Abdurrahman Cahid ÖRENGÜL, OSMAN TALAT SABUNCUOĞLU

Dikkat eksikliği hiperaktivite bozukluğu olan çocuklarda akran örselemesi/zorbalık

Amaç: Bu araştırmanın amacı, yeni tanı konmuş ve ilaç kullanmamış dikkat eksikliği hiperaktivite bozukluğu (DEHB) olan çocuklarla en az iki okul dönemi düzenli metilfenidat kullanmakta olan çocukların akran örselemesi açısından karşılaştırılmasıdır. Yöntem: Sekiz-on altı yaşları arasındaki DEHB tanısı konulmuş, herhangi bir psikot-rop ilaç kullanmamış 34 çocuk (yaş ort. 10.3±1.81) ve en az iki okul dönemi düzenli metilfenidat kullanmış olan 30 çocuk (yaş ort. 10.5±1.83) Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi ile DEHB ve eş tanılar açısından değerlendirildi. Olguların akran örselemesi açısından değerlendirilmesi için kendileri Olweus Zorba/Kurban Ölçeğini, anne-babaları ve öğretmenleri de aynı ölçekten düzenlenmiş bir formu tamamladı. Sonuçlar: Öz-değerlendirme ölçeklerinde ilaç kullanmamış DEHB’li çocukların 41.2%’si (s=14) kurban, %8.8’i (s=3) zorba/kurban olarak sınıflanmıştır. Tedavi görmüş olan grupta ise çocukların %22.6’sı (s=7) kurban, %6.5’i (s=2) zorba, %12.9’u (s=4) zorba/kurban olarak sınıflandırılmıştır. İki grubun karşılaştırmasında akran zorbalığına katılım oranlarında istatistiksel olarak anlamlı bir fark saptanmamıştır. Anne-baba ve öğretmen değerlendirmele-rinde zorbalığa katılım değerleri özbildirimlere göre çok düşük (sırasıyla %13.8 ve %3.1) bulunmuştur. Tedavi gören grubun anne-babalarının %26.7’si (s=8), öğretmenlerinin %50’si (s=4) ilaç tedavisi sonrasında çocukların zorbalığa katılımında azalma olduğunu bildirmişlerdir. Tartışma: Araştırmamızda saptanan yüksek oranlar göz önüne alındı-ğında, akran örselemesinin değerlendirilmesi DEHB’li çocukların klinik değerlendirmelerinin bir parçası olmalı ve bu konuda çocuktan mutlaka bilgi alınmalıdır. Akran örselemesine uğrayan çocuklarda ilaç tedavisine ek olarak okulda zorbalığı azaltmaya yönelik girişimler yapılmalıdır. (Anadolu Psikiyatri Derg 2018; 19(4):405-410)

Peer victimization in children with attention-deficit/hyperactivity disorder

Objective: The purpose of this study is to compare the presence of bullying behavior (both being a bully and being a victim) in newly diagnosed, medication naive children with attention-deficit/hyperactivity disorder (ADHD) with those who have been on a regime of regular methylphenidate treatment for ADHD for at least the past two school terms. Methods: A total of 34 medication-naive children (mean age 10.3±1.81) and 30 children (10.5±1.83) who were between 8 and 16 years, were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL) for diagnoses of ADHD and coexisting psychiatric disorders. Children completed the Revised Olweus Bully/Victim Questionnaire and their parents and teachers completed a form based on the same questionnaire to identify the bullying involvement of the children. Results: In self-report measures, 41.2% (n=14) of the newly diagnosed children were classified as victims and 8.8% (n=3) as bully/victims. In the treatment group, 22.6% (n=7) of the children were classified as victims, 6.5% (n=2) as bullies and 12.9% (n=4) as bully/victims. The difference in victimization rates between the two groups did not reach the statistically significant levels. Bullying involvement rates were lower than self-reports according to the parent and teacher-rated bullying questionnaires (13.8% and 3.1% respectively). 26.7% (n=8) of the parents and 50% (n=4) of the teachers reported a decrease in bullying involvement after methylphenidate treatment. Conclusion: Peer victimization should be a part of clinical examination in children with ADHD. In addition to medication use, school interventions aiming at re-ducing peer victimization is indicated in children with ADHD. (Anatolian Journal of Psychiatry 2018; 19(4):405-410)

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