Hilal ADALETLİ, Hatice GÜNEŞ, CANAN TANIDIR, Caner MUTLU, Tuğçe AYTEMİZ, Ali Güven KILIÇOĞLU, Kayhan BAHALI, Sema KURBAN, Özden Şükran ÜNERİ

Trikotillomanisi olan çocuk ve ergenlerde klinik özellikler ve eşlik eden psikiyatrik bozukluklar: Klinik bir örneklem

Amaç: Trikotillomani (TTM), diğer psikiyatrik bozuklukların sık eşlik ettiği, saçlı deri, kaş, kirpik ve vücudun diğer bölgelerinden yineleyici kıl koparma davranışı ile karakterizedir. Bu çalışmada TTM'Ii çocuklarda klinik ve sosyodemografik özellikler ile eşlik eden psikiyatrik bozuklukların araştırılması amaçlanmıştır. Yöntem: Çalışmaya polikliniğimizde TTM tanısı ile izlenen 15'i kız, sekizi erkek 23 çocuk ve ergen alınmıştır (ortanca yaş 12, yaş aralığı 6-18). Psikiyatrik eş tanı/arın değerlendirilmesi için Okul Çağı (6-18 yaş) Çocukları için Duygu/anım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Versiyonu- Türkçe Versiyonu (ÇGDŞ-ŞY--T) uygulanmıştır. Depresyon ve anksiyete düzeyleri, Çocuklar için Depresyon Ölçeği ve Çocuklar için Durumluk-Sürekli Anksiyete Ölçeği ile değerlendirilmiştir. Sonuçlar: TTM'den en sık etkilenen vücut bölgesi saçlı deridir (s=13) Dokuz olguda ikiden fazla alan etkilenmiştir. Başvuru anında belirtilerin ortanca süresi 7i20.01 aydı (aralık: gün-72 ay). Olguların %65.2'si TTM'yi başlatıcı bir stresör tanımlamaktaydı. Olguların 19'unda (%82. 6) en az bir psikiyatrik bozukluk, 16'sından (%60. 8) en az iki psikiyatrik bozukluk eşlik etmekteydi. En sık eşlik eden psikiyatrik bozukluklar anksiyete bozukluğu (s=15), yıkıcı davranış bozuklukları (s=6), tik bozukluğu (s=3) ve enürezis nokturna (s=3) idi. Ortalama depresyon puanı 132518.45 idi. Durum/uk ve sürekli anksiyete ortalama puanları ise sırasıyla 37.191801 ve 37. 62: 7.61 idi. Başvuruya kadar geçen süre ile çoklu psikiyatrik tanı arasında anlamlı ilişki bulundu. Tartışma: TTM'li çocuk ve ergenlerde diğer psikiyatrik bozuklukların sık eşlik ettiğini saptadık. Psikiyatrik yardım arayışında gecikme diğer psikiyatrik bozukluklarla ilişkili görünmektedir. Tedavi seçimi ve prognozu etkileyebileceğinden, erken girişimle eşlik eden psikiyatrik bozukluklar azaltılabilir.

Clinical features and comorbid psychiatric disorders in children and adolescents with trichotillomania: a clinical sample

Objective: Trichotillomania (TTM) is characterized by the repetitive pulling out of one's own hair from the scalp, eyebrows, eyelashes, or other areas of the body and is often associated with other psychiatric disorders. In this study we aimed to investigate the clinical and sociodemographic characteristics and comorbid psychiatric disorders in children with TTM. Methods: Twenty-three children and adolescents (15 females and 8 males, median age: 12, range: 6-18 years), who were followed at our outpatient clinic with the diagnosis of TTM, were included in the study. The Turkish version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime version was used to detect the comorbid psychiatric disorders. Depression and anxiety levels were measured by Childhood Depression Inventory (CDI) and State-Trait Anxiety Inventory for Children, respectively. Results: The most commonly affected areas were; the scalp (n=13). Nine cases have been affected more than two areas. Median duration of the symptoms were 7±20.01 months (range: 7 days-72 months) at admission. 65.2% of the cases reported precipitating stress factors before the beginning of TTM symptoms. Nineteen (82.6%) subjects suffered from at least one psychiatric disorder and 14 (60.8%) from at least two psychiatric disorders. The most common comorbid disorders were anxiety disorders (n=15), disruptive behavioral disorders (n=6), tic disorder (n=3) and enuresis nocturna (n=3). The mean score in the CDI was 13.25±8.45. Mean state and trait anxiety scores were 37.19±8.01 and 37.62±7.61, respectively. There was a significant relationship between the time passed until admission to a psychiatry clinic and having multiple comorbid psychiatric disorders. Conclusion: High rates of comorbid psychiatric disorders were found in children and adolescents with TTM. Delay in psychiatric help-seeking seems to be associated with other psychiatric disorders. Early intervention may decrease comorbid psychiatric disorders, which may affect treatment options and prognosis.

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