Abstract
Selective Mutism (SM) is a disorder characterized by the individual's persistent inability to speak in specific social situations (e.g., school) where speech is expected, even though the individual is able to speak in other situations. It is a rare anxiety disorder and is often seen in children between the ages of 4-8. The presence of SM in family members is important in terms of both etiology and clinical course. While family burden is a factor that increases the incidence of SM, according to some research results, the clinical symptoms of twin cases diagnosed with SM are more severe than those of non-twins. A positive family history negatively affects the prognosis of SM and increases resistance to treatment. In this article, the diagnosis and treatment process of 14-year-old monozygotic twin adolescents who have been followed up with the diagnosis of SM for a long time will be discussed. The main treatment methods for SM are medication and psychotherapy. It is known that psychotherapeutic interventions in particular vary depending on individual differences. The most important purpose of this article is to draw attention to the differences in treatment interventions of twin SM cases and to evaluate the clinical features of the cases in the light of the literature.
Keywords
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Arlington (VA): American Psychiatric Association; 2013.
- Hua A, Major N. Selective mutism. Curr Opin Pediatr. 2016;28(1):114-120. doi:10.1097/MOP.0000000000000300
- Dogru H, Ucuz I, Uzun Cicek A, Comertoglu Arslan S. Clinical characteristics according to sex and symptom severity in children with selective mutism: a four-center study. Nord J Psychiatry. 2023;77(2):158-164. doi:10.1080/08039488.2022.2146748
- Viana AG, Beidel DC, Rabian B. Selective mutism: a review and integration of the last 15 years. Clin Psychol Rev. 2009;29(1):57-67. doi:10.1016/j.cpr.2008.09.009
- Remschmidt H, Poller M, Herpertz-Dahlmann B, Hennighausen K, Gutenbrunner C. A follow-up study of 45 patients with elective mutism. Eur Arch Psychiatry Clin Neurosci. 2001;251(6):284-296. doi:10.1007/pl00007547
- Smith-Schrandt HL, Ellington E. Unable to Speak: Selective Mutism in Youth. J Psychosoc Nurs Ment Health Serv. 2018;56(2):14-18. doi:10.3928/02793695-20180122-04
- Oerbeck B, Overgaard KR, Stein MB, Pripp AH, Kristensen H. Treatment of selective mutism: a 5-year follow-up study. Eur Child Adolesc Psychiatry. 2018;27(8):997-1009. doi:10.1007/s00787-018-1110-7
- Segal N. 'Two' quiet: monozygotic female twins with selective mutism. Clin Child Psychol Psychiatry. 2003;8(4):473-488. doi:10.1177/13591045030084005
- Sharkey L, Mc Nicholas F. Female monozygotic twins with selective mutism--a case report. J Dev Behav Pediatr. 2006;27(2):129-133. doi:10.1097/00004703-200604000-00008
- Tachibana R, Nakamura K, Schichiri K, et al. Elective mutism in twins. Jpn J Child Adolesc Psychiatry. 1982;23:277-286.
- Dummit ES, Klein RG, Tancer NK, Asche B, Martin J, Fairbanks JA. Systematic assessment of 50 children with selective mutism. J Am Acad Child Adolesc Psychiatry. 1997;36(5):653-660. doi:10.1097/00004583-199705000-00016
- Mora G, Devault S, Schopler E. Dynamics and psychotherapy of identical twins with elective mutism. J Child Psychol Psychiatry. 1962;3:41-52. doi:10.1111/j.1469-7610.1962.tb02037.x
Abstract
Selektif mutizm (SM), bireyin başka durumlarda konuşuyor olmasına karşın, konuşmasının beklendiği özgül toplumsal durumlar (örn. okul), sürekli bir biçimde, konuşamıyor olması ile karakterize bir bozukluktur. Nadir görülen bir anksiyete bozukluğu olup sıklıkla çocuklarda 4-8 yaş aralığında görülmektedir. Aile bireylerinde SM varlığı hem etiyoloji hem de klinik gidişat açısından önemlidir. Aile yüklülüğü SM’nin görülme sıklığını artıran bir faktör iken bazı araştırma sonuçlarına göre, SM tanısı olan ikiz olguların klinik semptomları ikiz olmayanlara göre daha şiddetlidir. Aile öyküsünün pozitif olması SM’de klinik gidişatı olumsuz etkilemekte, tedaviye direnci artırmaktadır. Bu yazıda, 14 yaşlarında, uzun süredir SM tanısı ile takip edilen monozigot ikiz ergenlerin tanı ve tedavi süreci ele alınacaktır. SM’de başlıca tedavi yöntemi ilaç tedavisi ve psikoterapidir. Özellikle psikoterapötik müdahalelerin bireysel farklılıklar doğrultusunda çeşitlilik gösterdiği bilinmektedir. Bu yazının en önemli amacı, ikiz SM olgularının tedavi müdahalelerindeki farklılığa dikkat çekmek ve olguların klinik özelliklerini literatür eşliğinde değerlendirmektir.
Keywords
Ethical Statement
Written informed consent for the presentation and publication of the case was obtained from the patients and their parents on the condition that the patients' anonymity must be preserved.
Supporting Institution
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Thanks
The authors would like to thank the patients and their family for collaborating in the study.
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Arlington (VA): American Psychiatric Association; 2013.
- Hua A, Major N. Selective mutism. Curr Opin Pediatr. 2016;28(1):114-120. doi:10.1097/MOP.0000000000000300
- Dogru H, Ucuz I, Uzun Cicek A, Comertoglu Arslan S. Clinical characteristics according to sex and symptom severity in children with selective mutism: a four-center study. Nord J Psychiatry. 2023;77(2):158-164. doi:10.1080/08039488.2022.2146748
- Viana AG, Beidel DC, Rabian B. Selective mutism: a review and integration of the last 15 years. Clin Psychol Rev. 2009;29(1):57-67. doi:10.1016/j.cpr.2008.09.009
- Remschmidt H, Poller M, Herpertz-Dahlmann B, Hennighausen K, Gutenbrunner C. A follow-up study of 45 patients with elective mutism. Eur Arch Psychiatry Clin Neurosci. 2001;251(6):284-296. doi:10.1007/pl00007547
- Smith-Schrandt HL, Ellington E. Unable to Speak: Selective Mutism in Youth. J Psychosoc Nurs Ment Health Serv. 2018;56(2):14-18. doi:10.3928/02793695-20180122-04
- Oerbeck B, Overgaard KR, Stein MB, Pripp AH, Kristensen H. Treatment of selective mutism: a 5-year follow-up study. Eur Child Adolesc Psychiatry. 2018;27(8):997-1009. doi:10.1007/s00787-018-1110-7
- Segal N. 'Two' quiet: monozygotic female twins with selective mutism. Clin Child Psychol Psychiatry. 2003;8(4):473-488. doi:10.1177/13591045030084005
- Sharkey L, Mc Nicholas F. Female monozygotic twins with selective mutism--a case report. J Dev Behav Pediatr. 2006;27(2):129-133. doi:10.1097/00004703-200604000-00008
- Tachibana R, Nakamura K, Schichiri K, et al. Elective mutism in twins. Jpn J Child Adolesc Psychiatry. 1982;23:277-286.
- Dummit ES, Klein RG, Tancer NK, Asche B, Martin J, Fairbanks JA. Systematic assessment of 50 children with selective mutism. J Am Acad Child Adolesc Psychiatry. 1997;36(5):653-660. doi:10.1097/00004583-199705000-00016
- Mora G, Devault S, Schopler E. Dynamics and psychotherapy of identical twins with elective mutism. J Child Psychol Psychiatry. 1962;3:41-52. doi:10.1111/j.1469-7610.1962.tb02037.x
Details
| Primary Language | English |
|---|---|
| Subjects | Mental Health Services |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | June 29, 2024 |
| Submission Date | April 4, 2024 |
| Acceptance Date | May 31, 2024 |
| Published in Issue | Year 2024 |