Journal of the American Academy of Child & Adolescent Psychiatry
ArticlesAggression and Psychiatric Comorbidity in Children With Hypothalamic Hamartomas and Their Unaffected Siblings
Section snippets
Patient Sample and Comparison Sample
The study was approved by the Institutional Review Board of the National Institute of Neurological Disorders and Stroke. The patient sample included 12 children between the ages of 3 and 14 years. Parents gave informed consent for all children participating. Children 7 years of age and older were asked for, and provided, assent to participate in the study. Subjects were recruited from around the United States, mainly from the Hypothalamic Hamartoma With Uncontrolled Gelastic Seizures (HHUGS)
RESULTS
Parents of 10 (83.3%) of the 12 patients with hypothalamic hamartomas reported significant problems of aggression, rage, temper outbursts and tantrums, violence, and other manifestations of emotional lability. Of the two children reported not to be aggressive, only one child had no behavioral abnormalities. A 4-year-old was described as nonaggressive, but demonstrated speech, learning, and communication deficits. Eight patients (66.7%) were receiving anticonvulsant and psychotropic medications
DISCUSSION
The findings of this study of 12 patients with hypothalamic hamartomas and gelastic seizures are as follows: (1) compared with sibling controls, these children demonstrate significantly more expressions of aggression and rage; (2) these expressions of aggression and rage are more affective than predatory in nature; (3) by parent report, these patients demonstrate behaviors that meet DSM-IV criteria for oppositional defiant disorder, ADHD, conduct disorder, and mood and anxiety disorders more
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This paper was edited with the help of Marisa Alter, B.S., Tamar Yemini, B.A., and Lisa Korenman, B.S.