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Down Sendromlu Çocuk ve Ergenlerde Eşlik Eden Psikiyatrik Bozukluklar; Retrospektif Bir Çalışma

Yıl 2025, Cilt: 47 Sayı: 5, 684 - 693, 04.09.2025
https://doi.org/10.20515/otd.1635929

Öz

Down Sendromu zihinsel yetersizliğin eşlik ettiği en yaygın kromozomal anormalliklerden biridir. Ancak Down Sendromlu çocukların zihinsel yetersizlik dışında psikiyatrik tanı ve takipleri hakkında bilinenler kısıtlıdır. Bu çalışmada Down sendromlu çocukların zihinsel yetersizlik düzeyleri, komorbid psikiyatrik tanıları, tedavi ve klinik izlemlerine dair verilerin incelenmesi amaçlanmıştır. Bu çalışma Ocak 2016 ve Aralık 2023 tarihleri arasında hastanemize başvurusu olan, Down Sendromu tanısı almış 18 yaş altı olgularla yapılmıştır. Toplam 181 olgunun sosyodemografik verileri, komorbid psikiyatrik ve tıbbi tanı ve tedavi verileri geriye dönük olarak incelenmiştir. Çalışmaya toplam 102’si erkek (%56,4) olmak üzere 181 Down Sendromlu birey dahil edilmiştir. Olgularda zihinsel yetersizlik düzeylerine göre sınıflandırıldığında en sık hafif düzeyde zihinsel yetersizliğin görüldüğü bulunmuştur. Olguların %58 ‘ine en az bir tıbbi komorbidite, %22, 4’ünde ise psikiyatrik komorbidite bulunmuştur. En sık eşlik eden psikiyatrik tanının Dikkat Eksikliği Hiperaktivite Bozukluğu tanısı olduğu ve eşlik eden psikiyatrik bozukluk tanısının cinsiyet, zihinsel yetersizlik düzeyleri ile ilişkili olmadığı bulunmuştur. Down Sendromu tanılı bireylerin hastane başvurularının sağlık kurulu raporları üzerinden olduğu görülmüştür. Zihinsel yetersizlik dışındaki komorbid psikiyatrik bozukluklar ve tedaviler için poliklinik başvurularının az olduğu saptanmıştır. Sonuç olarak; Down sendromlu bireylerin ileri yaşlardaki olumlu kazanımlarını sağlamak amacıyla psikiyatrik takiplerini sağlayan sağlık politikaları geliştirilmesi önerilmektedir.

Kaynakça

  • 1. Bull MJ. Down Syndrome. N Engl J Med. 2020;382(24):2344–52.
  • 2. Startin CM, D’Souza H, Ball G, Hamburg S, Hithersay R, Hughes KMO, et al. Health comorbidities and cognitive abilities across the lifespan in Down syndrome. J Neurodev Disord. 2020;12:4.
  • 3. Vicari S, Pontillo M, Armando M. Neurodevelopmental and psychiatric issues in Down’s syndrome: assessment and intervention. Psychiatr Genet. 2013;23(3):95–107.
  • 4. Esbensen AJ, Hooper SR, Fidler D, Hartley SL, Edgin J, d’Ardhuy XL, et al. Outcome Measures for Clinical Trials in Down Syndrome. Am J Intellect Dev Disabil. 2017;122(3):247–81.
  • 5. de Winter CF, Jansen A a. C, Evenhuis HM. Physical conditions and challenging behaviour in people with intellectual disability: a systematic review. J Intellect Disabil Res. 2011;55(7):675–98.
  • 6. Foley KR, Jacoby P, Girdler S, Bourke J, Pikora T, Lennox N, et al. Functioning and post-school transition outcomes for young people with Down syndrome. Child Care Health Dev. 2013;39(6):789–800.
  • 7. Dykens EM. Psychiatric and behavioral disorders in persons with Down syndrome. Ment Retard Dev Disabil Res Rev. 2007;13(3):272–8.
  • 8. Visootsak J, Sherman S. Neuropsychiatric and behavioral aspects of trisomy 21. Curr Psychiatry Rep. 2007;9(2):135–40.
  • 9. Naerland T, Bakke KA, Storvik S, Warner G, Howlin P. Age and gender-related differences in emotional and behavioural problems and autistic features in children and adolescents with Down syndrome: a survey-based study of 674 individuals. J Intellect Disabil Res. 2017;61(6):594–603.
  • 10. Marino M, Scala I, Scicolone O, Strisciuglio P, Bravaccio C. Distribution and age of onset of psychopathological risk in a cohort of children with Down syndrome in developmental age. Ital J Pediatr. 2019;45(1):92.
  • 11. Ekstein S, Glick B, Weill M, Kay B, Berger I. Down Syndrome and Attention-Deficit/Hyperactivity Disorder (ADHD). J Child Neurol. 2011;26(10):1290–5. 12. Esbensen AJ, Vincent LB, Epstein JN, Kamimura-Nishimura K, Wiley S, Angkustsiri K, et al. Co-occurring medical and behavioural conditions in children with Down syndrome with or without ADHD symptom presentation. Journal of Intellectual Disability Research. 2022;66(3):282–96.
  • 13. Oxelgren UW, Myrelid Å, Annerén G, Ekstam B, Göransson C, Holmbom A, et al. Prevalence of autism and attention-deficit-hyperactivity disorder in Down syndrome: a population-based study. Dev Med Child Neurol. 2017 Mar;59(3):276–83.
  • 14. Yahia S, El-Hadidy M, El-Gilany AH, Amdel-Hady D, Wahba Y, Al-Haggar M. Disruptive behavior in Down syndrome children: a cross-sectional comparative study. Ann Saudi Med. 2014;34(6):517–21.
  • 15. Fucà E, Cirillo F, Celestini L, Alfieri P, Valentini D, Costanzo F, et al. Assessment of oppositional defiant disorder and oppositional behavior in children and adolescents with Down syndrome. Front Psychiatry. 2023; 13.
  • 16. Patria SY, Triono A. Health comorbidities in children with down syndrome (DS) at Dr. Sardjito General Hospital, Yogyakarta. Indonesian Journal of Biomedicine and Clinical Sciences. 2024;56(3).
  • 17. Efendi GY, Uytun MÇ, Yürümez E, Öztop DB, Babayiğit TM, Kılıç BG. The Need for Psychiatric Assessment in Children with Down Syndrome and Factors Affecting Their Use of Mental Health Services: A Cross-Sectional Study from Turkey. Perspectives in Psychiatric Care. 2023;2023(1):3864073.
  • 18. Isik CM, Baysal, SG. Complaints, diagnosis, follow-up, and treatment of patients applying to 0-6 years old child psychiatry and developmental pediatrics outpatient clinic. Ann Med Res. 2024;31(4):297-303.
  • 19. van Gameren-Oosterom HBM, Fekkes M, van Wouwe JP, Detmar SB, Oudesluys-Murphy AM, Verkerk PH. Problem behavior of individuals with Down syndrome in a nationwide cohort assessed in late adolescence. J Pediatr. 2013;163(5):1396–401.
  • 20. Chapman RS, Hesketh LJ. Behavioral phenotype of individuals with Down syndrome. Ment Retard Dev Disabil Res Rev. 2000;6(2):84–95.
  • 21. Patterson T, Rapsey CM, Glue P. Systematic review of cognitive development across childhood in Down syndrome: implications for treatment interventions. J Intellect Disabil Res. 2013;57(4):306–18.
  • 22. Karmiloff-Smith A, Al-Janabi T, D’Souza H, Groet J, Massand E, Mok K, et al. The importance of understanding individual differences in Down syndrome. F1000Res. 2016;5:F1000 Faculty Rev-389.
  • 23. Downes A, Anixt JS, Esbensen AJ, Wiley S, Meinzen-Derr J. Psychotropic Medication Use in Children and Adolescents With Down Syndrome. Journal of Developmental & Behavioral Pediatrics. 2015;36(8):613–9.
  • 24. Spinazzi NA, Santoro JD, Pawlowski K, Anzueto G, Howe YJ, Patel LR, et al. Co-occurring conditions in children with Down syndrome and autism: a retrospective study. J Neurodev Disord. 2023;15:9.
  • 25. Warner G, Howlin P, Salomone E, Moss J, Charman T. Profiles of children with Down syndrome who meet screening criteria for autism spectrum disorder (ASD): a comparison with children diagnosed with ASD attending specialist schools. J Intellect Disabil Res. 2017;61(1):75–82.
  • 26. Soriano L del H, Sterling A, Edgin J, Hamilton DR, Berry-Kravis E, Nunnally AD, et al. Associations Among Sex, Cognitive Ability, and Autism Symptoms in Individuals with Down Syndrome. Journal of Autism and Developmental Disorders. 2022;54(1):301.
  • 27. Reilly C. Autism spectrum disorders in Down syndrome: A review. Research in Autism Spectrum Disorders. 2009;3(4):829–39.
  • 28. Ersoy SA, Güler HA, Çetin FH. Psychopathology in Down Syndrome. In: Dey S, editors. Advances in Research on Down Syndrome. IntechOpen; 2018, 1: 17.
  • 29. Määttä T, Tervo-Määttä T, Taanila A, Kaski M, Iivanainen M. Mental health, behaviour and intellectual abilities of people with Down syndrome. Downs Syndr Res Pract. 2006;11(1):37–43.
  • 30. Çam O, Bilge A. The Process of Stigmatization, Attitude, and Belief about Mental Illness and Patient in Turkey: A Systematic Review. Journal of Psychiatric Nursing. 2013;4;91–102.
  • 31. Rogers-Sirin L, Yanar C, Yüksekbaş D, Senturk MI, Sirin SR. Religiosity, Cultural Values, and Attitudes Toward Seeking Psychological Services in Turkey. Journal of Cross-Cultural Psychology. 2017;48;1587–1604.
  • 32. Dijkstra M, Rommes E. Dealing with Disability: Challenges in Dutch Health Care of Parents with a Non-Western Migration Background and a Child with a Developmental Disability. Disability and Rehabilitation. 2021;1–12.
  • 33. Ördem ÖA. Families of Children with Down Syndrome in Turkey: A Sociocultural Approach. International Journal of Social Science Studies. 2018; 6(10), 67–73.
  • 34. Jacola LM, Hickey F, Howe SR, Esbensen A, Shear PK. Behavior and adaptive functioning in adolescents with Down syndrome: specifying targets for intervention. J Ment Health Res Intellect Disabil. 2014;7(4):287–305.
  • 35. Patel L, Wolter-Warmerdam K, Leifer N, Hickey F. Behavioral Characteristics of Individuals with Down Syndrome. Journal of Mental Health Research in Intellectual Disabilities. 2018;11(3):221–46. 36. Haddad F, Bourke J, Wong K, Leonard H. An investigation of the determinants of quality of life in adolescents and young adults with Down syndrome. PLOS ONE. 2018;13(6):e0197394.

Comorbid Psychiatric Disorders in Children and Adolescents with Down Syndrome: A Retrospective Study

Yıl 2025, Cilt: 47 Sayı: 5, 684 - 693, 04.09.2025
https://doi.org/10.20515/otd.1635929

Öz

Down syndrome is one of the most common chromosomal abnormalities accompanied by intellectual disability. However, limited information is available regarding the psychiatric diagnoses and follow-ups of children with Down syndrome, except for intellectual disability. This study aimed to investigate the data on degrees intellectual disability, comorbid psychiatric diagnoses, treatment, and clinical follow-ups of children with Down syndrome. This study was conducted with cases who applied to our hospital between January 2016 and December 2023, were under the age of 18 and diagnosed with Down syndrome. Sociodemographic, comorbid psychiatric and medical diagnosis, and treatment data of a total of 181 cases were retrospectively analyzed. A total of 181 individuals (102 males and 79 females) with Down syndrome were included in the study. When the cases were classified based on their intellectual disability levels, it was found that mild intellectual disability was the most common. 58% of the cases had at least one medical comorbidity, and 22.4% had a psychiatric comorbidity. It was found that the most frequently diagnosed comorbid psychiatric disorder was Attention Deficit Hyperactivity Disorder, and comorbid psychiatric disorders were not associated with gender or degrees intellectual disability.It was observed that hospital applications of individuals diagnosed with Down syndrome were through health board reports. It was determined that outpatient clinic applications for comorbid psychiatric disorders and treatments, other than intellectual disability, were low. As a result, it is recommended to develop health policies that ensure psychiatric follow-ups of individuals with Down syndrome to ensure their positive gains in later life.

Kaynakça

  • 1. Bull MJ. Down Syndrome. N Engl J Med. 2020;382(24):2344–52.
  • 2. Startin CM, D’Souza H, Ball G, Hamburg S, Hithersay R, Hughes KMO, et al. Health comorbidities and cognitive abilities across the lifespan in Down syndrome. J Neurodev Disord. 2020;12:4.
  • 3. Vicari S, Pontillo M, Armando M. Neurodevelopmental and psychiatric issues in Down’s syndrome: assessment and intervention. Psychiatr Genet. 2013;23(3):95–107.
  • 4. Esbensen AJ, Hooper SR, Fidler D, Hartley SL, Edgin J, d’Ardhuy XL, et al. Outcome Measures for Clinical Trials in Down Syndrome. Am J Intellect Dev Disabil. 2017;122(3):247–81.
  • 5. de Winter CF, Jansen A a. C, Evenhuis HM. Physical conditions and challenging behaviour in people with intellectual disability: a systematic review. J Intellect Disabil Res. 2011;55(7):675–98.
  • 6. Foley KR, Jacoby P, Girdler S, Bourke J, Pikora T, Lennox N, et al. Functioning and post-school transition outcomes for young people with Down syndrome. Child Care Health Dev. 2013;39(6):789–800.
  • 7. Dykens EM. Psychiatric and behavioral disorders in persons with Down syndrome. Ment Retard Dev Disabil Res Rev. 2007;13(3):272–8.
  • 8. Visootsak J, Sherman S. Neuropsychiatric and behavioral aspects of trisomy 21. Curr Psychiatry Rep. 2007;9(2):135–40.
  • 9. Naerland T, Bakke KA, Storvik S, Warner G, Howlin P. Age and gender-related differences in emotional and behavioural problems and autistic features in children and adolescents with Down syndrome: a survey-based study of 674 individuals. J Intellect Disabil Res. 2017;61(6):594–603.
  • 10. Marino M, Scala I, Scicolone O, Strisciuglio P, Bravaccio C. Distribution and age of onset of psychopathological risk in a cohort of children with Down syndrome in developmental age. Ital J Pediatr. 2019;45(1):92.
  • 11. Ekstein S, Glick B, Weill M, Kay B, Berger I. Down Syndrome and Attention-Deficit/Hyperactivity Disorder (ADHD). J Child Neurol. 2011;26(10):1290–5. 12. Esbensen AJ, Vincent LB, Epstein JN, Kamimura-Nishimura K, Wiley S, Angkustsiri K, et al. Co-occurring medical and behavioural conditions in children with Down syndrome with or without ADHD symptom presentation. Journal of Intellectual Disability Research. 2022;66(3):282–96.
  • 13. Oxelgren UW, Myrelid Å, Annerén G, Ekstam B, Göransson C, Holmbom A, et al. Prevalence of autism and attention-deficit-hyperactivity disorder in Down syndrome: a population-based study. Dev Med Child Neurol. 2017 Mar;59(3):276–83.
  • 14. Yahia S, El-Hadidy M, El-Gilany AH, Amdel-Hady D, Wahba Y, Al-Haggar M. Disruptive behavior in Down syndrome children: a cross-sectional comparative study. Ann Saudi Med. 2014;34(6):517–21.
  • 15. Fucà E, Cirillo F, Celestini L, Alfieri P, Valentini D, Costanzo F, et al. Assessment of oppositional defiant disorder and oppositional behavior in children and adolescents with Down syndrome. Front Psychiatry. 2023; 13.
  • 16. Patria SY, Triono A. Health comorbidities in children with down syndrome (DS) at Dr. Sardjito General Hospital, Yogyakarta. Indonesian Journal of Biomedicine and Clinical Sciences. 2024;56(3).
  • 17. Efendi GY, Uytun MÇ, Yürümez E, Öztop DB, Babayiğit TM, Kılıç BG. The Need for Psychiatric Assessment in Children with Down Syndrome and Factors Affecting Their Use of Mental Health Services: A Cross-Sectional Study from Turkey. Perspectives in Psychiatric Care. 2023;2023(1):3864073.
  • 18. Isik CM, Baysal, SG. Complaints, diagnosis, follow-up, and treatment of patients applying to 0-6 years old child psychiatry and developmental pediatrics outpatient clinic. Ann Med Res. 2024;31(4):297-303.
  • 19. van Gameren-Oosterom HBM, Fekkes M, van Wouwe JP, Detmar SB, Oudesluys-Murphy AM, Verkerk PH. Problem behavior of individuals with Down syndrome in a nationwide cohort assessed in late adolescence. J Pediatr. 2013;163(5):1396–401.
  • 20. Chapman RS, Hesketh LJ. Behavioral phenotype of individuals with Down syndrome. Ment Retard Dev Disabil Res Rev. 2000;6(2):84–95.
  • 21. Patterson T, Rapsey CM, Glue P. Systematic review of cognitive development across childhood in Down syndrome: implications for treatment interventions. J Intellect Disabil Res. 2013;57(4):306–18.
  • 22. Karmiloff-Smith A, Al-Janabi T, D’Souza H, Groet J, Massand E, Mok K, et al. The importance of understanding individual differences in Down syndrome. F1000Res. 2016;5:F1000 Faculty Rev-389.
  • 23. Downes A, Anixt JS, Esbensen AJ, Wiley S, Meinzen-Derr J. Psychotropic Medication Use in Children and Adolescents With Down Syndrome. Journal of Developmental & Behavioral Pediatrics. 2015;36(8):613–9.
  • 24. Spinazzi NA, Santoro JD, Pawlowski K, Anzueto G, Howe YJ, Patel LR, et al. Co-occurring conditions in children with Down syndrome and autism: a retrospective study. J Neurodev Disord. 2023;15:9.
  • 25. Warner G, Howlin P, Salomone E, Moss J, Charman T. Profiles of children with Down syndrome who meet screening criteria for autism spectrum disorder (ASD): a comparison with children diagnosed with ASD attending specialist schools. J Intellect Disabil Res. 2017;61(1):75–82.
  • 26. Soriano L del H, Sterling A, Edgin J, Hamilton DR, Berry-Kravis E, Nunnally AD, et al. Associations Among Sex, Cognitive Ability, and Autism Symptoms in Individuals with Down Syndrome. Journal of Autism and Developmental Disorders. 2022;54(1):301.
  • 27. Reilly C. Autism spectrum disorders in Down syndrome: A review. Research in Autism Spectrum Disorders. 2009;3(4):829–39.
  • 28. Ersoy SA, Güler HA, Çetin FH. Psychopathology in Down Syndrome. In: Dey S, editors. Advances in Research on Down Syndrome. IntechOpen; 2018, 1: 17.
  • 29. Määttä T, Tervo-Määttä T, Taanila A, Kaski M, Iivanainen M. Mental health, behaviour and intellectual abilities of people with Down syndrome. Downs Syndr Res Pract. 2006;11(1):37–43.
  • 30. Çam O, Bilge A. The Process of Stigmatization, Attitude, and Belief about Mental Illness and Patient in Turkey: A Systematic Review. Journal of Psychiatric Nursing. 2013;4;91–102.
  • 31. Rogers-Sirin L, Yanar C, Yüksekbaş D, Senturk MI, Sirin SR. Religiosity, Cultural Values, and Attitudes Toward Seeking Psychological Services in Turkey. Journal of Cross-Cultural Psychology. 2017;48;1587–1604.
  • 32. Dijkstra M, Rommes E. Dealing with Disability: Challenges in Dutch Health Care of Parents with a Non-Western Migration Background and a Child with a Developmental Disability. Disability and Rehabilitation. 2021;1–12.
  • 33. Ördem ÖA. Families of Children with Down Syndrome in Turkey: A Sociocultural Approach. International Journal of Social Science Studies. 2018; 6(10), 67–73.
  • 34. Jacola LM, Hickey F, Howe SR, Esbensen A, Shear PK. Behavior and adaptive functioning in adolescents with Down syndrome: specifying targets for intervention. J Ment Health Res Intellect Disabil. 2014;7(4):287–305.
  • 35. Patel L, Wolter-Warmerdam K, Leifer N, Hickey F. Behavioral Characteristics of Individuals with Down Syndrome. Journal of Mental Health Research in Intellectual Disabilities. 2018;11(3):221–46. 36. Haddad F, Bourke J, Wong K, Leonard H. An investigation of the determinants of quality of life in adolescents and young adults with Down syndrome. PLOS ONE. 2018;13(6):e0197394.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Genetik Hastalıkları, Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları, Psikiyatri
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Merve Yazıcı 0000-0001-8217-0043

Uğur Tekeoğlu 0000-0002-8432-7566

Yüksel Sümeyra Naralan 0000-0002-7788-5711

Yayımlanma Tarihi 4 Eylül 2025
Gönderilme Tarihi 8 Şubat 2025
Kabul Tarihi 26 Mayıs 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 5

Kaynak Göster

Vancouver Yazıcı M, Tekeoğlu U, Naralan YS. Comorbid Psychiatric Disorders in Children and Adolescents with Down Syndrome: A Retrospective Study. Osmangazi Tıp Dergisi. 2025;47(5):684-93.


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