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Yıl:2015; Cilt: 2; Sayı: 2>> Özet
TAM METİN
The Journal of Neurobehavioral Sciences; 2015;2(2):50-55
Madde Kullanım Bozukluğu Olan Hastalarda Dikkat Eksikliğive Hiperaktivite Bozukluğu Tanısı ve Sosyodemografik ve KlinikÖzelliklerle İlişkisi: Retrospektif Bir Çalışma
S Nurmedov, OC Noyan, AE Darçın, O Yılmaz, N Dilbaz
Üsküdar Üniversitesi, İstanbul
Amaç: Madde Kullanım Bozukluğu (MKB), olumsuz sonuçlarına karşın kompulsif madde kullanımının devam ettiği yineleyen, kronik bir hastalıktır. MKB, DEHB’si olan bireylerde, DEHB de MKB’si olan bireylerde daha sıktır. Bu araştırma, DSM-IV TR’ye göre madde bağımlılığı/kötüye kullanımı olan bireylerde DEHB sıklığının ve sosyodemografik ve klinik özellikleri ile ilişkisinin araştırmayı amaçlamıştır. Yöntem: Bu araştırmada 485 hastanın tıbbi kayıtları incelenmiştir. Hastaların hepsi alkol veya madde kötüye kullanımı/bağımlılığı tanısını almıştır. Sosyo-demografik ve klinik özellikleri ile ilgili veriler tıbbi kayıtlardan elde edilmiştir. Bulgular: Araştırmaya dâhil edilen 395 hastanın 37 (%9.4)’si kadın, 358 (%90.6)’sı erkek olduğu ve ortalama yaşlarının 31.53 ±10.44 olduğu tespit edilmiştir. DEHB komorbiditesi 82 (%20.8) hastada tespit edilmiştir. DEHB komorbiditesi olan grupta ortalama yaş DEHB komorbiditesi olmayanlara göre daha düşük olduğu tespit edilmiştir (27.10± [7.87] ile 32.69± [10.73], p<0.05). DEHB’si olmayan grupta remisyon oranı daha düşük bulunmuştur (%48,8 ile %33,2, p<0.05). Esrar ve türevleri DEHB’si olan grupta daha fazla kullanılıyor iken, alkol ve çoğul madde kullanımı DEHB’si olmayan grupta daha sık olduğu tespit edilmiştir (p<0.05). Sonuç: DEHB’si olan hastaların büyük bir kısmının tanısı madde kullanımına başlandıktan sonra konduğu tespit edilmiştir. Bu bulgular, erişkinlerde DEHB tanısının yeterince bilinmediği ve bu konuda daha dikkatli olmamız gerektiğini akla getirmektedir.
Diagnosis of Attention Deficit and Hyperactivity Disorder among patients with Substance Use Disorder and Association with Sociodemographic and Clinical Characteristics: A Retrospective Study
Objective: Substance use disorders (SUD) are chronic, relapsing disorders in which compulsive behaviors persist despite severe negative consequences. SUD is frequent among patients with ADHD and ADHD is frequent among patients with SUD. The aim of this study was to investigate the prevalence of ADHD among patients with substance abuse/dependence according to DSM-IV TR retrospectively, and to demonstrate whether the diagnosis of ADHD is associated with sociodemographic and clinical characteristics of these patients. Method:We analyzed the medical records of 485 patients. All participants were diagnosed as having alcohol or substance abuse/dependence.Socio-demographic and data regarding clinical characteristics were derived from patient records. Results: Of the included 395 participants, 37 (9.4%) were female and 358 (90.6%) were male. The mean age was 31.53±10.44 years. Comorbid ADHD was diagnosed among 82 (20.8%) of all participants. The mean age in ADHD group was significantly lower than that of the group without ADHD (27.10± [7.87] versus 32.69± [10.73], p<0.05).Also, rate of remission was significantly lower in the group without ADHD (%48.8 vs. %33.2, p<0.05). Cannabis and derivatives abuse/dependence were found to be higher in the group with ADHD, whereas alcohol or multidrug abuse/dependence were higher in the group without ADHD comorbidity (p<0.05). Conclusion: In conclusion, we found that in the majority of the participants with ADHD had their diagnosis after the substance use problems had developed. This finding suggests that ADHD can be underdiagnosed in adults and we should be aware of this diagnosis

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