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Yıl:2016; Cilt: 2; Sayı: 1>> Özet
Türkiye Klinikleri Çocuk Psikiyatrisi Özel Dergisi; 2016;2(1):19-24
Bipolar Bozukluk Tanılı Çocuk ve Ergenlerde Klinik, Tanı ve Ayırıcı Tanı
SA Güney, Nİ Emiroğlu
Dokuz Eylül Üniversitesi, İzmir
Bipolar bozukluk (BB), duygu, düşünce, davranış ve algıda dönemsel dalgalanmaların gözlendiği bir duygudurum bozukluğudur. Daha önceleri manik depresyon olarak adlandırılan bipolar bozukluğun geçmişte çocuk ve ergenlerde çok seyrek görüldüğü düşünülmekteydi. Bununla birlikte bipolar bozukluk tanılı erişkinlerin yaklaşık beşte birinde hastalığa ait belirtilerin başlangıç yaşı ergenlik dönemidir. Poligenik araştırmalar, (psikozun eşlik ettiği ya da eşlik etmediği) bu bozukluğun şizoafektif bozukluk ve şizofreniden fenotipik açıdan ayrı bozukluklar olduğuna işaret etmektedir. Zihinsel Bozuklukların Tanısal ve İstatistiksel El Kitabı, V. Baskı (DSM-V), BB'luğu erişkin başlangıçlı, çocukluk dönemi veya ergenlik başlangıçlı olarak ayırmamaktadır. Bununla birlikte, BB'luğa ait tanılama ölçütleri de hastalığın başlangıç yaşından bağımsız olarak benzerdir. BB'luğun gidişinde var olan, çocuk veya ergende de klinik olarak önemli farklılılara rağmen, yaş dönemleri temel alınarak bir tanısal uyarlama yapılmamıştır. Bununla birlikte pediyatrik popülasyonda BB erişkin tip BB'un ağır tipine ait karakteristik özelliklerin yanı sıra, hızlı dugudurum değişimlerinin (mani/depresyon) gözlendiği, duygudurum epizodları arasında ötimik dönemlerin kısa sürdüğü, yüksek oranda psikiyatrik eş tanıların görüldüğü bir durumdur.Bu yazında çocuk ve ergenlerde görülen BB'nin klinik görünümü, tanı ve ayırıcı tanısının tartışılması amaçlanmıştır.
Clinical Presentation, Diagnosis and Differential Diagnosis in Children and Adolescents with Bipolar Disorder
Bipolar disorder(BD) is a mood disorder in which feelings, thoughts, behaviors, and perceptions are altered in the context of episodes. Previously known as manic depression, BD was once thought to occur rarely in youth. However, approximately one out of five adults with BD had symptoms beginning in adolescence. Polygenic investigations indicate that this disorder is phenotypically separate (with or without psychosis) from schizoaffective disorders and schizophrenia. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) does not distinguish adultonset from childhood- or adolescent-onset symptoms of BD. However, the diagnostic criteria for BDare the same regardless of the patient's age at the onset of disease. Despite clinically important differences in the prognosis BD, in children and adolescents, no diagnostic accommodation have yet been made on the basis of age. However pediatric presentation of BD shares characteristics of severe adult BD, with rapid changes in mood (depression/mania), shorter periods of uthymia between mood episodes, and high rates of psychiatric comorbidity. In this article, it has been aimed to discuss about clinical presentation, diagnosis and differantial diagnosis of pediatric BD.

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