Özgül öğrenme bozukluğu olan çocuklarda psikiyatrik komorbidite yaygınlığı ve ilişkili değişkenler

Year 2024, Volume: 49 Issue: 3, 521 - 534, 30.09.2024

Serdar Akkuş , Ayla Uzun Cicek , İlknur Ucuz , Cansu Mercan Işık

https://doi.org/10.17826/cumj.1399849

Abstract

Amaç: Psikiyatrik bozukluk komorbiditesi, özgül öğrenme bozukluğunda (ÖÖB) genel popülasyona kıyasla daha fazladır ve son derece yaygındır. ÖÖB ile ilişkili psikiyatrik bozukluklar daha fazla bilişsel, sosyal ve duygusal zorluklara neden olmakta, işlevselliği daha da bozmakta ve prognozu kötüleştirmektedir. Bu çalışmanın amacı, ÖÖB olan çocuklarda psikiyatrik komorbidite sıklığını ve komorbidite ile ilişkili sosyodemografik özellikleri ve klinik değişkenleri incelemektir.
Gereç ve Yöntem: Bu çalışmaya Mart 2021 ile Ağustos 2021 tarihleri arasında polikliniğimize başvuran ve özgül öğrenme güçlüğü tanısı almış 7-17 yaş arasındaki 226 çocuk ve ergenler dahil edilmiştir. Tüm katılımcılara Okuma testi, Yazma testi, Matematik testi, Saat Çizme Testi, Baş Sağ-Sol Ayrım Testi, Bender Gestalt Görsel-Motor Algı Testi uygulanmıştır. Ayrıca Kent-EGY Testi-Porteus Labirent Testi (PMT) veya Weschler Çocuklar için Zeka Ölçeği (WISC-R) uygulanmıştır. Katılımcılar ve ebeveynleri ile yarı yapılandırılmış tanısal görüşme yapılarak geçmişte ve günümüzde herhangi bir psikopatoloji olup olmadığı araştırılmıştır (Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Versiyonu'nun Türkçe versiyonu uygulanmıştır (DSM-5-K-SADS-PL-DSM-5-T).
Bulgular: Katılımcıların %81,4'ünde en az bir komorbid psikiyatrik bozukluk vardı. En sık görülen komorbid bozukluk %73,5 ile dikkat eksikliği hiperaktivite bozukluğudur. Diğer yaygın bozukluklar yıkıcı davranış bozuklukları, eliminasyon bozuklukları, anksiyete bozuklukları, depresif bozukluklar ve tütün kullanım bozukluklarıdır. Psikiyatrik komorbiditeleri olanlarda ağır ÖÖB türleri daha yaygındı ve ortalama yaş, olmayanlara kıyasla önemli ölçüde daha yüksekti.
Sonuç: ÖÖB olan çocukların karşı karşıya olduğu psikiyatrik komorbiditenin farkında olmak, uygun değerlendirme standartlarının oluşturulması, dolayısıyla bu çocuklara kişiselleştirilmiş psikiyatrik bakım sağlanması ve yaşam kalitelerinin artırılması için gereklidir.

Keywords

Özgül öğrenme güçlüğü, Psikiyatrik komorbidite, Dikkat eksikliği hiperaktivite bozukluğu, Duygudurum ve anksiyete bozuklukları, Dışa atım bozuklukları, sigara içmek

Ethical Statement

Etik kurul onayı: Çalışma için Sivas Cumhuriyet Üniversitesi Sağlık Hizmetleri Uygulama ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu'ndan 2021-02/19 karar numarası ile alınmıştır. Hasta onayı: Çalışmaya katılımı sağlamak için ebeveyn ve hasta bilgilendirilip yazılı onam alınmıştır.

Supporting Institution

YOK

Thanks

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Prevalence of psychiatric comorbidity and related variables in children with specific learning disabilities

Abstract

Purpose: Psychiatric comorbidity is more common in specific learning disabilities (SLDs) than in the general population. It is extremely common. Psychiatric disorders associated with SLD cause more cognitive, social, and emotional difficulties, further impair functionality and worsen prognosis. This study aimed to examine the frequency of psychiatric comorbidity and the sociodemographic characteristics and clinical variables associated with comorbidity in children with SLD.
Materials and Methods: This study included 226 children and adolescents aged 7-17 years who were diagnosed with specific learning disabilities and who applied to our outpatient clinic between March 2021 and August 2021. A battery of tests was administered to all participants, including the Reading Test, Writing Test, Mathematics Test, Clock Drawing Test, Head Right-Left Discrimination Test, and Bender Gestalt Visual-Motor Perception Test. In addition, the Kent-EGY Test-Porteus Maze Test (PMT) or the Weschler Intelligence Scale for Children (WISC-R) were administered. A semi-structured diagnostic interview was conducted with the participants and their parents to investigate the presence of any psychopathology in the past and present (Turkish version of the Turkish version of the Schedule for the Interview for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (DSM-5-K-SADS-PL-DSM-5-T) was applied.
Results: There was at least one comorbid psychiatric disorder in 81.4% of the participants. The most common comorbid disorder was attention deficit hyperactivity disorder, with a frequency of 73.5%. Other common disorders were disruptive behavior disorders, elimination disorders, anxiety disorders, depressive disorders, and tobacco use disorders. Severe types of SLD were more common in those with psychiatric comorbidities, and the mean age was significantly higher than in those without.
Conclusion: Being aware of the psychiatric comorbidity that children with SLD are called to face is essential for drawing up proper standards of assessment, hence ensuring these children have personalized psychiatric care and enhancing their quality of life.

Keywords

Specific learning disorder, Psychiatric comorbidity, Attention deficit disorder and hyperactivity, Mood and anxiety disorders, Elimination disorders, Smoking

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