A Case of Pediatric Post-Traumatic Stress Disorder Presenting as Attention Deficit Hyperactivity Disorder: A Case Report

Abstract

In the past few years, there has been increased recognition that children, who have faced traumatic incidences, can develop post-traumatic stress disorder (PTSD), just like in adults. We present a case of PTSD in a 6-year-old child who endured three surgical procedures because he was suffering from a congenital cranial stenosis (Pfeiffer) syndrome. Because of repetitive painful episodes, resulting from the syndrome, and then post-surgical complications, the child developed behavioral outbursts, hypervigilence, concentration problems, and irritability. In the past, the child was diagnosed with attention deficit hyperactivity disorder (ADHD) in the realm of his behavioral complaints, and he was already on stimulant medications for last one year. But there was no remarkable effect of pharmacotherapy on child’s behavior despite increasing dosages. Ultimately the child’s medical and psychiatric history was reviewed and a diagnosis of pediatric PTSD was made. Stimulant medications were discontinued and management was started on the lines of pediatric PTSD, resulting in a remarkable improvement in child’s psychiatric outcome.

Attention-deficit/hyperactivity disorder: clinical phenotypes, polymorphism of life-course manifestations, and therapeutic strategies

“…Діагноіз РДУГ, як було показано вище, генетично тісно пов'язаний з ПТСР [9]. Обидва розлади часто супроводжуються симптомами тривоги, депресії та хронічного болю [42,43].…”

“…Наявні окремі повідомлення про те, що атомоксетин може бути корисним при лікуванні ПТСР, хронічного больового розладу та депресії у пацієнтів із РДУГ. Він має перевагу над стимулянтами при лікуванні РДУГ із симптомами депресії, зокрема у пацієнтів, які страждають від психічної травми, через те, що лікування препаратами метилфенідату та амфетаміну має більший ризик посилення симптомів депресії [42,43].…”