Stressor-related disorders in tuberous sclerosis.
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.
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA, Department of Pediatric Neurology, Vall d'Hebron Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain. E-mail: ethiele@partners.org.
Susana
S
Boronat
Agnies M
AM
Van Eeghen
Julianna E
JE
Shinnick
Peter
P
Newberry
Elizabeth A
EA
Thiele
D000275:Adjustment Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D013997:Time Factors; D014402:Tuberous Sclerosis / Q000453:epidemiology / Q000503:physiopathology*; D055815:Young Adult