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Yıl:2016; Cilt: 6; Sayı: 4>> Özet
Psikiyatride Güncel; 2016;6(4):265-275
Erişkinlerde DEHB’yi fark etmek!
B Öncü
Ankara Üniversitesi, Ankara
Dikkat eksikliği ve hiperaktivite bozukluğu (DEHB) çocukluk çağında en sık tanı konan psikiyatrik bozukluktur. Tedavi edildiğinde belirgin düzelme sağlanırken tedavisiz kaldığında ciddi psikiyatrik ve sosyal sorunlara yol açabilir. Epidemiyolojik çalışmalara göre erişkinlerdeki sıklığı %2.5-4.9’dur ve erişkinlerde de en sık görülen psikiyatrik bozukluklardandır. Ancak DEHB’li erişkinlerin çok büyük kısmına tanı konmamakta, olguların %90’ı tedavisiz kalmaktadır. Bunun nedenleri arasında i. DEHB’nin erişkin psikiyatrisinde yeterince tanınmaması, ii. DEHB belirtilerinin erişkin dönemde farklı biçimlerde kendini göstermesi, iii. olgulara başka psikiyatrik tanılar konması ve tedavi edilmesi, iv. yüksek eş tanı oranları, v. psikostimulanların kullanımıyla ilgili çekinceler sayılabilir. DEHB dikkat bozuklukları, hareketlilik, içsel huzursuzluk, dürtüsellik belirtilerinin göründüğü pek çok psikiyatrik tabloyla karıştığı için ayırıcı tanı önemlidir. DEHB fark edilmediğinde psikiyatrik yardım için gelen DEHB’li erişkin olgular genellikle duygudurum bozukluğu, anksiyete bozukluğu, alkol ve madde kötüye kullanımı ve bağımlılığı, kişilik bozukluğu ve dürtü kontrol bozukluğu tanılarıyla tedavi olmaktadır. DEHB’li erişkinlerde eş tanı sıklığı %50-87, ortalama eş tanı sayısı 3 olarak bildirilmektedir. Eş tanılar tanı ve tedaviyi daha da komplike hale getirir. DEHB tedavi edilmediğinde eş tanının tedavisi de yetersiz kalmakta ya da başarısız olabilmektedir. Bu yazıda DEHB belirtilerinin erişkin dönemde nasıl gözlemlendiği, DEHB’li olgularda sık görülen diğer belirtiler, DEHB ile karışan ve DEHB ile sıklıkla birlikte görülen psikiyatrik tablolar gözden geçirilecektir.
Recognizing ADHD in adults!
Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric diagnosis of childhood. Efficient treatment of ADHD results with significant improvements. No treatment might lead to serious psychiatric and social problems. Prevalence of adult ADHD varies between 2.5-4.9% in epidemiological studies and it is among the most prevalent psychiatric disorders in adults. However, most adults with ADHD are undiagnosed and 90% of adults with ADHD are untreated. Possible reasons for this might be i. insufficient recognition of ADHD in adult psychiatry, ii. different presentations of ADHD symptoms in adulthood, iii. diagnosing and treating psychiatric conditions other than ADHD and, iv. high comorbidity rates, and v. drawbacks regarding the use of psychostimulant use in adults. ADHD shares similar symptoms with many psychiatric disorders such as attention problems, overactivity, inner restlessness, impulsivity and needs to be differentiated from these disorders. If ADHD goes unnoticed adults with ADHD seeking psychiatric help are mostly diagnosed and treated for mood disorders, anxiety disorders, alcohol and substance abuse and dependency, personality disorders and impulse control disorders. Comorbidity rates of adult ADHD vary between 50-87% and mean number of comorbid conditions is three. Diagnosis and treatment might get complicated as a result of comorbidites. No treatment of ADHD might result with inefficient or unsuccessful treatment of the comorbid condition. Symptoms of adulthood ADHD, other frequent features, comorbid disorders and differential diagnosis issues will be reviewed in this paper.

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