Celik Gonca, Diler Rasim Somer, Tahiroglu Aysegul Yolga, Avci Ayşe
Department of Child and Adolescent Psychiatry, Cukurova University, Adana, Turkey 01330.
J Child Adolesc Psychopharmacol. 2007 Apr;17(2):233-6. doi: 10.1089/cap.2006.0057.
Feeding disorders of infancy or early childhood are relatively uncommon in the pediatric population. In posttraumatic eating disorder, the infant demonstrates food refusal after a traumatic event or repeated traumatic events to the oropharynx or esophagus. We present case reports of 24-month-old twin girls, A and B, who presented to our clinic with food refusal and fear of feeding. Several invasive gastrointestinal procedures were performed when they were 3 months old, and they started to refuse all solid food and some liquids soon after hospitalization. Fluoxetine 0.3 mg/kg per day (5 mg/day) was started to target their anxiety and fear about feeding. In the second month of weekly follow up, the children began to be fed without a nasogastric catheter. A significant decrease in anxiety and fear was observed during feeding. Although the use of serotonin-selective reuptake inhibitors (SSRIs) in preschool children is controversial due to the lack of empirical data in this age group, we observed clinical improvements in anxiety in these two cases. Furthermore, fluoxetine was well tolerated and no side effects were observed.
婴儿期或幼儿期喂养障碍在儿科人群中相对不常见。在创伤后进食障碍中,婴儿在经历一次或多次口咽或食管创伤事件后会出现食物拒绝。我们报告了一对24个月大的双胞胎女孩A和B的病例,她们因食物拒绝和害怕进食前来我们诊所就诊。她们3个月大时接受了几次侵入性胃肠道手术,住院后不久就开始拒绝所有固体食物和一些液体。开始每天给予0.3 mg/kg(5 mg/天)的氟西汀,以针对她们对进食的焦虑和恐惧。在每周随访的第二个月,孩子们开始不用鼻胃管进食。喂食期间观察到焦虑和恐惧显著减轻。尽管由于该年龄组缺乏经验数据,5-羟色胺选择性再摄取抑制剂(SSRI)在学龄前儿童中的使用存在争议,但我们在这两个病例中观察到焦虑症状有临床改善。此外,氟西汀耐受性良好,未观察到副作用。