Evaluation of Sociodemographic and Clinical Characteristics of Children and Adolescents with Intellectual Disability

Öz

Background: Intellectual disability (ID) is a neurodevelopmental disorder that occurs in the developmental process and impairs the functionality of the individual in social, applied and conceptual areas. Psychiatric and organic disorders are more common in children and adolescents diagnosed with ID compared to their peers. These comorbid diagnoses further impair the functionality of the individual. In this study, we aimed to investi-gate the sociodemographic and clinical characteristics of children and adolescents diagnosed with ID. Materials and Methods: The files of the patients who applied between 15.04.2019 and 15.04.2021 were scanned retrospectively and the information of the patients diagnosed with EY was saved. Diagnoses were made by clinical evaluation and psychometric tests appropriate to the age of the individual. Results: 154 children and adolescents diagnosed with ID were included in the study. The mean age of the cases was 9.50±4.53 years and 59.7% were male and 40.3% were female. We found organic comorbidity in 38.9% (n=60) and psychiatric comorbidity in 36.3% (n=56). We detected that the most common organic comorbidity was epilepsy with 14.2% (n=22) and ADHD with 22.7% (n=35) psychiatric comorbidity and that 42.8% (n=66) of the cases received one or more medical treatments. Conclusions: Our study is important in terms of presenting data on comorbid disorders in individuals with EY and the treatments used for these disorders. There is a need for multicenter studies in this issue to be conduc-ted with a larger sample.

Entelektüel Yetiyitimi Olan Çocuk ve Ergenlerin Sosyodemografik ve Klinik Özelliklerinin Değerlendirilmesi

Öz

Amaç: Entelektüel yetiyitimi gelişimsel süreçte ortaya çıkan, bireyin toplumsal, uygulamalı ve kavramsal alanlarda işlevselliğini bozan nörogelişimsel bir bozukluktur. EY tanısı olan çocuk ergenlerde yaşıtlarına kıyasla daha fazla psikiyatrik ve organik bozukluk görülmektedir. Bu komorbid tanılar bireyin işlevselliğini daha fazla bozmaktadır. Bu çalışmada EY tanısı alan çocuk ve ergenlerin sosyodemografik ve klinik özelliklerini araştırmayı amaçladık. Materyal ve Metod: 15.04.2019-15.04.2021 tarihleri arasında başvurusu olan hastaların dosyaları retrospektif taranarak EY tanısı alan hastaların bilgileri kaydedilmiştir. Tanılar klinik değerlendirme ve bireyin yaşına uygun psikometrik testler uygulanarak konulmuştur. Bulgular: Çalışmaya EY tanısı alan 154 çocuk ve ergen dahil edildi. Vakaların ortalama yaşı 9,50±4,53 ve %59,7’si erkek kalan %40,3’ü kızdı. Katılımcıların %38,9’unda (n=60) organik komorbidite, %36,3’ünde (n=56) psikiyatrik komorbidite saptadık. En sık organik komorbiditenin %14,2 (n=22) oranı ile epilepsi, psikiyatrik komorbiditenin de %22,7 (n=35) oranı ile DEHB olduğunu ve vakaların %42,8’sinin (n=66) bir veya daha fazla medikal tedavi aldığını saptadık. Sonuç: Çalışmamız, EY tanılı bireylerde görülen komorbid bozukluklara ve bu bozukluklar nedeni ile kullanılan tedavilere dair verilerin sunulması açısından önemlidir. Bu alanda daha geniş örneklemde yürütülecek çok merkezli çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Entelektüel yetiyitimi
• Komorbidite
• Ruh sağlığı

Kaynakça

1. American Psychiatric Association. DSM-V - Diagnostic and Statistical Manual of Mental Disorders. 5th Ed. Washington DC.: American Psychiatric Association; 2013.
2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Washington, D.C. 2000
3. Harris JC. Intellectual disability: Understanding its development, causes, classification, evaluation, and treatment. Oxford University Press.; 2006.
4. Türkiye Özürlüler Araştırması. Devlet İstatistik Enstitüsü Özürlüler İdaresi Başkanlığı. Ankara: Devlet İstatistik Enstitüsü Matbaası; 2002.
5. Maulik PK, Mascarenhas MN, Mathers CD, Dua T, Saxena S. Prevalence of intellectual disability: A meta-analysis of population-based studies. Res Dev Disabil [Internet]. 2011 Mar;32(2):419–36.
6. Chapman DA, Scott KG, Stanton-Chapman TL. Public health approach to the study of mental retardation. Am J Ment Retard [Internet]. 2008 Mar;113(2):102–16.
7. Anlar B EH. Zeka Gerilikleri. 1. Basım. Çetin F , Coşkun A İE ve ark., editor. Ankara: HYB Basın Yayın,; 2008. 187–198 p.
8. Nemerimana M, Chege MN, Odhiambo EA. Risk Factors Associated with Severity of Nongenetic Intellectual Disability (Mental Retardation) among Children Aged 2–18 Years Attending Kenyatta National Hospital. Neurol Res Int [Internet]. 2018;2018:1–11.

9. Wang M, Turnbull AP, Summers JA, Little TD, Poston DJ, Mannan H, et al. Severity of Disability and Income as Predictors of Parents’ Satisfaction with Their Family Quality of Life during Early Childhood Years. Res Pract Pers with Sev Disabil [Internet]. 2004 Jun 1;29(2):82–94.
10. Einfeld SL, Ellis LA, Emerson E. Comorbidity of intellectual disability and mental disorder in children and adolescents: A systematic review. J Intellect Dev Disabil [Internet]. 2011 Jun 25;36(2):137–43.
11. Buckley N, Glasson EJ, Chen W, Epstein A, Leonard H, Skoss R, et al. Prevalence estimates of mental health problems in children and adolescents with intellectual disability: A systematic review and meta-analysis. Aust New Zeal J Psychiatry [Internet]. 2020 Oct 30;54(10):970–84.
12. Sawyer M., Arney FM, Baghurst PA, Clark JJ, Graetz BW, Kosky RJ, et al. The Mental Health of Young People in Australia: Key Findings from the Child and Adolescent Component of the National Survey of Mental Health and Well-Being. Aust New Zeal J Psychiatry [Internet]. 2001 Dec 17;35(6):806–14.
13. Platt JM, Keyes KM, McLaughlin KA, Kaufman AS. Intellectual disability and mental disorders in a US population representative sample of adolescents. Psychol Med [Internet]. 2019 Apr 12;49(6):952–61.
14. Aktepe E, Sönmez Y. Bir üniversite hastanesinde zekâ geriliği tanısı konulan çocuk ve ergenlerde psikiyatrik ve organik eş tanılar. New Symp Psikiyatr nöroloji ve davraniş Bilim Derg. 2012;50(2):67.
15. Ward DI, Buckley BA, Leon E, Diaz J, Galegos MF, Hofherr S, et al. Intellectual disability and epilepsy due to the K/L-mediated Xq28 duplication: Further evidence of a distinct, dosage-dependent phenotype. Am J Med Genet Part A [Internet]. 2018 Mar;176(3):551–9.
16. Glasson EJ, Buckley N, Chen W, Leonard H, Epstein A, Skoss R, et al. Systematic Review and Meta-analysis: Mental Health in Children With Neurogenetic Disorders Associated With Intellectual Disability. J Am Acad Child Adolesc Psychiatry [Internet]. 2020;59(9):1036–48.
17. Tonge, B. J., & Einfeld SL. Psychopathology and intellectual disability. The Australian Child to Adult Longitudinal study. , International review of research in mental retardation. (Ed.) ILMG, editor. San Diego, CA: Academic Press.; 2003. Vol. 26, pp. 61–91.
18. Savasir I, Sezgin N, Erol N. Ankara Gelisim Tarama El Kitabi. Ankara; 1994.
19. Uğurel-Şermin R. Zekânın değerlendirilmesi: Stanford-Binet testlerinin İstanbul çocuklarına standartlanması. İstanbul: İstanbul Üniversitesi Edebiyat Fakültesi Yayınları.; 1972.
20. Savasır, I, Sahin N. Manual for the Wechsler Intelligence Scale for Children—Revised (WISC-R). Ankara: Turkish Pscyhology Association Publication; 1995.
21. Uzun Cıcek A, Sarı SA, Mercan Isık C. Sociodemographic Characteristics, Risk Factors, and Prevalence of Comorbidity among Children and Adolescents with Intellectual Disability: A Cross-sectional Study. J Ment Health Res Intellect Disabil [Internet]. 2020;13(2):66–85.
22. Lai DC, Tseng YC, Hou YM, Guo HR. Gender and geographic differences in the prevalence of intellectual disability in children: Analysis of data from the national disability registry of Taiwan. Res Dev Disabil [Internet]. 2012;33(6):2301–7.
23. Langridge AT, Glasson EJ, Nassar N, Jacoby P, Pennell C, Hagan R, et al. Maternal Conditions and Perinatal Characteristics Associated with Autism Spectrum Disorder and Intellectual Disability. Baud O, editor. PLoS One [Internet]. 2013 Jan 7;8(1):e50963.
24. Robertson J, Hatton C, Emerson E, Baines S. Prevalence of epilepsy among people with intellectual disabilities: A systematic review. Seizure [Internet]. 2015 Jul;29:46–62.
25. Syvertsen M, Koht J, Nakken KO. Forekomst av epilepsi i de nordiske landene. Tidsskr Den Nor legeforening [Internet]. 2015;135(18):1641–5. Available from: https://tidsskriftet.no/2015/10/oversiktsartikkel/forekomst-av-epilepsi-i-de-nordiske-landene
26. Yim S-Y, Yang C-Y, Park JH, Kim MY, Shin Y-B, Kang E-Y, et al. Korean Database of Cerebral Palsy: A Report on Characteristics of Cerebral Palsy in South Korea. Ann Rehabil Med [Internet]. 2017;41(4):638. Available from: http://e-arm.org/journal/view.php?doi=10.5535/arm.2017.41.4.638
27. Aktepe E, Demirci K, Çalışkan AM, Sönmez Y. Çocuk Ve Ergen Psikiyatrisi Polikliniğine Başvuran Hastalarda Belirti Ve Tanı Dağılımları. Dusunen Adam J Psychiatry Neurol Sci. 2010;23(2):100–8.
28. Buckles J, Luckasson R, Keefe E. A Systematic Review of the Prevalence of Psychiatric Disorders in Adults With Intellectual Disability, 2003–2010. J Ment Health Res Intellect Disabil [Internet]. 2013 Jul;6(3):181–207.
29. Dekker MC, Koot HM, Ende J van der, Verhulst FC. Emotional and behavioral problems in children and adolescents with and without intellectual disability. J Child Psychol Psychiatry [Internet]. 2002 Nov;43(8):1087–98.
30. Neece CL, Baker BL, Crnic K, Blacher J. Examining the Validity of ADHD as a Diagnosis for Adolescents with Intellectual Disabilities: Clinical Presentation. J Abnorm Child Psychol [Internet]. 2013 May 9;41(4):597–612.
31. Lindblad I, Gillberg C, Fernell E. ADHD and other associated developmental problems in children with mild mental retardation. The use of the “Five-To-Fifteen” questionnaire in a population-based sample. Res Dev Disabil [Internet]. 2011 Nov;32(6):2805–9.
32. Lindblad I, Svensson L, Landgren M, Nasic S, Tideman E, Gillberg C, et al. Mild intellectual disability and ADHD; a comparative study of school age children’s adaptive abilities. Acta Paediatr [Internet]. 2013 Oct;102(10):1027–31.
33. Reardon TC, Gray KM, Melvin GA. Anxiety disorders in children and adolescents with intellectual disability: Prevalence and assessment. Res Dev Disabil [Internet]. 2015 Jan;36:175–90.
34. Whitney DG, Shapiro DN, Peterson MD, Warschausky SA. Factors associated with depression and anxiety in children with intellectual disabilities. J Intellect Disabil Res [Internet]. 2019 May 26;63(5):408–17.
35. Reiss S, Rojahn J. Joint occurrence of depression and aggression in children and adults with mental retardation. J Intellect Disabil Res [Internet]. 2008 Jun 28;37(3):287–94.
36. Scheifes A, de Jong D, Stolker JJ, Nijman HLI, Egberts TCG, Heerdink ER. Prevalence and characteristics of psychotropic drug use in institutionalized children and adolescents with mild intellectual disability. Res Dev Disabil [Internet]. 2013 Oct;34(10):3159–67.
37. Bramble D. Psychotropic drug prescribing in child and adolescent learning disability psychiatry. J Psychopharmacol [Internet]. 2007 Jul 4;21(5):486–91.
38. Song M, Ware RS, Doan TN, McPherson L, Trollor JN, Harley D. Appropriateness of psychotropic medication use in a cohort of adolescents with intellectual disability in Queensland, Australia. BJPsych Open [Internet]. 2020 Nov 17;6(6):e142.
39. Simonoff E. Intellectual disability. In: Rutter’s Child and Adolescent Psychiatry [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2015. p. 719–37.
40. Saad HA, Elbedour S, Hallaq E, Merrick J, Tenenbaum A. Consanguineous Marriage and Intellectual and Developmental Disabilities among Arab Bedouins Children of the Negev Region in Southern Israel: A Pilot Study. Front Public Heal [Internet]. 2014;2.