ERGENLERDE BİPOLAR BOZUKLUK: TEDAVİ STRATEJİLERİ VE EŞ TANILAR

Abstract

Giriş: Bipolar bozukluk, genç nüfusta bilişsel ve fonksiyonel bozukluklar, intihar girişimleri gibi sonuçları nedeniyle önemli bir morbidite ve mortalite nedenidir. Erişkinlikte bipolar bozukluk tanısı konulan olguların genellikle ilk olarak ergenlik döneminde şikayetlerinin başladığı bilinmektedir. Ergen yaş grubunda tanınması ve tedavisi önemli olan bu bozukluğun kliniğimiz Ergen Ünitesinde eş tanı ve tedavi stratejilerini incelemeyi amaçladık. Yöntem: Ankara Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı Ergen Ünitesi polikliniğine Haziran 2016-Mayıs 2017 tarihleri arasında ayaktan başvuran bipolar bozukluk tanılı olguların dosyaları retrospektif olarak taranmıştır. Olguların eştanıları ve aldıkları tedaviler gözden geçirilmiş, veriler arasındaki ilişkiler istatistiksel analizler ile değerlendirilmiştir. Sonuçlar: 31 kadın (%66, yaş ort: 19,48), 16 erkek (%34, yaş ort: 18,94) olmak üzere 47 olgu çalışmaya dahil edilmiştir. Eş tanı sıklığı %59,6 olup, en sık eş tanılar; dikkat eksikliği ve hiperaktivite bozukluğu, mental retardasyon ve obsesif kompulsif bozukluktur. Olguların %87,2'si duygudurum düzenleyici, % 93,6'sı antipsikotik, %19,1’i antidepresan kullanmaktadır. Eş tanı varlığında çoklu ilaç kullanımının anlamlı derecede fazla olduğu saptanmıştır. Tartışma: Ergen bipolar bozuklukta örneklemimizde eş tanı ve çoklu ilaç kullanım oranlarının yüksek olduğu görülmektedir. Ergenlerde tanının zorluğu, ilaç tedavisi alan ergenlerin genellikle şiddetli belirtileri ve eşlik eden bozukluklarının olması bu durum üzerinde etkili olabilir.

Keywords

• ergen,bipolar bozukluk,eştanı,tedavi,dehb,psikostimülan

BIPOLAR DISORDER IN ADOLESCENTS: TREATMENT STRATEGIES AND COMORBIDITIES

Abstract

Introduction: Bipolar disorder is an important cause of morbidity and mortality because of its consequences such as cognitive/functional disorders and suicide attempts. Most of the cases that diagnosed as bipolar disorder in adulthood are known to have the symptoms since adolescence. Since recognition and treatment of this disorder is crucial in adulthood, we aim to investigate the comorbidities and treatment strategies of bipolar disorder in Adulthood Unit in our clinic. Method: The folders of the patients who admitted the Ankara University Department of Psychiatry Adulthood Outpatient Clinic between June 2016-May 2017 and diagnosed as bipolar disorder are searched retrospectively. Comorbidities and treatments of these patients are investigated, the relations between this data are analyzed with statistical analyses. Results: 47 cases; 31 female (66%, mean age: 19,48), 16 male (34%, mean age: 18,94) are included in the study. The rate of comorbidity is 59,6%, the most common comorbidities are; attention deficit and hyperactivity disorder, mental retardation and obsessive-compulsive disorder. 87,2% of the cases use mood stabilizer, 93,6% use antipsychotic drugs and 19,1% use antidepressants. Multiple drug use is significantly greater in the cases with comorbidities. Discussion: In our sample with adulthood bipolar disorder, the rates of comorbidity and multiple drug use are high. The difficulty of diagnosing in adolescents, the adolescents that use pharmacological treatment being the ones that have more severe symptoms and comorbidities may be the reason for these results.

Keywords

• Adolescent,bipolar disorder,comorbidity,adhd,psychostimulan

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