Asperger Sendromu Olan Çocuk ve Ergenlerde Komorbid Psikiyatrik Bozuklukların Yaygınlığı

Öz

Amaç: Literatürdeki Asperger sendromu (AS) olan çocuk ve ergenlerde komorbid psikiyatrik durumlar üzerine yapılan çalış-maların çoğu ya bireysel vaka raporlarından oluşmaktadır ya da vakaları yalnızca belirli bir eşlik eden psikiyatrik tanı açısından değerlendirmiştir. Bu nedenle, özellikle son yıllarda literatürde AS hastalarında tüm psikiyatrik bozuklukların komorbiditesini bütüncül bir şekilde inceleyen az sayıda çalışma bulunmaktadır. Bu çalışmada, AS'li 34 çocuk ve ergenden oluşan klinik bir örneklemde komorbid psikiyatrik bozuklukların yaygınlığının ve türlerinin belirlenmesi amaçlanmıştır. Materyal ve Metod: AS'li otuz dört çocuk ve ergen [31 erkek (%91,2), 3 kız (%8,8) ortalama yaş 12,62±3,75 yıl] 2017-2024 yılları arasındaki klinik başvurulardan toplandı. Katılımcıların sosyodemografik özellikleri, ilk AS tanı yaşı, klinik özellikler, komorbid psikiyatrik bozukluklar ve tedavi rejimleri her bir hastanenin kayıtlarından retrospektif olarak incelendi. AS tanısı, Ruhsal Bozuklukların Tanısal ve İstatistiksel El Kitabı 4. Baskı (DSM-IV) kriterlerine göre konuldu. Psikiyatrik komorbidite DSM-5 kriterlerine göre değerlendirildi. Bulgular: Olguların 31'inde (%91,2) komorbid psikiyatrik bozukluk, 5'inde (%14,7) tek bir komorbid psikiyatrik bozukluk, 26'sında (%76,5) ise en az iki komorbid psikiyatrik bozukluk vardı. En sık komorbid tanılar anksiyete bozuklukları (%67,6, n=23), dikkat eksikliği hiperaktivite bozukluğu (%64,7, n=22), obsesif kompulsif bozukluk (%29,4, n=10) ve depresyondu (%29,4, n=10). Hiçbir olguda travma sonrası stres bozukluğu (TSSB), panik bozukluğu, yeme bozuklukları, alkol veya madde kullanımı, bipolar bozukluk ve psikotik bozukluklar saptanmadı. Yaşa göre karşılaştırmalarda çocukluk çağında davranım bozukluğu, özgül fobi, ayrılma kaygısı bozukluğu ve enürezis daha sık görülürken, ergenlikte sosyal fobi, obsesif kompulsif bozukluk ve depresyon daha sık görüldü. Sonuç: Bulgularımız AS'li çocuk ve ergenlerde psikiyatrik komorbiditenin yüksek yaygınlığını vurgulamaktadır ve bu sıklıkla birden fazla durumu içermektedir. Psikiyatrik komorbiditenin rutin değerlendirmesi bu popülasyon için klinik değerlendirmele-rin ayrılmaz bir parçası olmalıdır.

Anahtar Kelimeler

• Asperger sendromu
• otizm spektrum bozukluğu
• psikiyatrik komorbidite
• psikopatoloji

The Prevalence of Comorbid Psychiatric Disorders in Children and Adolescents with Asperger Syndrome

Öz

Background: Most studies in the literature on comorbid psychiatric conditions in children and adolescents with Asperger syndrome (AS) either consist of individual case reports or have evaluated cases only in terms of a specific comorbid psychiatric diagnosis. Therefore, especially in recent years, there are few studies in the literature examining the comorbidity of all psychi-atric disorders in patients with AS in a holistic manner. The present study aimed to determine the prevalence and types of comorbid psychiatric disorders in a clinic-based sample of 34 children and adolescents with AS. Materials and Methods: Thirty-four children and adolescents with AS [31 males (91.2%), 3 females (8.8%) mean age 12.62±3.75 years] were gathered from clinical referrals between 2017 and 2024. Participants' sociodemographic characteris-tics, age at first diagnosis of AS, clinical features, comorbid psychiatric disorders, and treatment regimens were retrospective-ly reviewed from each hospital's records. AS diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria. Psychiatric comorbidity was assessed using DSM-5 criteria. Results: Comorbid psychiatric disorders were present in 31 (91.2%) of the cases, with 5 (14.7%) having a single comorbid disorder and 26 (76.5%) having at least two. The most common comorbid diagnoses were anxiety disorders (67.6%, n=23), attention deficit hyperactive disorder (64.7%, n=22), obsessive-compulsive disorder (29.4%, n=10), and depression (29.4%, n=10). No cases were identified with post-traumatic stress disorder, panic disorder, eating disorders, alcohol or substance use, bipolar disorder, and psychotic disorders. In age-related comparisons, conduct disorder, specific phobia, separation anxiety disorder, and enuresis were more frequently observed in childhood, whereas social phobia, obsessive-compulsive disorder, and depression were more prevalent in adolescence. Conclusions: Our findings highlight the high prevalence of psychiatric comorbidity in children and adolescents with AS, often involving multiple conditions. Routine assessment of psychiatric comorbidity should be an integral part of clinical evaluations for this population.

Anahtar Kelimeler

• Asperger syndrome
• autism spectrum disorder
• psychiatric comorbidity
• psychopathology
• child-adolescent

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