ABSTRACT CONTEXT: Rapunzel syndrome is a rare form of gastric trichobezoar that develops through outstretching of the bezoar from the stomach to the intestine. CASE REPORT: A 12-year-old girl who had been diagnosed with celiac disease six years earlier was brought to the department of pediatric gastroenterology because of abdominal distension. A palpable mass was detected. A trichobezoar that stretched to the small intestine was removed surgically. The patient was diagnosed as having anxiety and depressive disorder, and treatment started. Following the treatment, her previous trichophagia completely disappeared. CONCLUSION: Presence of trichobezoar should be kept in mind, especially when young girls who have psychiatric problems suffer from gastrointestinal symptoms.

Objectives. The aim of the present study was to investigate psychiatric symptoms in adolescents diagnosed as having chronic gastritis, and to evaluate family functioning. Methods. The population consisted of adolescents who were diagnosed endoscopically and histopathologically as having chronic gastritis without additional chronic disease. The anxiety levels, depression levels, and emotional and behavioral symptoms of the adolescents were measured using the Screen for Child Anxiety Related Emotional Disorders (SCARED), Beck Depression Inventory (BDI), and Strengths and Difficulties Questionnaire (SDQ). Family functioning was evaluated using the Family Assessment Device (FAD). Results. Fifty eight adolescents were included to study. According to the SDQ subscale results, adolescents with gastritis had more problems in emotional, hyperactivity, and peer relations areas, but the results in conduct problems and prosocial behaviors were normal. Levels of all subscales of Family Assessment Device were higher than 2, showing problems in family functioning. Conclusions. This study suggests that adolescents with chronic gastritis experience more difficulties in peer relations and family functioning, and they express more emotional problems.

Objetivos. El objetivo de este estudio fue investigar los síntomas psiquiátricos en adolescentes con diagnóstico de gastritis crónica y evaluar el funcionamiento familiar. Métodos. La población estuvo conformada por adolescentes con diagnóstico endoscópico e histopatológico de gastritis crónica sin otra enfermedad crónica adicional.Se midieron los niveles de ansiedad, los niveles de depresión y los síntomas emocionales y conductuales de los adolescentes mediante el cuestionario para trastornos emocionales infantiles relacionados con la ansiedad (Screen for Child Anxiety Related Disorders, SCARED), el inventario de depresión de Beck (Beck Depression Inventory, BDI) y el cuestionario de capacidades y dificultades (Strengths and Difficulties Questionnaire, SDQ). El funcionamiento familiar se evaluó con el instrumento McMaster de evaluación familiar (McMaster Family Assessment Device, FAD). Resultados. Se incluyó a 58 adolescentes en el estudio.Conforme a los resultados de las subescalas del SDQ, los adolescentes con gastritis tenían más trastornos en las dimensiones de problemas emocionales, hiperactividad y relación con los pares, aunque los resultados de problemas conductuales y conducta prosocial fueron normales. En todas las subescalas del instrumento McMaster de evaluación familiar, los puntajes fueron superiores a 2, lo que indica problemas en el funcionamiento familiar. Conclusiones. según este estudio, los adolescentes con gastritis crónica tienen más dificultades en la relación con los pares y en el funcionamiento familiar, y expresan más problemas emocionales.

ABSTRACT BACKGROUND: Studies have shown that children with anxiety disorders (ADs) present impaired family functioning and quality of life. We aimed to evaluate family functioning and quality of life among children with AD and healthy controls. DESIGN AND SETTING: Cross-sectional study (survey) at two centers in Turkey. METHODS: The study group comprised 42 children diagnosed with AD and 55 controls. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire was filled out by their parents to measure the severity of anxiety symptoms. Family functioning among the children was assessed using the Family Assessment Device (FAD) and Parental Attitude Research Instrument (PARI). The children’s quality of life was assessed through the Pediatric Quality of Life Inventory (PedsQL). RESULTS: The children’s average age was 10.00 ± 0.21 years in the AD group and 9.98 ± 1.53 years among the controls. There were higher scores on all FAD subscales in the AD group (2.15 ± 0.52; 2.29 ± 0.44; 2.44 ± 0.55; 2.10 ± 0.61; 2.56 ± 0.40; 2.32 ± 0.33; and 2.29 ± 0.47). On PARI subscales, there were significant differences favoring the AD group (p < 0.05), except for democratic attitude. All PedsQL subscales differed significantly between the groups, favoring the AD group. A statistically significant relationship was found between all PedsQL subscales and SCARED scores in the AD group. CONCLUSION: We found that both family functioning and quality of life among children with AD were negatively affected. However, further studies with larger sample sizes are required to reach stronger conclusions.

Abstract Introduction: this article examines a boy who was diagnosed with anorexia nervosa at eight years old. Pediatricians and family physicians encountered difficulties during the diagnosis and treatment stages due to the fact that early onset of the disease is rare. Case report: a boy aged eight years and four months presented with bradicardia, malnutrition and dehydration as far away from the preliminary diagnosis of anorexia nervosa investigated for possible organic pathologies at the pediatric ward. Finally, he was diagnosed with early-onset anorexia nervosa and anxiety disorder based on the Diagnostic and Statistical Manual of Mental Disorders 5. Discussion: the case highlights two important points. First, this case report demonstrates a limited awareness of anorexia nervosa and of a psychosomatic or psychiatric origin of weight loss in children among physicians. Second, disrupted eating behaviors and mood changes may be predicting factors for the development of full-blown anorexia nervosa.

Resumen Introducción: se presenta el caso clínico de un niño diagnosticado de anorexia nerviosa a los 8 años. Tanto los pediatras como los médicos de familia tuvieron problemas durante el diagnóstico y en el tratamiento debido a que su aparición a tan corta edad es poco frecuente. Caso clínico: un varón de ocho años y cuatro meses ingresó por bradicardia, desnutrición y deshidratación en un hospital pediátrico. Tras el despistaje de un origen orgánico, se diagnosticó de anorexia nerviosa y trastorno de ansiedad según DSM-5. Discusión: el caso pone de relieve dos aspectos. El primero, demuestra la atención limitada que prestan los médicos a un origen psicosomático o psiquiátrico, incluyendo la anorexia nerviosa, en una pérdida de peso en un niño. El segundo, que una alteración en la conducta alimentaria acompañada de cambios de carácter pueden ser factores predictores del desarrollo de un cuadro de anorexia nerviosa florido.