Stereotypic movement disorder: Difference between revisions

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'''Stereotypic movement disorder''' ('''SMD''') is a [[motor disorder]] with onset in childhood involving restrictive and/or repetitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results in bodily injury.<ref name=DSM307.3>{{Cite book | author= American Psychiatric Association | year= 2013 | title= Diagnostic and Statistical Manual of Mental Disorders | edition= Fifth | publisher= American Psychiatric Publishing | location= Arlington, VA | pages= [https://archive.org/details/diagnosticstatis0005unse/page/77 77–80] | isbn= 978-0-89042-555-8 | url= https://archive.org/details/diagnosticstatis0005unse/page/77 }}</ref> To be classified as SMD, the behavior in question must not be due to the direct effects of a substance, [[autism]], or another medical condition.<ref name=DSM307.3/> The cause of this disorder is not known.<ref name=MedlinePlus>{{cite web |url= https://www.nlm.nih.gov/medlineplus/ency/article/001548.htm |date= June 15, 2012 |access-date= October 6, 2013 |title= Stereotypic movement disorder |publisher= MedlinePlus}}</ref>

Common repetitive movements of SMD include head banging, arm waving, hand shaking, rocking and rhythmic movements, self-biting, self-hitting, and skin-picking;<ref name=DSM307.3/> other stereotypies are [[thumb-sucking]], dermatophagia, nail biting, [[trichotillomania]], [[bruxism]] and abnormal running or skipping.<ref name=Medscape>{{cite web |vauthors=Ellis CR, Pataki C |url= http://www.emedicine.com/ped/topic909.htm |title= Childhood Habit Behaviors and Stereotypic Movement Disorder |publisher= Medscape |access-date= October 6, 2013}}</ref>

Stereotyped movements are common in infants and young children; if the child is not distressed by movements and daily activities are not impaired, diagnosis is not warranted.<ref name=DSM307.3/> When stereotyped behaviors cause significant impairment in functioning, an evaluation for stereotypic movement disorder is warranted. There are no specific tests for diagnosing this disorder, although some tests may be ordered to rule out other conditions. SMD may occur with [[Lesch–Nyhan syndrome]], intellectual disability, and[[Autistic Spectrum Disorder]], fetal alcohol exposure, or as a result of amphetamine intoxication.<ref name=DSM307.3/>

There is no consistently effective medication for SMD, and there is little evidence for any effective treatment.<ref name=Singer/> In non-autistic people, [[habit reversal training]] may be useful <ref name=Singer/> as well as [[Decoupling for body-focused repetitive behaviors|decoupling]].<ref>{{Cite journal|last1=Lee|first1=Melissa T.|last2=Mpavaenda|first2=Davis N.|last3=Fineberg|first3=Naomi A.|date=2019-04-24|title=Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials|journal=Frontiers in Behavioral Neuroscience|volume=13|pages=79|doi=10.3389/fnbeh.2019.00079|pmid=31105537|pmc=6491945|issn=1662-5153|doi-access=free}}</ref> No treatment is an option when movements are not interfering with daily life.<ref name=Medscape/>

Although not necessary for the diagnosis, individuals with intellectual disability are at higher risk for SMD.<ref name=DSM307.3/> It is more common in boys,<ref name=MedlinePlus/> and can occurhappen at any age.<ref name=MedlinePlus/>

* {{cite journal | author last1= Freeman |first1=RD, |last2=Soltanifar |first2=A, |last3=Baer |first3=S |s2cid-access=free | date = Aug 2010 | title = Stereotypic movement disorder: easily missed | journal = Dev Med Child Neurol | volume = 52 | issue = 8| pages = 733–8 | doi = 10.1111/j.1469-8749.2010.03627.x | pmid = 20187883 | s2cid = 213050 | doi-access = free }}