EYLEM ÖZTEN, Ali Evren TUFAN, Gül ERYILMAZ, Gökben HIZLI SAYAR, Hüseyin BULUT

The prevalence of adult separation anxiety disorder in a clinical sample of patients with attention-deficit/hyperactivity disorder

Amaç: Erişkin ayrılma anksiyetesi bozukluğu DSM-5'te anksiyete bozukluğu grubuna eklenmiştir. Dikkat eksikliği hiperaktivite bozukluğunda (DEHB) yüksek oranda anksiyete bozukluğu eş tanısı görülmektedir. Bu çalışmada amaçlar erişkin DEHB grubunda erişkin ayrılma anksiyetesi bozukluğu yaygınlığını ile erişkin DEHB ve erişkin ayrılma anksiyetesi bozukluğu arasındaki ilişkiyi saptamaktır. Yöntem: Bir psikiyatrist tarafından DSM-IV'e göre DEHB tanısı konulmuş olan kişilere ve onlarla yaş, cinsiyet, medeni durum ve eğitim olarak eşleştirilmiş sağlıklı kontrollere ayrılma anksiyetesibelirtileri için yapılandırılmış klinik görüşme ölçeği, Yetişkin Ayrılma Anksiyetesi Anketi (YAAA) ve Ayrılma Anksiyetesi Belirti Ölçeğini (AABÖ) uyguladı. Bulgular: Bu çalışmada 30 erişkin DEHB hastası ve 26 sağlıklı kontrol alınmıştır. DEHB grubunda kontrol grubuna göre YAAA ve AABÖ puanları anlamlı olarak yüksekti. Ayrılma anksiyetesi belirtileri için yapılandırılmış klinik görüşmeye göre DEHB grubunun %53.3'ü, kontrol grubunun %11.5'i erişkinde ayrılma anksiyetesi bozukluğu ölçütlerini karşılarken, bu oranlar çocukluk ayrılma anksiyetesi bozukluğu için %63.3 ve %19.2'dir. DEHB grubundan üç hasta (%10) çocukluk ayrılma anksiyetesi bozukluğu tanı ölçütlerini karşılamazken, erişkin ayrılma anksiyetesi bozukluğu tanı ölçütlerini karşılamaktadır. DEHB grubundan altı hasta (%20) ve kontrol grubundan dört hasta (%15.4) çocukluk ayrılma anksiyetesi bozukluğu tanı ölçütlerini karşılarken, daha sonra iyileşme göstermiştir. Kontrol grubundan yalnız bir hastada kendiliğinden oluşan erişkin ayrılma anksiyetesi bozukluğu gelişmiştir. Biz erişkin DEHB'de yaşam boyu, çocukluk ve erişkin ayrılma anksiyetesi bozukluğu yaygınlığını yüksek saptadık. Tartışma: Bu çalışmada erişkin DEHB'ye yaşam boyu, çocukluk ve erişkin ayrılma anksiyetesi bozukluğunun yüksek oranda eşlik ettiği saptanmıştır. Ancak araştırmanın klinik örneklemde yapılmış olması nedeni ile, Türk toplumundaki erişkin ayrılma anksiyetesi bozukluğu yaygınlığını değerlendirecek toplum çalışmalarına da gereksinim vardır.

Erişkin dikkat eksikliği hiperaktivite bozukluğu hastaları klinik örnekleminde erişkin ayrılma anksiyetesi bozukluğu yaygınlığı

Objective: Separation anxiety disorder (SAD) of adulthood was added to the group of anxiety disorders in the DSM5. Attention-deficit/hyperactivity disorder (ADHD) displays elevated comorbidity with anxiety disorders. Aims of the present study are to determine a) the prevalence of SAD in a clinical, adult sample with ADHD and b) the correlates of SAD comorbidity in adults with ADHD. Methods: DSM-IV-Based Diagnostic and Evaluation Inventory for Adult ADD/ADHD to confirm ADD/ADHD diagnosis by the psychiatrist; Structured Clinical Interviews for the Symptoms of SAD (SCI-SAS); the Questionnaire for Adult SAD (A-SAQ); and the Inventory for Symptoms of SAD (SASI) were administered to ADHD patients and to the age, gender, marital status, and education-matched healthy controls. Results: Thirty adults with ADHD and 26 healthy controls were enrolled in the study. The ADHD group had significantly higher Adult Separation Anxiety Questionnaire (A-SAQ) and Separation Anxiety Symptom Inventory (SASI) scores than the control group. According to the Structured Clinical Interview for Separation Anxiety Symptoms (SCISAS), 53.3% of the ADHD group and 11.5% of the control group fulfilled the SAD criteria while 63.3% and 19.2%, respectively, fulfilled the childhood SAD criteria. Three patients with ADHD (10.0%) that did not fulfil the childhood SAD criteria had the diagnosis as adults, while six ADHD patients (20.0%) and four control patients (15.4%) had childhood SAD and recovered from it. Only one of the controls (3.9%) developed de novo SAD. We found signifycantly increased life-time, childhood, and adult prevalence of SAD in adult patients with ADHD. Conclusions: Due to the self- selected, clinical sample, this rate may not reflect the true population prevalence of SAD among Turkish adults; community studies evaluating SAD's prevalence are needed.

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