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Yıl:2022; Cilt: 29; Sayı: 3>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2022;29(3):189-197
Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocuk ve Ergenlerin Tedavisinin İşlevsellikteki Bozulma Üzerine Etkisi
Z Vatansever Pınar , İ D Çimen , M C Tarakçıoğlu , Ö Y Gündoğdu
Kartal Dr. Lütfi Kırdar Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Çalışmada dikkat eksikliği hiperaktivite bozukluğu (DEHB) tanısı almış çocuk ve ergenlerin günlük yaşamlarında yaşadıkları işlevselliklerindeki bozulma düzeyinin 1 yıllık takip ve tedavi sonrasında değişiminin incelenmesi, tedavide kullanılan ilaç türünün işlevsellikteki rolünün, DEHB tedavisinin çocuk ve ergen yaş gruplarındaki işlevselliğe etkisinin retrospektif olarak değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmanın verileri Eylül 2012-Aralık 2020 tarihleri arasında Kocaeli Üniversitesi Tıp Fakültesi Çocuk ve Ergen Psikiyatri Bölümü'nde yarı yapılandırılmış klinik görüşme sonucu DEHB tanısı almış, 6-14 yaş arasında olan, dışlama kriterlerimiz sonucu çalışmaya alınması uygun bulunan hastaların dosyaları geriye doğru taranarak elde edilmiştir. Hastaların sosyodemografik bilgileri değerlendirilmiş, işlevsellik için ilk başvuru ve kontrol randevularında rutin olarak verilen Weiss işlevsellikte bozulma ölçeği ebeveyn formları (WİBÖ-E) ve klinik global izlem (KGİ) ölçekleri değerlendirmeye alınmıştır. Bulgular: Çalışmaya 9’u kız, 45’i erkek toplam 54 hastanın verileri dahil edilmiştir. Katılımcıların 1 yıllık düzenli takip ve tedavi sonrası KGİ ölçekleri puan ortalamalarında belirgin düzelme olduğu saptanmıştır. WİBÖ-E toplam ve çeşitli alt ölçek puanlarında da anlamlı oranda düzelmeler bulunmuş olup işlevsellik alanlarındaki düzelmelerin yaş grupları ve ilaç türleri arasında farklılık gösterdiği gözlenmiştir. Sonuç: DEHB kliniklerimize en sık başvuru sebeplerinden biri olup işlevsellikte ciddi bozulmalara yol açmaktadır. Bu nedenle başvuran hastalarda işlevsellikte bozulma olan alanların değerlendirilmesi önemlidir. Tedavinin bozulma olan bu alanlara ve hastaya göre bireyselleştirilmesi açısından yaş gruplarına göre ihtiyaç olan ve ilaç tedavilerinin etkin olduğu işlevsellik alanlarının saptanması yararlı olacaktır. Yazında DEHB’de işlevselliğin değerlendirildiği sınırlı sayıda çalışma olduğu gözlenmiş olup bu alanda yapılacak çalışmalara ihtiyaç vardır
Effect of Treatment of Children and Adolescents with Attention Defıcit Hyperactivity Disorder on Impaired Functioning
Objectives: In this study, it was aimed to examine the change in functioning impairment in patients diagnosed with attention deficit hyperactivity disorder (ADHD) after 1 year of follow-up and treatment, to evaluate the role of the type of medication used, and the effect of treatment on functionality. Materials and Methods: The data of the study were obtained by retrospectively scanning the files of patients aged 6-14 years, who were diagnosed with ADHD as a result of a semi-structured clinical interview in Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry between September 2012 and December 2020, and who were eligible to be included in the study as a result of our exclusion criteria. The sociodemographic information of the patients was evaluated, the parent forms of the Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P) and the clinical global impressions scales (CGI), which are routinely given at the first admission and control appointments, were evaluated. Results: Data of 54 patients, 9 girls and 45 boys, were included in the study. It was determined that there was a significant improvement in the mean scores of the CGI scales after 1 year of regular follow-up and treatment. Significant improvements were also found in WFIRS-P total and various subscale scores, and it was observed that the improvements in functionality areas differed between age groups and drug types. Conclusion: ADHD is one of the most common reasons for admission to our departments and causes serious impairments in functionality. For this reason, it is important to evaluate the areas with impaired functionality. In terms of individualizing the treatment according to those areas and patients, it will be useful to determine the areas of impaired functioning needing treatment according to age groups and in which areas drug treatments are effective. There are limited studies in the literature addressing functioning in ADHD and further studies in this area are needed.

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