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Yıl:2013; Cilt: 24; Sayı: 3>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2013;24(3):158-167
Kronik Tik Bozukluklarında Sosyodemografik, Klinik Özellikler ve Risk Etmenleri
ST Hesapçıoğlu, MK Tural, S Kandil
Muş Devlet Hastanesi, Muş
Amaç: Bu çalışmada Tourette Sendromu (TS) ve kronik motor veya vokal tik bozukluğu (KMVTB) bulunan çocuk ve ergenlerin, sosyodemografik, klinik özelliklerinin, eş hastalanımların incelenmesi ve tik bozukluğu gelişiminin yordayıcılarının saptanması amaçlanmıştır. Yöntem: Çalışmaya TS ve KMVTB olan 57 çocuk ve ergen alınarak kontrol grubu ile karşılaştırıldı. Yale Genel Tik Ağırlığını Derecelendirme Ölçeği, Yıkıcı Davranım Bozuklukları için DSM-IV’e Dayalı Tarama ve Değerlendirme Ölçeği, Çocuklar için Depresyon Envanteri, Çocuklarda Anksiyete Bozukluklarını Tarama Ölçeği, Maudsley Obsesif Kompulsif Bozukluk Ölçeği, Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Versiyonu (ÇDŞG-ŞY) kullanılarak veriler toplandı. Bulgular: Hastaların yaş ortalaması 10,5 ± 2,4 olarak saptandı. Basit motor tikler hastaların 56’sında (%98,2), karmaşık motor tikler 50’sinde (%87,7), ses tikleri ise 43’ünde (%75,4) bulunuyordu. Kendine zarar verme davranışı olguların 24’ünde (%42,1) vardı. Hastaların 46’sında (%80,7) eşlik eden bir veya daha fazla bozukluk mevcuttu. Eşlik eden bozukluklar içinde dikkat eksikliği hiperaktivite bozukluğu (DEHB) %40,4 ile birinci sırayı alıyordu. Bunu %19,3 ile obsesif kompulsif bozukluk takip ediyordu. Lojistik regresyon analizi uygulanarak koruyucu ve risk etmenleri incelendiğinde anne eğitiminin artması, tik bozukluğu bulunması riskini azaltan, DEHB’nin varlığı ise arttıran bir etmen olarak saptandı. Ailede psikiyatrik hastalık bulunması tik bozukluğu riskini 5,61 katına, çocukta tırnak yemenin olması 8,2 katına çıkarıyordu. Çocuklar için Depresyon Ölçeği’nde her bir birimlik artış, riski %12 oranında arttırıyordu. Sonuç: Kronik tik bozukluklarına sıklıkla başka psikiyatrik bozukluklar eşlik etmektedir. Hem çocuk hem de aile kaynaklı nedenler tik bozukluğu gelişimi riskini etkilemektedir. Koruyucu ve risk etmenlerinin bilinmesinin toplumsal ruh sağlığının geliştirilmesi açısından yararlı olabileceği düşünülmektedir.
Sociodemographic/Clinical Characteristics and Risk Factors Associated with Chronic Tic Disorders
Objective: This study aimed to investigate comorbidity, and sociodemographic and clinical characteristics in children and adolescents with Tourette’s syndrome (TS) and chronic motor or vocal tic disorder (CMVTD), and to determine the predictors of tic disorders. Materials and Methods: In all, 57 children and adolescents with TS and CMVTD were compared with a control group. Data were obtained using the Yale Global Tic Severity Scale (YGTSS), Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Children’s Depression Inventory (CDI), Screen for Child Anxiety-Related Disorders (SCARED), Maudsley Obsessive-Compulsive Inventory (MOCI), and Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). Results: Mean age of the patients was 10.5 ± 2.4 years. In all, 56 (98.2%) of the patients had simple motor tics, 50 (87.7%) had complex motor tics, and 43 (75.4%) had vocal tics. Self-injurious behavior was observed in 24 (42.1%) patients. In total, 46 (80.7%) of the patients had ?1 comorbid disorder. Among the observed comorbid disorders, attention deficit-hyperactivity disorder (ADHD) was the most common (observed in 40.4% of the patients), followed by obsessive-compulsive disorder (OCD) (19.3%). A higher-level of maternal education and absence of ADHD were associated with a reduction in the risk of a tic disorder. A family history of psychiatric disorder increased the risk of a tic disorder 5.61-fold, and nail biting increased the risk of a tic disorder 8.2-fold. Every 1-unit increase in CDI score increased the risk of a tic disorder by 12%. Conclusion: Chronic tic disorders (CTDs) are often accompanied by other psychiatric disorders. Both child- and family-related factors are associated with the risk of developing a tic disorder. Determination of both the protective and risk factors would be beneficial for improving the mental health of the general public.

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