Objectives
Skin-picking disorders, trichotillomania, and nail biting are all characterized by repetitive behaviors resulting in functional deterioration and remarkable changes in physical appearance with repeated attempts to stop or decrease the behavior. While standard pharmacotherapy for obsessive-compulsive disorder and related disorders consists of serotonergic reuptake inhibitors, their moderate efficacy pushed researchers to find alternative treatment approaches. Some of these alternatives are glutamate-modulating agents. The most widely studied of these glutamate modulator agents is N-acetylcysteine (NAC), which is a derivative of the amino acid cysteine.
Methods
This report describes a case series of 3 patients in whom skin-picking disorders, trichotillomania, and nail biting were diagnosed at a center in Turkey.
Results
First case was a 42-year-old female patient who had been picking her skin from her arm area, especially in stressful times. Second case was a 31-year-old female patient who has a habit of pulling her hair for the last 20 years. The third case was 24-year-old male patient with a habit of eating his own nails that he has had for as long as he could remember. We successfully treated 3 of our patients who suffer from previously mentioned disorders with NAC.
Conclusions
Outcome of our cases demonstrates the efficacy of NAC, which is effective and well tolerated on the treatment of obsessive-compulsive disorder–related disorders.
Some antipsychotic drugs have treatment efficacy for mania and bipolar disorder. However, these drugs may rarely cause manic symptoms in some schizophrenic patients. We hereby report a 22-year-old female patient with schizophrenia who experienced a manic episode during a switch from paliperidone ER to paliperidone palmitate. This case is an important reminder that an abrupt switch from oral paliperidone to paliperidone palmitate may predispose certain patients to hypomanic or manic symptoms.
Trichotillomania (TTM) is a disorder characterized by repetitive hair pulling resulting in hair loss and it is usually difficult to treat with a chronic course of illness. Currently, the selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed drugs for adults with TTM. Various studies and case reports give mixed results. Therefore, the treatment effectiveness of SSRIs remains uncertain. There is a growing interest regarding the use of glutamatergic agents in obsessive compulsive disorder and obsessive compulsive spectrum disorder. Here, we report an 18-year-old female patient with TTM, which successfully treated with glutamate modulator n-acetylcysteine.
Objective: We aimed to investigate possible links between screen time, self-regulation skills and sleep quality in preschool children.
Material and Methods: The study was carried out with 140 mothers with 4-6 years old children who visited the family medicine outpatient clinic between March and May 2022. Children’s age, gender, existing chronic diseases, the most used technological product, purpose of use, time and duration were recorded. Children’s sleep habits were evaluated with the “Children’s Sleep Habits Questionnaire (CSHQ)”, and their self-regulation skills were evaluated with the “Self-Regulation Skills Scale for 4-6 Years-Old Children(Mother Form)(SrSS)”.
Results: The median age of the children in our study was 60 (48-72) months. 75/140 of the participants were girls. The most used technological product at home was the smartphone (48.2%). 64% of the participants reported less than 2 hours screen time, 21.6% of them reported between 2-4 hours and 14.4% of them reported over 4 hours. Educational status of mothers (p=0.003) and fathers (p<0.001) of those with a lot of screen exposure was lower. Delay in falling asleep score, one of the CSHQ subscales, was higher in those with screen exposure over 4 hours (p<0.001). Self-regulation skills scale total score (p=0.001), attention (p=0.014), inhibitory control-emotion (p=0.004), and inhibitory control-behavior (p=0.029) sub-scale scores were lower in children with longer screen time.
Conclusion: Excessive screen exposure in preschool children is associated with delay in falling asleep and low self-regulation skills.
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