Epilepsili Çocuklarda Psikopatoloji, Yaşam Kalitesi ve Ebeveynlerinde Psikopatoloji Taraması

Yıl 2018, Cilt: 16 Sayı: 1, 55 - 68, 01.04.2018

Sevgi Özmen , Esra Demirci Hatice Doğan Saliha Demirel Özsoy Hüseyin Per Didem Behice Öztop

Öz

GİRİŞ ve AMAÇ: Epilepsi en sık görülen kronik nörolojik bozukluklardan biridir. Epilepsili çocukların
sağlıklı çocuklara ve diğer kronik hastalıkları olan çocuklara göre daha çok psikiyatrik hastalığa sahip
olduğu bilinmektedir. Bu çalışma ile epilepsili çocuklardaki psikopatoloji, yaşam kalitesi algıları,
ebeveynlerindeki psikopatolojiyi belirlemek amaçlanmıştır.

YÖNTEM ve GEREÇLER: Çalışmaya 48 epilepsili çocuk ve 48 sağlıklı çocuk ve ailesi dahil edildi.
Değerlendirmeler için Ankara Gelişim Tarama Envanteri (AGTE), Kısa 1-3 Yaş Sosyal ve Duygusal
Değerlendirme Ölçeği (K-1/3SDD), Erken Çocukluk Envanteri–4: Ebeveyn Formu (EÇE-4: EF),
Çocuklar için Yaşam Kalitesi Ölçeği (ÇİYKÖ), Ruhsal Belirti Tarama testi (SCL-90) kullanıldı.

BULGULAR: 1-3 yaş grubundaki epilepsili çocukların sosyal ve duygusal değerlendirme ölçek puanları
kontrol grubu ile benzer bulundu. 4-6 yaş çocukları için EÇE-4: EF ile yapılan değerlendirmede, dikkat
eksikliği hiperaktivite bozukluğu (DEHB), distimik bozukluk, yaygın anksiyete bozukluğu (YAB),
travma sonrası stres bozukluğu (TSSB) ve eliminasyon bozuklukları kontrollere kıyasla yüksek oranda
tespit edildi. Epilepsili grubun annelerinde somatizasyon, depresyon, anksiyete, öfke-düşmanlık, fobik
anksiyete ve ek skala puanları anlamlı derecede yüksek bulunmuştur. Epilepsili grubun yaşam kalitesi
toplam puan ve alt ölçek puanları kontrol grubu ile benzer tespit edildi.

TARTIŞMA ve SONUÇ: Bu çalışmada 1-3 yaş grubu epilepsili çocuklarda her hangi bir psikopatoloji
saptanmazken, 4-6 yaş epilepsili çocuklarda psikopatoloji sıklığı artmıştır. Epilepsili çocukların
annelerinde ruhsal belirti sıklığının arttığı tespit edilmiştir.

ABSTRACT

INTRODUCTION: Epilepsy is one of the most common chronic neurological disorders. It is known
that epileptic children have more psychiatric diseases than normal population and children with other
chronic diseases. The present study was aimed to identify the psychopathology of children with epilepsy,
their life quality and the psychopathology of their parents.

METHODS: 48 children with epilepsy, 48 children for control group and their parents were included in
this study. We used Ankara Development Screening Inventory (ADSI), Brief Infant Toddler Social
Emotional Assessment (BITSEA), Early Childhood Inventory-Parent Scale (ECI-4), Pediatric Quality
of Life Inventory (PedsQL) and Symptoms Checklist-90 (SCL-90) for assessments.
RESULTS: There was no difference between the epilepsy and the control groups in BITSEA scores for
1-3 years. In the ECI-4 assessment for 4-6 years, Attention Deficit Hyperactivity Disorder (ADHD),
general anxiety disorder (GAD), social phobia (SP), posttraumatic stress disorder (PTSD), dysthymic
disorders and elimination disorder (ED) were found higher in the children with epilepsy. In the mothers
of the children with epilepsy, psychiatric symptoms were found higher than the controls. There was no
difference in quality of life scores between the children with epilepsy and the control groups.

DISCUSSION AND CONCLUSION: In the present study, no psychopathology was detected in the
children with epilepsy 1-3 years of age, while frequency of psychopathology was increased in those 4-
6 years of age. Also, it was found that the frequency of psychiatric symptoms was increased in the
mothers of the children with epilepsy.

Anahtar Kelimeler

Epilepsi, Çocuk, Yaşam Kalitesi

Kaynakça

• 1. Austin JK, Dunn DW, Huster GA. Childhood epilepsy and asthma: changes in behavior problems related to gender and change in condition severity. Epilepsia 2000 May; 41:615-23.
• 2. Ott D, Siddarth P, Gurbani S, et al. Behavioral disorders in pediatric epilepsy:unmet psychiatric need. Epilepsia 2003; 44:591-7.
• 3. Shamsaei F, Cheraghi F, Zamani G. Comparing Mental Health of School-Age Children with and without Epilepsy. Iran J Child Neurol 2016 Summer;10:35-41.
• 4. Carrozzino D, Marchetti D, Laino D, et al. Anxiety in adolescent epilepsy. A clinimetric analysis. Nord J Psychiatry 2016 Aug;70:424-9.
• 5. Blummer D. Psychiatric aspect of interactable epilepsy. Adv Exp Med Biol 2000; 497: 133-47.
• 6. Hermann BP, Seidenberg M, Bell B. Psychiatric co-morbidity in chronic epilepsy: identification, consequences and treatment of major depression. Epilepsia 2004; 41: 3-41.
• 7. Johnson EK, Jones JE, Seidenberg M, Hermann BP. The relative impact of anxiety, depression, and clinical seizure features on health-related quality of life in epilepsy. Epilepsia 2004;45:544-50.
• 8. Stevanovic D, Jancic J, Lakic A. The impact of depression and anxiety disorder semptoms the health-related of life of children and adolescents with epilepsy. Epilepsia 2011; 52:75-8.
• 9. Choi HY, Kim SE, Lee HW, Kim EJ. Social Behavioral Problems and the Health-Related Quality of Life in Children and Adolescents with Epilepsy. Psychiatry Investig. 2016 Sep;13:488-95.
• 10. Speechley KN, Ferro MA, Camfield CS, et al. Quality of life in children with new-onset epilepsy. American Academy of Neurology 2012; 79:1548-55.
• 11. Mu PF. Paternal reactions to a child with epilepsy: uncertainty, coping strategies and depression. J Adv Nurs 2005; 49:367-76.
• 12. Fazlıoğlu K, Hocaoğlu Ç, Sönmez FM. Impact of Childhood Epilepsy on the Family Current Approaches in Psychiatry 2010; 2:190-205.
• 13. Erol N, Sezgin N, Savaşır I. Validity of Ankara Developmental Screening Inventory. Turkish Journal of Psychology 1993; 29:16-22.
• 14. Briggs-Gowan MJ, Carter AS, Irwin JR, Watchtel K, Cicchetti DV. The brief infant-toddler social and emotional assessment: Screening for social-emotional problems and delays in competence. Journal of Pediatric Psychology 2004; 29:143-55.
• 15. Gadow KD, Sprafkin J. Early Childhood Inventory-4 Screening Manual., NY: Stony Brook Press; 2000.
• 16. Varni JW, Seid M, Rode CA. Measurement Model for the Pediatric Quality of Life Inventory. Med Care 1999; 37:126-39.
• 17. Derogatis LR. Confirmation of the dimensional structure of the SCL-90: a study in construct validation. J Clin Psychiatry 1977; 33:981-9.
• 18. Seidenberg M, Hermann BP, Dohan FC. Hippocampal sclerosis and verbal encoding ability following anterior temporal lobectomy. Neuropsychologia 1996; 34:690-708.
• 19. Drell MJ, Hanson White TJ. The Response of Children's Disease and Hospitalization. Caplan HI, Sadock BJ, editors. Comprehensive Textbook of Psycihatry. Volume 4. Ankara: Güneş Press, 2007; p:3425-33.
• 20. Torres AR, Whitney J, Gonzalez-Heydrich J. Attention-deficit/hyperactivity disorder in pediatric patients with epilepsy: review of pharmacological treatment. Epilepsy Behav 2008; 12:217-33.
• 21. Parisi P, Moavero R, Verrotti A, Curatolo P. Attention deficit hyperactivity disorder in children with epilepsy. Brain Dev 2010; 32:10-6.
• 22. Schubert R. Attention deficit disorder and epilepsy. Pediatr Neurol 2005; 32:1-10.
• 23. Thome-Souza S, Kuczynski E, Assumpcao F Jr, et al. Which factors may play a pivotal role on determining the type of psychiatric disorder in children and adolescents with epilepsy. Epilepsy Behav 2004; 5:988-94.
• 24. Ettinger AB, Weisbrot DM, Nolan EE, et al. Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia 1998; 39:595-9.
• 25. Caplan R, Siddarth P, Gurbani S, Hanson R, Sankar R, Shields WD. Depression and anxiety disorders in pediatric epilepsy. Epilepsia 2005; 46:720-30.
• 26. Dunn DW, Austin JK, Huster GA. Symptoms of depression in adolescents with epilepsy. J Am Acad Child Adolesc Psychiatry 1999; 38:1132-8.
• 27. Berg AT, Caplan R, Hesdorffer DC. Psychiatric and neurodevelopmental disorders inchildhoodonset epilepsy. Epilepsy Behav 2011; 20:550-5.
• 28. Seltzer MM, Greenberg JS, Floyd FJ. Life course impact of parenting a child with a disability. Am J Ment Retard 2001; 106:265-86.
• 29. Shore CP, Austin JK, Dunn DW. Maternal adaptation to a child's epilepsy. Epilepsy & Behavior 2004; 5:557-68.
• 30. Eddy CM, Rizzo R, Gulisano M, Cali P, Robertson MM, Cavanna AE. Quality of life in young people with treatment-responsive epilepsy: A controlled study. Epilepsy Behaviour. 2010;19: 623- 6.