Otizm Spektrum Bozukluğu Olan Çocuklarda Gastrointestinal Sistem ve Uyku Sorunları: Bunların Problemli Davranışlarla İlişkisi

Yıl 2024, , 1 - 6, 10.01.2024

Kardelen Akbal Bağcı , Özge Parlak Gözükara , Esra Çöp , Zeynep Göker

https://doi.org/10.12956/tchd.1302455

Cited By: 1

Öz

Amaç: Bu araştırmanın amacı, otizm spektrum bozukluğu (OSB) olan çocuklarda uyku ve gastrointestinal sorunları ve bunların birbirleriyle, otizm şiddeti ve problemli davranışlarla olan ilişkisini incelemektir.

Gereç ve Yöntemler: Hastanemizde 3 aylık bir sure içinde çocuk psikiyatrisi polikliniklerine başvuran ve DSM-5’e göre OSB tanısı alan çocuklar çalışmaya alındı. Ebeveynler tarafından Sorun Davranış Kontrol Listesi (SDKL), PediatrikGastrointestinal Semptomlar Ölçeği- Ebeveyn Rapor Formu, Çocuk Uyku Alışkanlıkları Anketi (ÇUAA), Otizm Davranış Kontrol Listesi (ODKL) ve sosyodemografik veri formu dolduruldu. Klinisyen tarafından Çocukluk Otizm Derecelendirme Ölçeği (ÇODÖ) uygulandı.

Bulgular: Çalışmaya 97 OSB hastası dahil edildi. Pediatrik Gastrointestinal Semptomlar Ölçeği- Ebeveyn Rapor Formuna göre vakaların %38.1’inde olası fonksiyonel gastrointestinal problem saptandı. Bunlardan %26.8’i (n=26) fonksiyonel konstipasyon, %8.2’si (n=8) retansif olmayan fekal inkontinans, %2.1’i (n=2) aerofaji, %3.1’i (n=3) ruminasyon sendromu, %4.1’i (n=4) irritabl bağırsak sendromu, %1’i (n=1) fonksiyonel karın ağrısı sendromu, %1’i (n=1) fonksiyonel dispepsi, %3.1’i (n=3) fonksiyonel karın ağrısı, %1’i siklik kusma ve %1’i (n=1) abdominal migrendi. ÇUAA’ya göre vakaların %58.8’inde uyku problemi vardı. Fonksiyonel gastrointestinal problemi olan OSB hastalarının, fonksiyonel gastrointestinal problemi olmayan hastalara göre ÇUAA, ODKL ve SDKL toplam puanları daha yüksek saptandı.

Sonuç: Bulgularımız OSB’li çocuklara gastrointestinal ve uyku sorunlarının sıkça eşlik ettiğini göstermiştir. Özellikle davranış sorunları eşlik eden OSB’li hastaların, altta yatan gastrointestinal ve uyku sorunları açısından değerlendirilmesi önemli görünmektedir. Gastrointestinal hastalıkları ve uyku problemlerini tedavi etmek, OSB’ye sık eşlik eden davranış sorunlarını azaltabilir.

Anahtar Kelimeler

Otizm, Gastrointestinal Hastalıklar, Uyku, Sorunlu Davranış

Gastrointestinal and Sleep Problems in Children with Autism Spectrum Disorder: Their Relationship with Problematic Behavior

Öz

Objective: The purpose of this research is to investigate sleep and gastrointestinal problems in children with autism spectrum disorder (ASD) and their relationship with each other, autism severity and problematic behavior.

Material and Methods: The children who were admitted to outpatient clinics of child psychiatry at our hospital in a 3-months period and had diagnosis of ASD according to DSM-5 were included. The parents filled Aberrant Behavior Checklist (AbBC), Rome-3 Diagnostic Questionnaire for Pediatric Functional Gastrointestinal Disorders Parent Report Form (QPGS-RIII), Children’s Sleep Habits Questionnaire (CSHQ), Autism Behavior Checklist (ABC) and sociodemographic data form. The clinician applied Childhood Autism Rating Scale (CARS).

Results: Ninety-seven children with ASD were included. According to QPGS-RIII, 38.1% of the cases had probable functional gastrointestinal problems. Those were 26.8% (n=26) functional constipation, 8.2% (n=8) nonretentive fecal incontinence, 2.1% (n=2) aerofaji, 3.1% (n=3) rumination syndrome, 4.1% (n=4) irritable bowel syndrome, 1% (n=1) functional abdominal pain syndrome, 1% (n=1) functional dyspepsia, 3.1% (n=3) functional abdominal pain, 1% cyclic vomiting and 1% (n=1) abdominal migraine. According to CSHQ 58.8% of the cases had sleep problems. ASD patients with functional gastrointestinal problems, had higher total scores of CSHQ, ABC and AbBC, compared to children with no functional gastrointestinal problems.

Conclusion: Our findings revealed that frequency of gastrointestinal and sleep problems were high in children with ASD. It is appropriate to evaluate patients with ASD in terms of gastrointestinal and sleep problems especially if behavioral problems accompanies. And treating gastrointestinal and sleep problems might decrease challenging behaviors that seen in ASD.

Anahtar Kelimeler

Autism, Gastrointestinal diseases, Sleep, Problem behavior

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