The Prevalence of Symptoms and Diagnosis of Attention-Deficit- Hyperactivity Disorder Among Adult Female Patients with Mild / Moderate Major Depressive Disorder Who Were Referred to the Psychiatric Outpatient Department of a Training Hospital: A Preliminary Study

Amaç: Erişkin dikkat eksikliği hiperaktivite bozukluğu (DEHB) sıklıkla majör depresif bozuklukla (MDB) birlikte görülmektedir. Erişkinlikte DEHB tanısı konan bireyler psikiyatri polikliniklerine, çoğunlukla anksiyete ve depresyona bağlı şikayetler, özellikle de iritabilite yakınması ile başvurmaktadırlar. Bu araştırmada, polikliniğe ilk kez başvuran, MDB tanısı konan erişkin kadın hastalarda DEHB belirtileri ve tanısının yaygınlığı ve DEHB belirtileri ile MDB ilişkisini belirlemek amaçlanmıştır.Yöntem: Haziran 2008 - Temmuz 2009 tarihleri arasında bir eğitim ve araştırma hastanesi psikiyatri polikliniğine ilk kez başvuran, Klinik Global İzlenim Ölçeği (KGİ) ile depresif belirtilerinin şiddeti hafif-orta olarak belirlenen, eş tanısı olmayan MDB tanılı 61 kadın hasta çalışmaya alınmıştır. Hastalara Hamilton Depresyon Ölçeği (HDÖ-17), Wender-Utah Derecelendirme Ölçeği (WUDÖ), Erişkin Dikkat Eksikliği Hiperaktivite Değerlendirme Ölçeği (E-DEHDÖ) uygulanmıştır. Analizlerde non-parametrik testler kullanılmış ve p değeri 0.05 olarak kabul edilmiştir. Bulgular: Çalışmada hastaların %31.1'inde WUDÖ puanları 36 ve üstünde saptanmıştır. Bu hastalar E-DEHDÖ ve DSM-IVTR ölçütlerine göre değerlendirildiğinde ise dört kişi (tüm örneklemin %6.5'i, WUDÖ ile belirlenenlerin %11.1'i) tanı almıştır. WUDÖ puanları >=36 olan grup ve geri kalanlar arasında ortalama eğitim süresi, HDÖ-17 puanları, epizot sayısı ve son epizotta tedavi için geçen süre karşılaştırılmış ve iki grup arasında fark saptanmamıştır. Diğer yandan WUDÖ >=36 olanlar ve ek olarak E-DEHDÖ ve DSM-IV ölçütlerine göre erişkin DEHB tanısı alanların ortalama eğitim süresi, yaş, epizot sayısı, son epizod tedavi süresi ve ilk HDÖ-17 puanları karşılaştırıldığında aralarında anlamlı fark saptanmamıştır.Sonuç: Örneklemimizde saptanan erişkin tip DEHB yaygınlığı ülkemizde, genel toplum için bildirilen yaygınlığın üzerindedir. DEHB tanısı ile MDB'ye ilişkin çalışmada değerlendirilen değişkenler arasında bağlantı bulunamaması örneklemimizin ayakta takip edilen, hafif-orta şiddette MDB hastalarını kapsamasıyla ilişkili olabilir. Bu noktaları ele alacak yeni çalışmalar MDB-DEHB birlikteliğine yönelik farklı bilgiler ortaya koyabilir

Bir eğitim hastanesinin psikiyatri polikliniğine ilk kez başvuran ve hafif-orta şiddette majör depresif bozukluk tanısı alan erişkin kadın hastalarda dikkat eksikliği/hiperaktivite belirtileri ve tanısının yaygınlığı: Öncül bir araştırma

Objective: Attention deficit hyperactivity disorder (ADHD) and major depressive disorder (MDD) are frequently comorbid among adults. Also, people diagnosed with ADHD in adulthood frequently apply to psychiatry departments with complaints of anxiety and depression, especially irritability. In this study, it was aimed to determine the prevalence of ADHD symptoms and diagnosis among adult female patients, who were referred to the outpatient psychiatry clinic and diagnosed with MDD as well as to evaluate the relationship between symptoms of ADHD and MDD.Method: Sixty-one female patients with MDD, who were evaluated for the first time in a training and research hospital between June 2008 and July 2009 were enrolled in the study. MDD severity was mild-moderate according to Clinical Global Impression Scale (CGI-S) and none of the patients had Axis I comorbidity. Hamilton Depression Rating Scale (HAM-D), Wender Utah Rating Scale (WURS) and Adult ADHD Rating Scales (A-ADHRS) were applied to the participants. Non-parametric methods were used for analyses and p value was set at 0.05. Results: In the study, 31.1% of patients were found to have WURS scores 36 and above. Four patients (6.5% of the whole sample and 11.1% of those scoring at least 36 with WURS) had adult type ADHD, when they were evaluated with A-ADHRS and interviewed according to DSM-IV criteria. There were no significant differences between patients with WURS ≥36 and others in terms of their educational levels, HAM-D scores, number of depressive episodes, and duration for the remission of index episode. Similarly, there were no significant differences between patients with WURS ≥36 and patients diagnosed with adult ADHD according to A-ADHRS and DSM-IV criteria in terms of their age, educational levels, HAM-D scores, number of depressive episodes, and duration for the remission of index episode.Conclusion: The prevalence of adult ADHD was higher than those reported for general community in our country. The lack of relationship between the evaluated variables of MDD and symptoms as well as diagnosis of ADHD in our sample may be due to our inclusion of female outpatients with mild/moderate MDD. Further studies evaluating those relationships may yield different data related to comorbidity of ADHD-MDD

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