Type I diabetes mellitus is the most common endocrinologic disorder affecting pediatric patients. Diet regimen adaptations in patients with diabetes may result in focusing on only diet and weight control, which causes eating disorders more often in these patients. Diabulimia is an eating disorder specific to patients with diabetes characterized by limiting and/or skipping insulin dosing. It is well observed that diet management and insulin treatment are withheld for body appearence and social acceptance issues, especially in patients whose disease is diagnosed during adolescence. We hereby present a patient who was diagnosed as having diabetes at the age of 12 years and skipped insulin doses in order to control weight and was subsequently diagnosed as having diabulimia. (Turk Pediatri Ars 2017; 52: 46-9)
Attention deficit hyperactivity disorder (ADHD) is one of the most common disorders in childhood which deficits of inattention, hyperactivity and impulsive behavior. Disruptive mood dysregulation disorder is characterized by severe recurrent temper outbursts that are inconsistent with developmental level and manifest verbally or behaviorally. The disorder can co-exist with ADHD and conduct disorder. In treatment of ADHD most common used pharmacological agent is methylphenidate. Atypical antipsychotics (e.g. risperidone, aripiprazole, olanzapine) can be added to treatment in some cases because of unsatisfactory clinical response and comorbidities such as conduct disorder, pervasive developmental disorders, disruptive mood dysregulation disorder, mental retardation. Olanzapine is one of the Food and Drug Administration approved atypical antipsychotics which antagonizing the dopamine (D1, D2, D4), serotonine (5-HT2A, 5-HT2C, 5-HT6), histamine (H1), alpha1-adrenergic and muscarinic (especially M1) receptors. It is used increasingly for the treatment mood disorders, schizophrenia, conduct disorder and pervasive developmental disorders at child and adolescent psychiatry clinics. Studies pointed that olanzapine causes mostly dry mouth, weith gain, increase apetite, sedation and hyperlipidemia. In this article, we report a 8-year-old male patient treated with olanzapine and OROS methylphenidate who have ADHD, disruptive mood dysregulation disorder and conduct disorder. This issue want to get attention that these two psychopharmacologic agent is usable concominantly ADHD and comorbidities.
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