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Yıl:2018; Cilt: 55; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2018;55(2):127-134
DSM- 5 Kriterlerine Göre Özgül Öğrenme Bozukluğu Tanısı Alan Olguların Psikiyatrik Eştanı ve WISC-R Profillerinin Değerlendirilmesi
MA Altay, I Görker
Edirne Sultan 1. Murat Devlet Hastanesi, Edirne
Amaç: Bu çalışmada, özgül öğrenme bozukluğu tanısı alan çocuk ve ergenlerde psikiyatrik eştanı sıklığı, eştanı sıklığına etki eden faktörler, özgül öğrenme bozukluğu alt tipleri ile bilişsel profil arasındaki ilişkiler araştırılmıştır. Yöntem: Çalışmamız, çocuk ve ergen psikiyatrisi polikliniğimize OcakHaziran 2015 tarihleri arasında ders başarısızlığı ile başvuran özgül öğrenme bozukluğu tanısı alan 6–15 yaş grubu 80 olguyla yapılmıştır. Çalışmada Çocuk ve Ergenlerde Davranış Bozuklukları için DSM-IV’e Dayalı Tarama ve Değerlendirme Ölçeği, Özel Öğrenme Güçlüğü Belirti Ölçeği ve WISC-R testi uygulanmıştır. Görüşme sırasında özgül öğrenme bozukluğu alt grubunu tanımlamak ve hata profilini değerlendirmek amacıyla okuma-yazma-matematik becerileri değerlendirme listesi (hata analizi) uygulanmıştır. Psikiyatrik eştanıların belirlenmesi amacıyla araştırmacı tarafından Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam boyu Şekli Türkçe uyarlaması (ÇDŞG-ŞY) uygulanmıştır. Bulgular: Olguların %92,5’inde eşlik eden bir psikiyatrik bozukluk saptanmıştır. Olgularda en sık görülen psikiyatrik eştanı, dikkat eksikliği ve hiperaktivite bozukluğu (%82,3) olup, bunu özgül fobi (%46,3), karşıt olma karşı gelme bozukluğu (%26,3), enürezis (%25) ve tik bozukluğu (%22,5) izlemektedir. Özgül öğrenme bozukluğuna dikkat eksikliği ve hiperaktivite bozukluğunun eşlik ettiği olgularda daha sık psikiyatrik eştanı bulunmuştur. Özgül öğrenme bozukluğu alt tiplerinden en sık olanı, okuma, yazma ve matematik bozukluğunun birlikte olduğu kombine tip bozukluktur (%37,5). Matematik bozukluğu olan olguların WISC-R puanları daha düşük olduğu bulunmuş, okuma ve yazmayı daha geç öğrendikleri ve eştanı psikiyatrik bozuklukların daha fazla olduğu saptanmıştır. Sonuç: Çalışmamızın sonuçları, özgül öğrenme bozukluğunun diğer psikiyatrik bozukluklarla birlikteliğinin sık olduğunu göstermektedir. Özgül öğrenme bozukluğunun tek bir klinik bozukluk olarak düşünülmemesi, eştanılı psikiyatrik bozukluklarla birlikte değerlendirilip tedavi edilmesi gerekmektedir.
Assessment of Psychiatric Comorbidity and WISC-R Profiles in Cases Diagnosed with Specific Learning Disorder According to DSM-5 Criteria
Introduction: In this study, the frequency of psychiatric comorbidity in children and adolescents who were diagnosed with specific learning disorder, the factors that affect the frequency of comorbidity, the subtypes of specific learning disorder and the effects on cognitive profile have been investigated. Methods: Our study was performed among 80 cases with the age range 6–15 years who diagnosed with specific learning disorder Child and Adolescent Psychiatry Department between January and June 2015. In the study, DSM-IV Based Screening and Evaluation Scale for Child and Adolescent Behavioral Disorders, Specific Learning Disability Evaluation Scale and the WISC-R test were performed. During the interview, reading-writing-math abilities evaluation list (error analysis) was performed in order to define the specific learning disorder subgroup and to evaluate the detailed error profile of the specific learning disorder subgroup. Kiddie Schedule for Affective Disorders and Schizophrenia for School-age Children-Present and Lifetime Turkish Version (KSADS) was performed to detect psychiatric comorbidity diagnoses. Results: 92.5% of the cases have a comorbid psychiatric disorder. The most frequent psychiatric comorbidity was attention deficit hyperactivity disorder (82.3%), followed by specific phobia (46.3%), oppositional defiant disorder (26.3%), enuresis (25%) and tic disorders (22.5%). Psychiatric comorbidity is detected more often in patients with specific learning disorder accompanied by attention deficit and hyperactivity disorder. The most frequent subtype of specific learning disorder is combined type disorder consisting of reading, writing and math disorder (37.5%). The WISC-R score of the patients who had math disorder were found to be lower than the others, and also it was detected that they learned reading and writing later, and have more comorbid psychiatric disorders. Conclusion: The results of our study indicate that associated psychiatric disorders are frequent with specific learning disorder. Specific learning disorder should not be considered as a single disorder, but should be assessed and treated with comorbid psychiatric disorders.

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