Murat COŞKUN, Süleyman Salih ZOROĞLU, Mücahit ÖZTÜRK

Pediyatrik bipolar bozuklukta psikiyatrik komorbidite ve ayırıcı tanı

Bipolar bozukluk çocuk, genç ve erişkin hastalarda sıklıkla diğer psikiyatrik bozukluklarla birlikte bulunmaktadır. Psikiyatrik komorbidite erişkin hastalarda tedaviyi ve hastalığın gidişini etkileyen önemli bir etken olarak bildirilmiş-tir. Pediatrik bipolar bozuklukta psikiyatrik komorbidite istisna olmaktan öte kural olarak kabul edilmektedir ve hastalığın tedavi ve gidişini etkilemesinin yanı sıra tanı aşamasında da önemli zorluklarla yol açabilmektedir. Diğer taraftan mani ya da hipomani belirtilerinin önemli bir kısmı diğer çocukluk çağı psikiyatrik bozukluklarında da sıklıkla bulunmakta, hatta tanı özellikleri arasında yer almaktadır. Yüksek komorbidite oranlarıyla birlikte belirtilerin diğer psikiyatrik bozukluklarla çakışması pediatrik bipolar bozukluktaki önemli tanısal zorlukların başında gelmek-tedir. Bu gözden geçirme yazısında pediatrik bipolar bozuklukla sıklıkla komorbidite gösteren ve/veya ayırıcı tanıda zorluk yaratan psikiyatrik bozuklukların literatur ışığında gözden geçirilmesi amaçlanmaktadır. Pubmed �pediatric/juvenile bipolar disorder, bipolar disorder children/adolescents, bipolar disorder comorbidity/differential diagnosis, ADHD, disruptive behavior/anxiety/substance use/psychotic disorders, schizophrenia� sözcükleri değişik kombinasyonlarda kullanılarak taranmış ve ilişkili makalelerin tam metin ya da özetlerinden faydalanılmıştır.

Psychiatric comorbidity and differential diagnosis in pediatric bipolar disorder

Bipolar disorder is frequently found in comorbidity with other psychiatric disorders in young and adult subjects. Psychiatric comorbidity has been reported play a significant role in the treatment and course of bipolar disorder in adult subjects. Meanwhile psychiatric comorbidity is a rule, rather than an exception, in pediatric bipolar disorder and has also a great impact on the treatment and course of the illness. Besides that, psychiatric comorbidity remains an important issue and difficulty while making diagnosis of bipolar disorder in young subjects. Meanwhile majority of symptoms of mania or hypomania are frequently encountered and even included among diagnostic characteristics of other childhood psychiatric disorders. Higher comorbidity and symptom overlapping with other psychiatric disorders is a major difficulty in the diagnosis and differentiation of bipolar disorder in young subjects. This review article aims to present and discuss psychiatric comorbidty and differential diagnosis in pediatric bipo-lar disorder in the light of current literature. A literature search was performed in Pubmed using different combina-tions of �pediatric/juvenile bipolar disorder, bipolar disorder children/adolescents, bipolar disorder comorbidity/ differential diagnosis, ADHD, disruptive behavior/anxiety/substance use/psychotic disorders, schizophrenia� and fulltext or abstract of relevant articles were reviewed.

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