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Yıl:2014; Cilt: 15; Sayı: 3>> Özet
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Anadolu Psikiyatri Dergisi; 2014;15(3):221-229
Erişkin Tip Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Bipolar Bozukluk Tip-I Hastalarının Mizaç ve Kişilik Özellikleri
N Oğuz, T Oral, M Oğuz
İzmir Katip Çelebi Üniversitesi, İzmir
Amaç: Daha önce yapılan çalışmalarda bipolar I bozukluğunda mizaç ve kişilik araştırılmış ancak erişkin DEHB nin eşlik ettiği bipolar I hastalarında mizaç ve kişilik araştırılmamıştır. Bu çalışmada amaç remisyonda olan bipolar I hastalarında DEHB nin mizaç ve kişilik üzerinde farklılık oluşturup oluşturmadığını kontrol grubu ile karşılaştırarak gözlemlemektir. Yöntem: Daha önceden bipolar I bozukluğu tanısı ile izlenen (n=121) hastalar (kadın 71, erkek 50) yaş, cinsiyet ve eğitim açısından eşleştirilmiş bilinen bir psikiyatrik hastalığı olmayan kontrol grubu (n=100 kadın 55 erkek 45) ile karşılaştırılmıştır. Tüm hastalara ve kontrol grubuna detaylı sosyodemografik form uygulandıktan sonra DSM IV ölçütlerine göre çocukluk çağı ve erişkin DEHB tanısı ve diğer eksen I tanıları için SCID I ve SCID II uygulanmıştır. Tüm hastalar ve kontrol grubuyla erişkin ve çocukluk DEHB tanısı için klinik görüşme yapılmıştır. Hastaların ve kontrol grubunun Erişkin Dikkat Eksikliği Hiperaktivite Ölçeğini doldurmaları istenmiştir. Ayrıca hastaların ve kontrol grubunun TEMPS-A anketini doldurmaları istenmiştir. Bulgular: Bipolar I hastalarında %22.3 (n=27) kontrol grubunda %8 (n=8) erişkin DEHB tanısı konmuştur. Bipolar I hastalarında “hafif şiddette” depresif ve anksiyöz mizaç gözlenmiştir. Erişkin DEHB’ nin eşlik ettiği bipolar I hastalarında hiç hafif şiddette dönem görülmezken, koruyucu tedavi başlangıcı daha erken, koruyucu tedavi süresi daha uzundur. DEHB nin eşlik ettiği bipolar I hastalarında DEHB nin eşlik etmediği bipolar I hastalarından mizaç tipi açısından bir farklılık gözlenmezken; kişilik bozukluğu açısından belirgin bir farklılık gözlenmiştir. DEHB nin eşlik etmediği bipolar I hastalarında hiç antisosyal kişilik bozukluğu gözlenmemiştir. Sonuç: DEHB nin eşlik ettiği bipolar I bozukluğu kliniğinin daha farklı olduğu, bu farkın eşlik eden kişilik bozukluğundan kaynaklanabileceği, bunun da DEHB’nin bipolar I bozukluğu üzerindeki etkisi olabileceği öne sürülebilir.
Temperament and Personality Traits of Bipolar Disorder I Patients Comorbid with Adult ADHD
Objective: Temperament and personality in bipolar I patients have been studied but temperament and personality in bipolar I patients comorbid with adult ADHD have not been studied. The aim of this study was to determine the effect of ADHD on the temperament and personality of bipolar I patients in remission. Materials and Method: Patients with a bipolar I disorder diagnosis (n=121) (female 71, male 50) were matched with control group with no known psychiatric illness (n=100 female 55 male 45) according to age, sex, education were recruited from consecutive admissions. Information about the characteristics of patients and control group were obtained from sociodemographic form, SCID-I, SCID-II. All patients were interviewed for the presence and history of current adult and childhood ADHD diagnosis. The subjects also completed the Adult ADD/ADHD DSM-IV Based Diagnostic and Screening Rating Scale Turkish version and the Turkish version of TEMPS-A scale. Results: Adult ADHD diagnosis were observed in bipolar I patients with 22.3% (n=27) and in control group with 8% (n=8). The mild depressive and anxious temperaments were observed in bipolar I patients. The bipolar patients comorbid with adult ADHD were observed to have moderate/severe episodes, earlier and longer maintenance treatment periods. Both groups didnot differ in terms of temperament. Antisocial personality disorder were observed only in bipolar I patients comorbid with adult ADHD. Conclusion: Bipolar I disorder comorbid with adult ADHD has significant clinical implications which may relate to a personality disorder. This may be due to the influence of ADHD on bipolar I disorder.

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