Diagnosis and treatment of obsessive compulsive behavior in a boy with Duchenne muscular dystrophy and autism spectrum disorder: A case report.
We describe a case study of comorbid obsessive-compulsive disorder (OCD) in a nine-year-old boy with Duchenne muscular dystrophy (DMD). Patient history included persistent deficits in social communication and restrictive and repetitive patterns of behavior: a diagnosis of autism spectrum was formalized. Due to serious disruption on social functioning and negative development of the obsessive behavior we decided to start pharmacotherapy. Fluoxetine 5 mg/day was started and gradually increased to 20 mg/day. A significant positive effect was observed by both parents and teacher in daily functioning. Although parents reported a positive change in mood, formal behavior rating by them did not reveal a significant effect, reflecting the insensitivity of general behavior rating scales. However, neuropsychological testing revealed a significant effect. This case report highlights the diagnostic and therapeutic challenges of complex neuropsychiatric comorbidities in DMD. It is the first scientific report on fluoxetine effectiveness in this patient group. Further research is needed.
Center of Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: hendriksenj@kempenhaeghe.nl.
Jos G M
JG
Hendriksen
Center of Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
Sylvia
S
Klinkenberg
Center of Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands; Koraalgroep, Gastenhof, Maasbracht, The Netherlands.
Phillipe
P
Collin
Division of Pediatric Neurology, Cincinnati Children's Hospital Medical Center, USA.
Brenda
B
Wong
Department of Neurology, Leiden University Medical Center, The Netherlands.
Erik H
EH
Niks
Center of Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
Johan S
JS
Vles
D000067877:Autism Spectrum Disorder / Q000150:complications* / Q000628:therapy; D002648:Child; D015897:Comorbidity; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications* / Q000523:psychology / Q000628:therapy; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors