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Yıl:2020; Cilt: 57; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2020;57(4):283-289
DSM-IV’e Göre Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) Olan Çocuk ve Ergenlerde DEHB Alt Tiplerinde Psikiyatrik Eş Tanı Varlığı
M İpçi, SB İnci İzmir, MH Türkçapar, K Özdel, ÜA Ardıç, ES Ercan
Hasan Kalyoncu Üniversitesi, Kocaeli
Amaç: Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) tanısı alan çocuk ve ergenlerde %60–80 oranında eşlik eden en az bir eş tanı olduğu bilinmektedir. Bu çalışmada DEHB tanısı alan çocuk ve ergenlerde DEHB’ye ve DEHB’nin alt tiplerine eşlik eden psikiyatrik tanılar araştırılmıştır. Yöntem: Araştırmanın örneklemini İzmir ilinde bir çocuk ergen psikiyatri kliniğine ilk kez başvuran ve bir psikiyatrist tarafından yapılan görüşme sonucunda ilk kez DEHB tanısı alan, 8–15 yaşları arasındaki 326 çocuk ve ergen oluşturmuştur. Çalışmada tüm görüşmelerde Sosyodemografik Veri Formu, Yıkıcı Davranış Bozukluklarını Tarama ve Değerlendirme Ölçeği ve Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi – Şimdi ve Yaşam Boyu Şekli psikiyatrik eş tanıları belirlemek amacıyla kullanılmıştır. Bulgular: DEHB’ye eşlik eden psikiyatrik tanılar Yıkıcı Davranım Bozuklukları (%28,8), Majör Depresyon (%13,2), Obsesif Kompulsif Bozukluk (%9,5) ve Anksiyete Bozuklukları (%6,1)’dır. DEHB-Bileşik Tip olan olgularda en sık görülen eş tanı Karşıt Olma Karşı Gelme Bozukluğu ve Davranım Bozukluğu; DEHB-Dikkat Eksikliği alt tip olan olgularda Anksiyete Bozuklukları olarak belirlenmiştir. Tartışma: Özellikle DEHB-Bileşik tipe sahip olan olgularda daha fazla eşlik eden eş tanının bulunması hem hastalık şiddetini arttırmakta, hem tedaviye yanıtı geciktirmekte hem de prognozu kötüleştirmektedir. Bu nedenle DEHB’ye hangi tanıların eşlik ettiğini belirlemek son derece önemlidir
Psychiatric Comorbidity in the Subtypes of ADHD in Children and Adolescents with ADHD According to DSM-IV
Introduction: The prevalence rate of psychiatric comorbidity in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) was 60–80%. The objective of this study was to examine comorbid disorders associated with ADHD and the subtypes of ADHD in children and adolescents with the diagnosis of ADHD. Method: The study included 326 children and adolescents aged between 8–15 years who were diagnosed with ADHD for the first time as a result of an interview by psychiatry, in a child adolescent psychiatry clinic in Izmir. Sociodemographic form, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale and Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version were used to assess psychiatric comorbidity. Results: The comorbidities accompanied ADHD were disruptive behavior disorder (28.8%), depressive disorder (13.2%), obsessivecompulsive disorder (9.5%) and anxiety disorder (6.1%), in respectively. When the subtypes of ADHD were assessed according to psychiatric comorbidity, oppositional defiant disorder and conduct disorder were frequently seen with ADHD combined type, whereas anxiety disorder was seen more frequent in children diagnosed with ADHD inattentive type. Discussion: Especially the presents of comorbidities in cases with ADHD Combined type increases the severity of disease, causes to retard in responses to treatment and exacerbates prognosis. Therefore, it is very important to determine which psychiatric diagnosis accompany with ADHD

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