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Possible Basal Ganglia Pathology in Children With Complex Symptoms

J Clin Psychiatry 2003;64:1495-1501

Background: Clinical observation of children presenting with a myriad of motor, behavioral, emotional, and sensorial symptoms who do not respond to treatment led to the hypothesis that these children may constitute a unique population, perhaps even a new clinical entity. The literature on child and adolescent psychopathology does not specifically address the phenomenological, diagnostic, and etiological factors that make these children unique. For this reason, a preliminary study was conducted to identify additional symptoms and features that make these children different.

Method: Data were collected in 2001 on 7 children with complex symptomatology using the Behavior Assessment System for Children, the Anxiety Disorders Interview Schedule for DSM-IV, and a neurological illnesses and symptoms questionnaire designed by the authors.

Results: On average, these children met full DSM-IV criteria for 1 to 5 diagnoses. The most prevalent diagnoses were attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, oppositional defiant disorder, and pervasive developmental disorder. These children also exhibited a high incidence of sensory hyperarousal, aggressiveness, hypersexuality, and neuroethological behaviors. Almost all of the children also had indications of a history of bacterial or viral infection.

Conclusion: The specific symptoms identified and the biological factors found in many of the children seem to suggest basal ganglia involvement.