PSYCHIATRIC COMORBIDITY AND SLEEP PROBLEMS IN CHILDREN AND ADOLESCENTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER IN RELATION TO ATTENTION DEFICIT HYPERACTIVITY DISORDER PRESENTATION, AGE AND GENDER

Yıl 2020, Cilt: 83 Sayı: 4, 363 - 372, 19.10.2020

Murat Coşkun Gökçen Güven Alper Alnak Ali Karayağmurlu

Öz

Objective: This study aimed to investigate psychiatric comorbidity and sleep problems and their relationships with ADHD presentation, age and gender in a clinical sample of children and adolescents with ADHD. Material and Method: One hundred fifty-four subjects aged 6-17 were included in the study. A semi-structured diagnostic interview was conducted to screen psychiatric disorders. The Child Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders (SCARED) and Children’s Sleep Habits Questionnaire (CSHQ) were used to investigate internalizing difficulties and sleep problems. Results: Overall high rates of comorbid disorders (78%) and sleep problems (97%) were found. ADHD-C was significantly more frequent in males and ADHD-I was more frequent in females (p<0.001). While oppositional defiant disorder (ODD), enuresis and encopresis were more frequent in subjects with ADHD-C (p<0.05), generalized anxiety (GAD) and social anxiety (SAD) disorders were more frequent in subjects with ADHD-I (p<0.05). Females, compared to males, had more frequent diagnoses of depression (p=0.021) and SAD (p=0.03). The majority of subjects (96.7%) scored above the cut off score of 41 in CSHQ (50.51±5.86). The ADHD-C group had significantly higher CSHQ total scores than the ADHD-I group (p<0.05). There was a significant positive correlation between CSHQ total scores and the number of lifetime comorbid diagnoses (p=0.006), self-reported anxiety (p=0.009) and depressive (p=0.004) symptoms. Conclusion: Comorbidity and sleep problems may be common in young people with ADHD and may have complex reciprocal relations with several factors including ADHD presentation, age, and gender.

Anahtar Kelimeler

ADHD, BMI, children, comorbidity, sleep

DİKKAT EKSİKLİĞİ HİPERAKTİVİTE BOZUKLUĞU TANILI ÇOCUK VE ERGENLERDE DİKKAT EKSİKLİĞİ HİPERAKTİVİTE BOZUKLUĞU GÖRÜNÜMÜ; YAŞ VE CİNSİYETE GÖRE PSİKİYATRİK KOMORBİDİTE VE UYKU PROBLEMLERİ

Öz

Amaç: Bu çalışmada, DEHB tanılı çocuk ve ergenlerden oluşan klinik bir örneklemde psikiyatrik komorbidite, uyku problemleri ve bunların DEHB görünümü, yaş ve cinsiyetle olan ilişkilerinin incelenmesi amaçlanmış. Gereç ve Yöntem: Çalışmaya 6-17 yaş arası 154 katılımcı dahil edildi. Psikiyatrik bozuklukları değerlendirmek amacıyla yarı yapılandırılmış bir klinik görüşme gerçekleştirildi. İçselleştirme ve uyku sorunlarını değerlendirmek için Çocuklar için Anksiyete Bozuklukları Tarama Ölçeği (ÇATÖ), Çocuk Depresyon Envanteri (ÇDE) ve Çocuk Uyku Alışkanlıkları Anketi (ÇUAA) kullanıldı. Bulgular: Katılımcılar arasında komorbid hastalık (%78) ve uyku problemleri (%97) sıklıkları oldukça yüksekti. DEHB bileşik görünüm erkeklerde daha sık olarak tespit edildi (p<0,001) ve karşıt olma-karşı gelme bozukluğu, enürezi ve enkoprezi bileşik görünümdeki olgularda daha sıktı (p<0,05). Dikkatsizlik görünümündeki olgularda ise sosyal anksiyete bozukluğu ve yaygın anksiyete bozukluğu görülme sıklıkları bileşik görünümdeki olgulara göre daha fazlaydı (p<0,05). Erkeklerle karşılaştırıldığında, kızlarda sosyal anksiyete bozukluğu (p=0,03) ve depresyon (p=0,021) daha sık olarak görülmekteydi. Katılımcıların %96,7’si ÇUAA’nde kesme puanı olan 41’in üzerinde skora sahipti (50,51±5,86). Bileşik görünümdeki olguların ÇUAA skorları dikkatsizlik görünümündeki olgulardan anlamlı olarak daha yüksekti (p<0,05). ÇUAA skorları ile toplam yaşam boyu psikiyatrik hastalık sayısı ve öz-bildirime dayalı depresyon (p=0,006) ve anksiyete (p=0,009) belirti şiddeti arasında pozitif yönde bir korelasyon saptandı. Sonuç: DEHB’de psikiyatrik komorbid bozukluklar ve uyku problemleri yaygın olarak görülür ve DEHB görünümü, yaş ve cinsiyet gibi faktörler ile etkileşimleri kompleks ve karşılıklı olabilir.

Anahtar Kelimeler

DEHB, çocuk, uyku, komorbidite, VKİ

Kaynakça

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