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Yıl:2012; Cilt: 50; Sayı: 4>> Özet
TAM METİN
Yeni Symposium; 2012;50(4):237-241
Otizm Spektrum Bozukluğu Bulunan Olguların Otizm Şiddetleri, Psikososyal ve Bilişsel Özellikleri Açısından Değerlendirilmesi
ST Hesapçıoğlu, Z Göker, Ç Bilginer, S Kandil
Muş Devlet Hastanesi
Amaç: Otizm Spektrum Bozuklukları (OSB), 3 yaşından önce ortaya çıkan, tekrarlayıcı ve steryotipik davranışların eşlik ettiği, sosyal ve iletişimsel eksikliklerle karakterize, heterojen bir grup nörogelişimsel hastalıktır. Bu çalışmada otizm spektrum bozukluğu bulunan bireylerin sosyodemografik özellikleri, psikososyal öyküleri, otizm şiddetleri, zekâ düzeyleri ve varsa Elektroensefalografi (EEG) patolojilerinin kesitsel olarak incelenmesi amaçlandı. Yöntem: DSM-IV tanı ölçütlerine göre Yaygın Gelişimsel Bozukluk tanısı konmuş hastalardan OSB olanlar çalışmaya dâhil edildi. Sosyodemografik veri formu doldurularak 'Childhood Autism Rating Scale (CARS)' ölçeği uygulandı. Zekâ düzeyi belirlenmesi amacıyla yönlendirildi ve EEG istendi. Otizm, Başka Türlü Adlandırılamayan Yaygın Gelişimsel Bozukluk, Asperger Sendromu tanıları dışında kalan Yaygın Gelişimsel Bozukluklar (YGB) çalışma dışında bırakıldı. Bulgular: Çalışmaya yaş aralığı 21 ay - 15 yaş arasında olan YGB tanısı almış 16'sı kız (%17.0), 78'i erkek (%83.0) olmak üzere toplam 94 birey dahil edildi. Büyük çoğunluğu Trabzon merkezinden (n=49, %52.1) geliyordu ve önemli bir kısmı şehir merkezlerinde yaşıyordu (n=53, %56.4). Annelerin yaşları 22-46 yaş (ortalama 31.9±5.5), babalarınki ise 25-55 yaş (ortalama 36.8±5.6) arasında değişiyordu. Olguların 85'inde (%90.4) aile öyküsünde tanı konulmuş herhangi bir psikiyatrik hastalık bulunmuyordu. CARS skorlarına göre hastaların 53'ü (%56.4) hafif-orta şiddette, 41'i (%43.6) ağır şiddette otizm bulgusu taşıyordu. Zekâ düzeyi belirlenebilen 77 hastanın 70'i nin (%74.5) zekâ düzeyi 70'i n altındaydı. Bir hastada 90'ın üzerinde zekâ bölümü elde edildi. Tartışma ve Sonuç: OSB etiyolojisinin daha çok biyolojik olduğu, diğer hastalıklar gibi psikososyal çevreden ekilenimin pek olmadığı konusunda görüş birliği sağlanmıştır. Çalışmamızda da eşlik eden nörolojik, zihinsel sorunların yaygınlığı, bu görüşü desteklemektedir. OSB çocukların psikososyal öykülerinin alınması, ayırıcı tanı açısından klinisyene yarar sağlayabilir.
Evaluation of the Cases with Autism Spectrum Disorders in Terms of Autism Severity, Their Psychosocial and Cognitive Characteristic
Purpose: Autism Spectrum Disorders (ASD), usually its symptoms show itself before the child is 3 [year]s old, are heterogeneous neurodevelopmental disorders accompanied by repetitive and stereotypic behaviors and characterized by impairments in the social interaction and communication. In this study, our aim is to investigate the cases with autism spectrum disorders in terms of their socio-demographic characteristics, psychosocial histories, severity of the autism, level of intelligence, and any electroencephalography (EEG) pathologies, cross-sectionally. Method: Among the cases diagnosed with Pervasive Developmental Disorder according to DSM-IV diagnostic criteria, those with ASD were included in the study. For each participant in this study, the data was collected using the socio-demographic data form and Childhood Autism Rating Scale (CARS). EEG was requested from the participants in addition to an intelligence test. Pervasive Developmental Disorders excluding Autism, Pervasive Developmental Disorders-Not Otherwise Specified and Asperger Syndrome were not included in this study. Findings: There were 94 participants in the study: 16 of them were girls (17.0%) and 78 were boys (83.0%). The participants were between 21 [month]s and 15 [year]s old and were diagnosed with YGB. Most of them (n=49, 52.1%) were coming from the city center of Trabzon and a majority of them (n=53, 56.4%) were living in urban areas. The mothers of the participants were between 22 and 46 [year]s old with a mean of 31.9±5.5 [year]s, and the fathers were between 25 and 55 [year]s old with a mean of 36.8±5.6 [year]s. 85 of the participants (90.4%) did not have any diagnosed psychiatric problem in their family history. According to their CARS scores, 53 (56.4%) of the participants had mild to moderate autism symptoms and 41 (43.6%) of them had severe autism symptoms. Among the 77 of the patients had an IQ score, 70 (74.5%) of them had a score below 70. One of the patients had an IQ score above 90. Discussion and Conclusion: There is a consensus among scientists that the etiology of ASD is more biological in comparison with other diseases where the etiology is more psychosocial and environmental. In our study, the abundance of the accompanying neurologic and mental problems supports in this point of view. It can be beneficial for the clinicians to take the psychosocial histories of children with OSB in terms of differential diagnoses.

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