Selective mutism and the anxiety spectrum: a long-term case report

Turkiewicz, Gizela; Castro, Lilian Lerner; Morikawa, Márcia; Costa, Carolina Zadrozny Gouvêa da; Asbahr, Fernando Ramos

doi:10.1590/s1516-44462008000200019

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Current reports advocate the adjunct to behavioral therapy of SSRIs such as fluoxetine, sertraline and paroxetine to help patients with selective mutism and anxiety disorders who do not respond to psychotherapeutic interventions or with a poor outcome as shown by our subject during the first weeks of CBT alone treatment. 17 18 19 …”

Section: Discussionmentioning

confidence: 99%

A Selective Mutism Arising from First Language Attrition, Successfully Treated with Paroxetine-CBT Combination Treatment

Mauro

Andaloro

Maiolino

et al. 2015

Psychiatry Investig

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After immersion in a foreign language, speakers often have difficulty retrieving native-language words and may experience a decrease in its proficiency, this phenomenon, in the non-pathological form, is known as first language attrition. Self-perception of this low native-language proficiency and apprehension occurring when speaking is expected and, may sometimes lead these people to a state of social anxiety and, in extreme forms, can involve the withholding of speech as a primitive tool for self-protection, linking them to selective mutism. We report an unusual case of selective mutism arising from first language attrition in an Italian girl after attending a two-year "German language school", who successfully responded to a paroxetine-cognitive behavioral treatment (CBT) combination treatment.

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Section: Discussionmentioning

confidence: 99%

A Selective Mutism Arising from First Language Attrition, Successfully Treated with Paroxetine-CBT Combination Treatment

Mauro

Andaloro

Maiolino

et al. 2015

Psychiatry Investig

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The use of medication in selective mutism: a systematic review

Manassis

Oerbeck

Øvergaard

2015

Eur Child Adolesc Psychiatry

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Despite limited evidence, selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) are used to reduce symptoms of selective mutism (SM) in children unresponsive to psychosocial interventions. We review existing evidence for the efficacy of these medications, limitations of the literature, and resulting treatment considerations. Bibliographic searches were conducted in Medline, Embase, PsycInfo, Web of Science and Cochrane up to June 2015. Two reviewers independently sought studies of children with SM as primary psychiatric diagnosis, which reported response to medication treatment. Abstracts were limited to those reporting original data. Two reviewers independently assessed the ten papers reporting on >2 subjects regarding study design, key results, and limitations. Heterogeneity of designs mandated a descriptive summary. Symptomatic improvement was found for 66/79 children treated with SSRIs and 4/4 children treated with phenelzine. Only 3/10 studies had unmedicated comparison groups and only two were double-blinded. This review may be affected by publication bias, missed studies, and variability of outcome measures in included studies. Although there is some evidence for symptomatic improvement in SM with medication, especially SSRIs, it is limited by small numbers, lack of comparative trials, lack of consistent measures, and lack of consistent reporting on tolerability. The clinician must weigh this paucity of evidence against the highly debilitating nature of SM, and its adverse effects on the development of those children whose progress with psychosocial interventions is limited or very slow. Studies of optimal dosage and timing of medications in relation to psychosocial treatments are also needed.

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