Dergi Ara >>
Yıl:2011; Cilt: 12; Sayı: 3>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2011;12(3):177-184
Sivas il merkezinde erişkin DEHB'nin yaygınlığı ve eşlik eden eksen-I, eksen-II tanıları
B Yapıcıoğlu, Ö Kavakcı, AS Güler, M Semiz, O Doğan
Cumhuriyet Üniversitesi Tıp Fakültesi Psikiyatri ABD, Sivas
Amaç: Bu çalışmanın amacı, Sivas il merkezindeki erişkin dikkat eksikliği hiperaktivite bozukluğu (DEHB) yaygın-lığını saptamak, bozukluğu olanların sosyodemografik özelliklerini ve eşlik eden eksen-I ve eksen-II tanı sıklığını saptamaktır. Yöntem: Çalışmada 18-44 yaş aralığındaki 901 kişiye ASRS (Adult ADHD Self Report Scale) uygu-lanarak kesme puanının üzerinde puan alan 34 kişiden, klinik görüşmeyi kabul eden 28 kişiye MINI Plus 5.0.0'ın (International Neuropsychiatric Interview) Çocukluk ve Yetişkinlik Dikkat Yetersizliği ve Aşırı Hareketlilik modülü uygulanmıştır. Erişkin DEHB tanısı konulan bireylere eşlik eden eksen-I ve eksen-II tanılarını saptamak amacıyla SCID-I (Structured Clinical Interview for DSM-IV Axis-I Disorders) ve SCID-II (Structured Clinical Interview for DSM-III-R Personalty Disorders) uygulanmıştır. Bulgular: ASRS ile yapılan tarama sonucunda erişkin DEHB yaygınlığı %3.8 iken, yapılandırılmış klinik görüşme ile bu oran %2.7'ye düşmüştür. Erişkin DEHB tanısı kadın-larda (%83.3) istatistiksel olarak anlamlı düzeyde daha sık bulunmuştur. Çalışmada erişkin DEHB tanısı konan-ların konmayanlara göre anlamlı olarak daha yüksek oranda çalışmadığı, daha sık iş değiştiği, orta düzeyde gelire sahip olduğu, intihar girişimlerinin daha fazla olduğu, daha çok sayıda sigara içtiği, kendilerinde ve ailelerinde psikiyatrik tanıların daha fazla olduğu, daha fazla psikiyatrik yardım aradıkları ve aldıkları saptanmıştır. Hastaların %83'ü nde (20/24) eşlik eden eksen-I tanısı saptanmıştır. En sık konulan eş tanılar, her biri %20.8 oranıyla olmak üzere obsesif kompulsif bozukluk, majör depresyon, distimik bozukluk olmuştur. Hastaların %33.3'ü nde herhangi bir eksen-II tanısı saptanmamıştır. En sık (her biri %25 oranında) obsesif kompulsif kişilik bozukluğu, pasif agresif kişilik bozukluğu tanıları bulunmuştur. Tartışma: DEHB, erişkin dönemde de süren ve başka psikiyatrik bozuk-lukların sıklıkla eşlik ettiği yaygın bir bozukluktur. Klinik uygulamada özellikle tedaviye iyi yanıt vermeyen psikiyatrik bozukluklarda DEHB eş tanısı düşünülmelidir.
Adult ADHD prevalence in Sivas province and comorbid axis-I, axis-II diagnoses
Objective: The purpose of this study was to determine the adult ADHD prevalence in Sivas province, to identify sociodemographic characteristics and comorbid axis-I and axis-II diagnoses in adults with ADHD. Methods: ASRS was administered to 901 subjects between 18-44 [year]s of age and Childhood and Adulthood Attention Deficit and Hyperactivity module of MINI Plus 5.0.0 was administered to 28 out of 34 subjects who had ASRS scores above cutoff point and who accepted clinical interview. SCID-I and SCID-II were used to evaluate co-morbid axis-I and axis-II diagnoses in subjects with ADHD. Findings: Screening with ASRS revealed a prevalence rate of 3.8% which dropped to 2.7% with the structured clinical interview. Adult ADHD was found to be higher (83.3%) in women in this sample which was statistically significant. Subjects with ADHD had lower employ-ment status, more frequent job changes, medium level of income, more suicide attempts, more cigarette con-sumption, more psychiatric diagnoses on behalf of themselves and in their parents and more reported psychiatric need when compared to subjects without ADHD. 83% of the subjects with ADHD (n=20) had comorbid axis I diag-noses. Most common comorbid diagnoses were obsessive compulsive disorder, major depression and dysthymic disorder, each of which were 20.8%. 33.3% of the patients didn?t have any axis II diagnoses. Most common axis II diagnoses were obsessive compulsive personality disorder (25%)and passive aggressive personality disorder (25%). Discussion: In conclusion, the main clinical implication of this study is that ADHD is a persistent diagnosis in adulthood. Given the high prevalence of adult ADHD and its high comorbidity with other psychiatric disorders, ADHD should be considered as a possible comorbid diagnosis for many patients in adult psychiatry clinics, especially for those who show continued impairment despite appropriate treatment or the presenting disorder.

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