depression and anxiety disorders for a better outcome.

Neuroleptic malignant syndrome, the most serious and potentially fatal side effect of neuroleptics, is characterized by altered consciousness, extrapyramidal symptoms, hyperthermia, elevated plasma creatine phosphoidnase and leukocytosis. In the child and adolescent population, the syndrome may be underrecognized or underreported. We describe a 15-year-old girl who developed neuroleptic malignant syndrome after a single injection of two different neuroleptics. We find the case interesting because the patient's course was unusual, and she was treated successfully with the combination of diazepam and biperiden. Our aim is to discuss several aspects of the syndrome through this case, particularly the problem of recognition.