Major Depressive Disorder presenting as a Psychiatric co-morbidity in a child with Prune Belly Syndrome: A Case Report

BACKGROUND: • Prune Belly Syndrome (PBS) is characterized by triad of partial/complete lack of abdominal wall muscles causing wrinkly appearance, bilateral cryptorchidism and urinary tract abnormalities. • It is rare genetic birth defect occurring among 1 in 40,000 births. It is seen in male neonates. • Children with PBS tend to face difficulties in everyday life ranging from personal, interpersonal, social and academic impairment due to associated physical anomalies like laxity of abdominal wall and urinary incontinence. • Such difficulties can act as risk factors for development of co-morbid major depressive disorder among children who are suffering from PBS. • Index child was 14 years old. AIM: • To assess presence and severity of comorbid major depressive disorder among index child with Prune Belly Syndrome. METHOD: • Beck’s Depression Inventory in Hindi (BDI-H) was applied to assess severity of depression as vernacular/native language of index child was Hindi. RESULTS: • On initial assessment, child had score of 25 on BDI-H which was suggestive of severe depression. • Child was started on tablet Sertraline 25mg/day and tablet Clonazepam 0.50mg/day, which were gradually titrated to the dose of 50mg/day and 0.25mg/day during subsequent visits. • At the end of fourth week, clonazepam was stopped and on Sertraline 50mg/day, BDI-H score was 4 which was suggestive of clinically insignificant depression. CONCLUSION: • This case report had depicted a rare genetic case of prune belly syndrome presenting to psychiatry outpatient with major depressive disorder. • Timely diagnosis of psychiatric co-morbidity, its management and proper referral may play a crucial role in better outcome.