Phenomenology and Psychiatric Comorbidity in Pediatric Bipolar Disorde

Amaç: Bipolar bozukluğu (BB) olan çocuk ve ergenlerden oluşan bir klinik örneklemde fenomenolojik özellikleri ve psikiyatrik komorbiditeyi araştırmak amaçlanmıştır. Gereç ve Yöntemler: Bir fakülte hastanesi kliniğinde BB tanısıyla takip edilen çocuk ve ergenler çalışmaya dahil edilmiştir. Duygudurum episodlarına ait fenomenolojik ve klinik özellikler, hasta dosyalarının incelenmesi, hasta ve ailelerle yapılan görüşmeler ve klinik takiplerden elde edilen bilgilerden derlenmiştir. Psikiyatrik değerlendirme aracı olarak yarı yapılandırılmış bir tanısal görüşme formu kullanılmıştır. Bulgular: Yaşları 11 ile 18 arasında değişen (14.87±1.94 yaş) 19 erkek (%63) ve 11 kadın (%37) hasta çalışmaya dahil edildi. Birincil tanıları BB tip I (n=22; %73), BB tip II (n=3; %10) ve başkatürlü-adlandırılamayan BB (n=5; %17) şeklindeydi. Olguların yarısından fazlasında (%53) psikotik semptomlar vardı. Dokuz olguda (%30) bir veya iki kez intihar girişimi öyküsü vardı. En az bir bozukluk için tanı kriterlerinin karşılandığı komorbid bozukluk tanı gruplarının sıklığı şöyleydi: anksiyete bozuklukları (n=28; %93), dikkat eksikliği hiperaktivite bozukluğu (n=23; 77%), depresif bozukluklar (n=16; %53), tik bozuklukları (n=15; %50), karşı olma karşı gelme bozukluğu (n=8; %27) ve madde kullanım bozuklukları (n=7; %23). Tartışma ve Sonuç: Pediyatrik BB'de hastalığın erişkin formuna kıyasla bazı gelişimsel farklılıklar görülebilir. Pediyatrik BB özellikle anksiyete, depresif bozukluklar ve dikkat eksikliği hiperaktivite bozukluğu olmak üzere diğer psikiyatrik bozukluklarla yüksek komorbidite göstermektedir. BB'li çocuk ve ergenler ayrıcı tanı ve tedavinin planlanışı açısından psikiyatrik komorbidite için ayrıntılı bir şekilde değerlendirilmelidir

Pediyatrik Bipolar Bozuklukta Fenomenolojik Özellikler ve Psikiyatrik Komorbidite

Aim: We aimed to investigate phenomenology and psychiatric comorbidity in a clinical sample of young patients with bipolar disorder (BD). Materials and Methods: Young patients who had been followed up after diagnosis with BD in a faculty clinic were included in the study. Data regarding phenomenology and clinical characteristics of mood episodes were gathered from medical records of the subjects, clinical interviews with the subjects and parents, and the follow-up data of the subjects. Psychiatric assessment was conducted by using a semi-structured diagnostic instrument. Results: Nineteen males (63%) and eleven females (37%) who were aged between 11 and 18 years (14.87±1.94 years) were included in the study. Their primary diagnoses were BD type I (n=22; 73%), BD type II (n=3; 10%), and BD-Not Otherwise Specified (n=5; 17%). More than half of the subjects (53%) had developed psychotic symptoms (i.e. perceptual and/or thought disturbances) during mood episodes. Nine subjects (30%) had attempted suicide once or twice. The frequency of diagnostic categories from which criteria for at least one disorder met was as follows: anxiety disorders (n=28; 93%), attention deficit hyperactivity disorder (n=23; 77%), depressive disorders (n=16; 53%), tic disorders (n=15; 50%), oppositional defiant disorder (n=8; 27%), and substance use disorders (n=7; 23%) Discussion and Conclusion: Compared to the adult form of the illness, some developmental differences may be observed in pediatric BD. BD in young subjects is highly comorbid with other psychiatric disorders, particularly anxiety, depressive disorders, and attention deficit hyperactivity disorder. Young subjects with BD should carefully be assessed for comorbid psychiatric disorders for differential diagnosis and treatment planning

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