XXXX in @entity6038 : epidemiology and management.

@entity1 @entity1032 @entity3119 @entity146 @entity7298 @entity914 @entity74 @entity716 @entity717 @entity6038 @entity8882
Although @entity1 with @entity717 are at increased risk for @entity146 , the type and rate of these problems differ between those with different causes for their retardation. In this paper, we review behavioural and @entity146 problems in @entity1 with @entity6038 , @entity74 caused by a paternally derived deletion at chromosome 15(q11-q13) in about 70% of affected @entity1 , and by @entity8882 in the majority of the remaining @entity1 . In addition to the syndrome's characteristic @entity7298 and food seeking, individuals with @entity6038 also have increased risks of nonfood, compulsive behaviours. These include skin picking, which is highly prevalent, as well as more variable rates of hoarding, redoing and concerns with symmetry, exactness, cleanliness, ordering and arranging. Relative to others with @entity1032 , @entity1 with @entity6038 are at a marked increased risk for developing full-blown, @entity3119 . In addition, many @entity1 with @entity6038 show increased rates of tantrums, oppositionality and @entity146 . Recent findings suggest that they also have an increased risk of @entity914 or affective illness with a @entity716 component, especially young adult @entity1 and those with the @entity8882 as opposed to paternal deletion. Dietary approaches include a reduced-calorie diet and increased physical activity, as well as close supervision around food and keeping food locked away. To date, neither CNS stimulants nor anorectic agents have been effective in treating @entity7298 , in part because @entity7298 in @entity6038 is attributed to decreased satiation as opposed to increased hunger. Treatment for @entity3119 and maladaptive behaviours include: behavioural programming; a structured, predictable routine; extra help with transitions; family support; and pharmacotherapy. Although formal drug studies have yet to be conducted, SSRIs have been effective in reducing skin picking, @entity3119 and @entity146 episodes in some individuals with @entity6038 . Atypical antipsychotics have also proven helpful in @entity1 with @entity146 and impulsivity. Largely on the basis of case studies, the risks and benefits of these and other drugs in @entity6038 are reviewed. Drug trials that move beyond case studies and that assess the relative efficacy of behavioural treatments alone or in combination with pharmacotherapy are sorely needed.
