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Özgül öğrenme bozukluğu olan çocuklarda psikiyatrik komorbidite yaygınlığı ve ilişkili değişkenler

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

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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References

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC, American Psychiatric Association.
  • Altay MA, Görker I. Assessment of psychiatric comorbidity and WISC-R profiles in cases diagnosed with specific learning disorder according to DSM-5 criteria. Noro Psikiyatri Ars. 2017;55:127–34.
  • Bandla S, Mandadi GD, Bhogaraju A. Specific learning disabilities and psychiatric comorbidities in school children in South India. Indian J Psychol Med. 2017;39:76–82.
  • Coşkun GN, Gürbüz HGA, Çeri V, Doğangün B. Psychiatric comorbidities in children with specific learning disability. Anadolu Psikiyatri Derg. 2018;19:87-94.
  • Khodeir MS, El-Sady SR, Mohammed HAER. The prevalence of psychiatric comorbid disorders among children with specific learning disorders: a systematic review. The Egyptian J Otolaryngology. 2020;36:1-10.
  • Sahoo MK, Biswas H, Padhy SK. Psychological co-morbidity in children with specific learning disorders. J Family Med Prim Care. 2015;4:21–25.
  • Törő KT, Miklósi M, Horanyi E, Kovács GP, Balázs J. Reading Disability Spectrum: Early and late recognition, subthreshold, and full comorbidity. J Learn Disabil. 2018;51:158–67.
  • Willcutt EG, Pennington BF. Psychiatric comorbidity in children and adolescents with reading disability. J Child Psychol Psychiatry. 2000;41:1039–48.
  • Willcutt EG, Pennington BF. Comorbidity of reading disability and attention-deficit/hyperactivity disorder: differences by gender and subtype. J Learn Disabil. 2000;33:179–91.
  • Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry.1997;36:980-8.
  • Ünal F, Öktem F, Çetin Çuhadaroğlu F, Reliability and validity of the schedule for affective disorders and schizophrenia for school-age children–present and lifetime version, DSM-5 November 2016–Turkish adaptation (K-SADS-PL-DSM-5-T). Turk Psikiyatri Derg. 2019;30:42-50.
  • Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36:980-88.
  • Gökler B, Ünal F, Pehlivantürk B, Çengel-Kültür E, Akdemir D, Taner Y. Okul çağı çocukları için duygulanım bozuklukları ve şizofreni görüşme çizelgesi-şimdi ve yaşam boyu şekli-türkçe uyarlamasının geçerlik ve güvenirliği. Çocuk ve Gençlik Ruh Sağlığı Dergisi. 2004;11:109-16.
  • Öner N Psychological Tests Used in Turkey, A Reference Source, 3rd ed. İstanbul, Boğaziçi University Publications, 1997.
  • Porteus SD. Porteus Maze Tests: Fifty Years' Application. Pacific Books. 1965.
  • Togrol B. The application and comparison of the porteus maze intelligence test with forms 2A and 2B of the RB Cattell intelligence test to 25 female and 25 male Turkish students aged 12.5 years. PhD Thesis. İstanbul, Tec. Institute of Psychology, 1972.
  • Gökçe Sarıpınar E, Erden G Usability of tests measuring academic skills and sensory-motor functions in reading disability. Turk Psikiyatri Derg. 2010; 25:56–66.
  • Wechsler D. Manual for The Wechsler Intelligence Scale for Children-Revised. New York, Psychological Corporation, 1974.
  • Savaşır I, Şahin N. Weschler Çocuklar İçin Zeka Ölçeği (WISC-R) El Kitabı. Ankara, Türk Psikologlar Derneği Yayınları, 1995.
  • Çutuk ZA, Kaya M. Depresyon, Anksiyete Ve Stres Ölçeği (DASS-42) lise formu: Türkçe geçerlik ve güvenirliği. Elektronik Sosyal Bilimler Dergisi. 2018;17:1327-36.
  • Zahn–Waxler C., Klimes–Dougan B, Slattery MJ. Internalizing problems of childhood and adolescence: prospects, pitfalls, and progress in understanding the development of anxiety and depression. Dev Psychopathol. 2000;12.3:443-66.
  • Hart SA, Petrill SA, Willcutt E. Exploring how symptoms of attention-deficit/hyperactivity disorder are related to reading and mathematics performance: general genes, general environments. Psychol Sci. 2010;21:1708–15.
  • Liederman J, Kantrowitz L, Flannery K. Male vulnerability to reading disability is not likely to be a myth: a call for new data. J Learn Disabil. 2005;38:109-29.
  • Oswald DP, Best AM, Coutinho MJ, Nagle HAL. Trends in the special education identification rates of boys and girls: A call for research and change. Exceptionality. 2003;11:223–37.
  • DuPaul GJ, Stoner G. ADHD in the schools: Assessment and intervention strategies. 3rd ed. New York, NY: Guilford. 2015.
  • Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164:942–48.
  • DuPaul GJ, Volpe RJ. ADHD and learning disabilities: Research findings and clinical implications. Curr Atten Disord Rep. 2009;1:152-55.
  • Wadsworth SJ, DeFries JC, Willcutt EG, Pennington BF, Olson RK. The Colorado longitudinal twin study of reading difficulties and ADHD: Etiologies of comorbidity and stability. Twin Res Hum Genet. 2015;18:755–61.
  • Willcutt EG, Pennington BF, Olson RK. Neuropsychological analyses of comorbidity between reading disability and attention deficit hyperactivity disorder: in search of the common deficit. Dev Neuropsychol. 2005;27:35–78.
  • Willcutt EG, Pennington BF, Smith SD, Cardon LR, Gayán J, Knopik VS et al. Quantitative trait locus for reading disability on chromosome 6p is pleiotropic for attention-deficit/hyperactivity disorder. Am J Med Genet. 2002;114:260-8.
  • Cheung CH, Frazier-Wood AC, Asherson P, Shared cognitive impairments and etiology in ADHD symptoms and reading difficulties. PloS One. 2014;9:e98590.
  • DuPaul GJ, Gormley MJ, Laracy SD. Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment. J Learn Disabil. 2013;46:43–51.
  • Maughan B, Pickles A, Hagell A. Reading problems and antisocial behavior: developmental trends in comorbidity. J Child Psychol Psychiatry. 1996;37:405–18.
  • Huc-Chabrolle M, Barthez MA, Tripi G. Psychocognitive and psychiatric disorders associated with developmental dyslexia: A clinical and scientific issue. L'Encephale. 2010;36:172-9.
  • Smith T, Adams G. The effect of comorbid AD/HD and learning disabilities on parent-reported behavioral and academic outcomes of children. Learn Disabil Q. 2006;29:101-12.
  • Esposito M, Carotenuto M, Roccella M. Primary nocturnal enuresis and learning disability. Minerva Pediatr. 2011;63:99–104.
  • De Bruyne E, Van Hoecke E, Van Gompel K, Verbeken S, Baeyens D, Hoebeke P et al. Problem behavior, parental stress and enuresis. J Urol. 2009;182:2015–20.
  • Brunelle K, Abdulle S, Gorey KM. Anxiety and depression among socioeconomically vulnerable students with learning disabilities: Exploratory meta-analysis. Child Adolesc Soc Work J. 2020;37:359–67.
  • Francis DA, Caruana N, Hudson JL, McArthur GM. The association between poor reading and internalizing problems: A systematic review and meta-analysis. Clin Psychol Rev. 2019;67:45–60.
  • Nelson JM, Harwood H. Learning disabilities and anxiety: a meta-analysis. J Learn Disabil. 2011;44:3–17.
  • Grills-Taquechel AE, Fletcher JM, Vaughn SR, Stuebing KK. Anxiety and reading difficulties in early elementary school: evidence for unidirectional- or bi-directional relations? Child Psychiatry Hum Dev. 2012;43:35–47.
  • Nelson JM, Gregg N. Depression and anxiety among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. J Atten Disord. 2012;16:244–54.
  • Nazeer A, Latif F, Mondal A. Obsessive-compulsive disorder in children and adolescents: epidemiology, diagnosis and management. Transl Pediatr. 2020;9:76–93.
  • Eapen V, Robertson MM, Alsobrook JP 2nd, Pauls DL. Obsessive compulsive symptoms in gilles de la tourette syndrome and obsessive compulsive disorder: differences by diagnosis and family history. Am J Med Genet. 1997;74:432-38.
  • Molina BS, Pelham WE. Substance use, substance abuse, and LD among adolescents with a childhood history of ADHD. J Learn Disabil. 2001;34:333–51.
  • McNamara J, Vervaeke SL, Willoughby T. Learning disabilities and risk-taking behavior in adolescents: a comparison of those with and without comorbid attention-deficit/hyperactivity disorder. J Learn Disabil. 2008;41:561–74.

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

Year 2024, Volume: 49 Issue: 3, 521 - 534, 30.09.2024
https://doi.org/10.17826/cumj.1399849

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.

References

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC, American Psychiatric Association.
  • Altay MA, Görker I. Assessment of psychiatric comorbidity and WISC-R profiles in cases diagnosed with specific learning disorder according to DSM-5 criteria. Noro Psikiyatri Ars. 2017;55:127–34.
  • Bandla S, Mandadi GD, Bhogaraju A. Specific learning disabilities and psychiatric comorbidities in school children in South India. Indian J Psychol Med. 2017;39:76–82.
  • Coşkun GN, Gürbüz HGA, Çeri V, Doğangün B. Psychiatric comorbidities in children with specific learning disability. Anadolu Psikiyatri Derg. 2018;19:87-94.
  • Khodeir MS, El-Sady SR, Mohammed HAER. The prevalence of psychiatric comorbid disorders among children with specific learning disorders: a systematic review. The Egyptian J Otolaryngology. 2020;36:1-10.
  • Sahoo MK, Biswas H, Padhy SK. Psychological co-morbidity in children with specific learning disorders. J Family Med Prim Care. 2015;4:21–25.
  • Törő KT, Miklósi M, Horanyi E, Kovács GP, Balázs J. Reading Disability Spectrum: Early and late recognition, subthreshold, and full comorbidity. J Learn Disabil. 2018;51:158–67.
  • Willcutt EG, Pennington BF. Psychiatric comorbidity in children and adolescents with reading disability. J Child Psychol Psychiatry. 2000;41:1039–48.
  • Willcutt EG, Pennington BF. Comorbidity of reading disability and attention-deficit/hyperactivity disorder: differences by gender and subtype. J Learn Disabil. 2000;33:179–91.
  • Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry.1997;36:980-8.
  • Ünal F, Öktem F, Çetin Çuhadaroğlu F, Reliability and validity of the schedule for affective disorders and schizophrenia for school-age children–present and lifetime version, DSM-5 November 2016–Turkish adaptation (K-SADS-PL-DSM-5-T). Turk Psikiyatri Derg. 2019;30:42-50.
  • Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36:980-88.
  • Gökler B, Ünal F, Pehlivantürk B, Çengel-Kültür E, Akdemir D, Taner Y. Okul çağı çocukları için duygulanım bozuklukları ve şizofreni görüşme çizelgesi-şimdi ve yaşam boyu şekli-türkçe uyarlamasının geçerlik ve güvenirliği. Çocuk ve Gençlik Ruh Sağlığı Dergisi. 2004;11:109-16.
  • Öner N Psychological Tests Used in Turkey, A Reference Source, 3rd ed. İstanbul, Boğaziçi University Publications, 1997.
  • Porteus SD. Porteus Maze Tests: Fifty Years' Application. Pacific Books. 1965.
  • Togrol B. The application and comparison of the porteus maze intelligence test with forms 2A and 2B of the RB Cattell intelligence test to 25 female and 25 male Turkish students aged 12.5 years. PhD Thesis. İstanbul, Tec. Institute of Psychology, 1972.
  • Gökçe Sarıpınar E, Erden G Usability of tests measuring academic skills and sensory-motor functions in reading disability. Turk Psikiyatri Derg. 2010; 25:56–66.
  • Wechsler D. Manual for The Wechsler Intelligence Scale for Children-Revised. New York, Psychological Corporation, 1974.
  • Savaşır I, Şahin N. Weschler Çocuklar İçin Zeka Ölçeği (WISC-R) El Kitabı. Ankara, Türk Psikologlar Derneği Yayınları, 1995.
  • Çutuk ZA, Kaya M. Depresyon, Anksiyete Ve Stres Ölçeği (DASS-42) lise formu: Türkçe geçerlik ve güvenirliği. Elektronik Sosyal Bilimler Dergisi. 2018;17:1327-36.
  • Zahn–Waxler C., Klimes–Dougan B, Slattery MJ. Internalizing problems of childhood and adolescence: prospects, pitfalls, and progress in understanding the development of anxiety and depression. Dev Psychopathol. 2000;12.3:443-66.
  • Hart SA, Petrill SA, Willcutt E. Exploring how symptoms of attention-deficit/hyperactivity disorder are related to reading and mathematics performance: general genes, general environments. Psychol Sci. 2010;21:1708–15.
  • Liederman J, Kantrowitz L, Flannery K. Male vulnerability to reading disability is not likely to be a myth: a call for new data. J Learn Disabil. 2005;38:109-29.
  • Oswald DP, Best AM, Coutinho MJ, Nagle HAL. Trends in the special education identification rates of boys and girls: A call for research and change. Exceptionality. 2003;11:223–37.
  • DuPaul GJ, Stoner G. ADHD in the schools: Assessment and intervention strategies. 3rd ed. New York, NY: Guilford. 2015.
  • Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164:942–48.
  • DuPaul GJ, Volpe RJ. ADHD and learning disabilities: Research findings and clinical implications. Curr Atten Disord Rep. 2009;1:152-55.
  • Wadsworth SJ, DeFries JC, Willcutt EG, Pennington BF, Olson RK. The Colorado longitudinal twin study of reading difficulties and ADHD: Etiologies of comorbidity and stability. Twin Res Hum Genet. 2015;18:755–61.
  • Willcutt EG, Pennington BF, Olson RK. Neuropsychological analyses of comorbidity between reading disability and attention deficit hyperactivity disorder: in search of the common deficit. Dev Neuropsychol. 2005;27:35–78.
  • Willcutt EG, Pennington BF, Smith SD, Cardon LR, Gayán J, Knopik VS et al. Quantitative trait locus for reading disability on chromosome 6p is pleiotropic for attention-deficit/hyperactivity disorder. Am J Med Genet. 2002;114:260-8.
  • Cheung CH, Frazier-Wood AC, Asherson P, Shared cognitive impairments and etiology in ADHD symptoms and reading difficulties. PloS One. 2014;9:e98590.
  • DuPaul GJ, Gormley MJ, Laracy SD. Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment. J Learn Disabil. 2013;46:43–51.
  • Maughan B, Pickles A, Hagell A. Reading problems and antisocial behavior: developmental trends in comorbidity. J Child Psychol Psychiatry. 1996;37:405–18.
  • Huc-Chabrolle M, Barthez MA, Tripi G. Psychocognitive and psychiatric disorders associated with developmental dyslexia: A clinical and scientific issue. L'Encephale. 2010;36:172-9.
  • Smith T, Adams G. The effect of comorbid AD/HD and learning disabilities on parent-reported behavioral and academic outcomes of children. Learn Disabil Q. 2006;29:101-12.
  • Esposito M, Carotenuto M, Roccella M. Primary nocturnal enuresis and learning disability. Minerva Pediatr. 2011;63:99–104.
  • De Bruyne E, Van Hoecke E, Van Gompel K, Verbeken S, Baeyens D, Hoebeke P et al. Problem behavior, parental stress and enuresis. J Urol. 2009;182:2015–20.
  • Brunelle K, Abdulle S, Gorey KM. Anxiety and depression among socioeconomically vulnerable students with learning disabilities: Exploratory meta-analysis. Child Adolesc Soc Work J. 2020;37:359–67.
  • Francis DA, Caruana N, Hudson JL, McArthur GM. The association between poor reading and internalizing problems: A systematic review and meta-analysis. Clin Psychol Rev. 2019;67:45–60.
  • Nelson JM, Harwood H. Learning disabilities and anxiety: a meta-analysis. J Learn Disabil. 2011;44:3–17.
  • Grills-Taquechel AE, Fletcher JM, Vaughn SR, Stuebing KK. Anxiety and reading difficulties in early elementary school: evidence for unidirectional- or bi-directional relations? Child Psychiatry Hum Dev. 2012;43:35–47.
  • Nelson JM, Gregg N. Depression and anxiety among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. J Atten Disord. 2012;16:244–54.
  • Nazeer A, Latif F, Mondal A. Obsessive-compulsive disorder in children and adolescents: epidemiology, diagnosis and management. Transl Pediatr. 2020;9:76–93.
  • Eapen V, Robertson MM, Alsobrook JP 2nd, Pauls DL. Obsessive compulsive symptoms in gilles de la tourette syndrome and obsessive compulsive disorder: differences by diagnosis and family history. Am J Med Genet. 1997;74:432-38.
  • Molina BS, Pelham WE. Substance use, substance abuse, and LD among adolescents with a childhood history of ADHD. J Learn Disabil. 2001;34:333–51.
  • McNamara J, Vervaeke SL, Willoughby T. Learning disabilities and risk-taking behavior in adolescents: a comparison of those with and without comorbid attention-deficit/hyperactivity disorder. J Learn Disabil. 2008;41:561–74.
There are 46 citations in total.

Details

Primary Language English
Subjects Child and Adolescent Psychiatry
Journal Section Research
Authors

Serdar Akkuş 0000-0002-9978-6861

Ayla Uzun Cicek 0000-0003-2274-3457

İlknur Ucuz 0000-0003-1986-4688

Cansu Mercan Işık 0000-0001-9437-3024

Publication Date September 30, 2024
Submission Date December 4, 2023
Acceptance Date June 22, 2024
Published in Issue Year 2024 Volume: 49 Issue: 3

Cite

MLA Akkuş, Serdar et al. “Prevalence of Psychiatric Comorbidity and Related Variables in Children With Specific Learning Disabilities”. Cukurova Medical Journal, vol. 49, no. 3, 2024, pp. 521-34, doi:10.17826/cumj.1399849.