Ahmet Koyuncu, Zerrin Binbay

8750

Sosyal Anksiyete Bozukluğu Dikkat Eksikliği Hiperaktivite Bozukluğu Birlikteliği

Sosyal anksiyete bozukluğu hastalarında yüksek oranlarda eştanı varlığı bildirilmesine rağmen, bu çalışmalarda dikkat eksikliği hiperaktivite bozukluğu (DEHB) eştanısı çok araştırılmamıştır. Sosyal anksiyete bozukluğu hastalarında erişkin DEHB eştanı sıklığını araştıran özgül çalışmalar kısıtlıdır ve çok az şey bilinmektedir. Bunun nedeni ise uzun dönem boyunca DEHB'nin bir çocukluk dönemi hastalığı olarak görülmesi olabilir. Yapılan ileriye yönelik çalışmalarda DEHB'nin sıklıkla erişkinliktede sürdüğü, etkilerini devam ettirdiği gözlenmiştir. Diğer yandan bakıldığında ise, DEHB çalışmalarında, sosyal anksiyete bozukluğu yüksek oranlarda görülen bir anksiyete bozukluğu eştanısı olarak bildirilmektedir. Anksiyete bozukluğu eştanısı, DEHB'nin dürtüsel özelliğini arttırır, işlevselliğin daha çok bozulmasına ve tedavi uyumunu bozarak direnç oluşmasına neden olabilir. Bu yazının amacı sosyal anksiyete bozukluğu ve DEHB eştanı durumunu kapsamlı olarak incelemek ve sosyal anksiyete bozukluğu hastalarında tedavi esnasında ortaya çıkan antidepresana bağlı hipomanik kayma ile ilgili bir hipotezimizi tartışmaktır.
Anahtar Kelimeler:

Sosyal anksiyete bozukluğu, dikkat eksikliği hiperaktivite bozukluğu, bipolar bozukluk

Comorbidity of Social Anxiety Disorder and Attention Deficit Hyperactivity Disorder

Despite high rates of reported comorbidity in patients with social anxiety disorder, attention deficit hyperactivity disorder comorbidity was not evaluated in these studies. Studies, investigating the prevalence of adult attention deficit hyperactivity disorder (ADHD) comorbidity in social anxiety disorder are limited and little is known about it. The reason for this may be the fact that, ADHD have been seen as a childhood disease over a period of time. In the prospective studies ,it is reported that ADHD is often observed in the adulthood and effects persist . On the other hand, studies on attention deficit hyperactivity disorder, higher rates of social anxiety disorder comorbidity have been reported. The presence of comorbid anxiety disorder increases the risk of impulsive feature in ADHD, causes problems in functionality, impaired compliance and resistance to the treatment. The aim of this article is to investigate the the status of social anxiety disorder and ADHD comorbidity and to discuss the hypothesis of antidepressant-associated hypomanic shift due to antidepressant treatment in social anxiety disorder patients.
Keywords:

Social anxiety disorder, attention deficit hyperactivity disorder, bipolar disorder,

PDF

___

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Washington, DC , American Psychiatric Press, 1994.
  • Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S et al. Lifetime and 12- month prevalence of DSM-IIIR psychiatric disorders in the United States. Arch Gen Psychiatry 1994; 51:8-19.
  • Koyuncu A, Binbay Z, Özyıldırım İ, Ertekin E. Sosyal anksiyete bozukluğunda başlangıç yaşının klinik gidiş üzerine etkisi. Klinik Psikiyatri Dergisi 2012; 15:111-120.
  • Stein MB. An epidemiologic perspective on social anxiety disorder. J Clin Psychiatry 2006; 67 suppl(12): 3-8.
  • Acarturk C, de Graaf R, van Straten A, Have MT, Cuijpers P. Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking: a population-based study. Soc Psychiatry Psychiatr Epidemiol 2008; 43:273-279.
  • Ohayon MM, Schatzberg AF. Social phobia and depression: prevalence and comorbidity. J Psychosom Res 2010; 68:235– 2
  • Binbay Z, Koyuncu A. Sosyal anksiyete bozukluğu ve duygudurum bozuklukları birlikteliği. Psikiyatride Güncel Yaklaşımlar 2012; 4:1-13.
  • Soykan A, Taner YI. Çocuk Ergen Ruh Sağlığı ve Hastalıkları. İstanbul, Johnson&Johnson, 2007.
  • Erşan EE, Doğan O, Doğan S, Sümer H. The distribution of symptoms of attention deficit/ hyperactivity disorder and oppositional defiant disorder in school age children in Turkey. Eur Child Adolesc Psychiatry 2004; 13:354-361.
  • Akgün GM, Tufan AE, Yurteri N, Erdoğan A. Dikkat eksikliği hiperaktivite bozukluğunun genetik boyutu. Psikiyatride Güncel Yaklaşımlar 2011; 3:15-48.
  • Schneier FR, Johnson J, Hornig CD, Liebowitz MR, Weissman MM. Social phobia: comorbidity and morbidity in an epidemiologic sample. Arch Gen Psychiatry 1992; 49:282–288.
  • Kessler RC, Stang P, Wittchen HU, Stein M, Walters EE. Lifetime comorbidities between social phobia and mood disorders in the US national comorbidity survey. Psychol Med 1999; 29:555–567.
  • Magee WJ, EatonWW, Wittchen HU, McGonagle KA, Kessler RC. Agoraphobia, simple phobia, and social phobia in the national comorbidity survey. Arch Gen Psychiatry 1996; 53:159–168.
  • Davidson JRT, Huges DL, George LK. The epidimiological of social phobia: findings from the Duke Epidemiological Catchment Area Study. Psychol Med 1993; 23:709-718.
  • Chartier MJ, Walker JR, Stein MB. Considering comorbidity in social phobia. Soc Psychiatry Psychiatr Epidemiol 2003; 38:728-734.
  • Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC. Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med 2008; 38:15–28.
  • Lara C, Fayyad J, de Graaf R, Kessler RC, Aguilar-Gaxiola S, Angermeyer M et al. Childhood predictors of adult attentiondeficit/hyperactivity disorder: results from the World Health Organization World Mental Health Survey Initiative. Biol Psychiatry 2009; 65:46-54.
  • Mancini C, Van Ameringen M, Oakman JM, Figueiredo D. Childhood attention deficit /hyperactivity disorder in adults with anxiety disorders. Psychol Med 1999; 29:515-525.
  • Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M. Adult outcome of hyperactive boys: educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiatry 1993; 50: 565-576.
  • Rasmussen P, Gillberg C. Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Adolesc Psychiatry 2000; 39:1424-1431.
  • Biederman J, Petty CR, Evans M, Small J, Faraone SV. How persistent is ADHD? a controlled 10-year follow-up study of boys with ADHD. Psychiatry Res 2010; 177:299-304.
  • Biederman J, Petty CR, Clarke A, Lomedico A, Faraone SV. Predictors of persistent ADHD: an 11-year follow-up study.J Psychiatr Res 2011; 45:150-155.
  • Kavakcı Ö. Erişkin dikkat eksikliği/hiperaktivite bozukluğunun epidemiyolojisi. Türkiye Klinikleri Psikiyatri Özel Dergisi 2012; 5:8-13.
  • Tuğlu C, Şahin ÖÖ. Erişkin dikkat eksikliği hiperaktivite bozukluğu: nörobiyoloji, tanı sorunları ve klinik özellikler . Psikiyatride Güncel Yaklaşımlar 2010; 2:75-116.
  • Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006; 163:716-723.
  • Park S, Cho MJ, Chang MS, Jeon HJ, Cho S, Kim BS. Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: results of the Korean epidemiologic catchment area study. Psychiatry Res 2011; 186 :378-383.
  • Safren SA, Lanka GD, Otto MW, Pollack MH. Prevalence of childhood ADHD among patients with generalized anxiety disorder and a comparison condition, social phobia. Depress Anxiety 2001; 13:190-191.
  • Van Ameringen M, Mancini C, Simpson W, Patterson B. Adult attention deficit hyperactivity disorder in an anxiety disorders population.CNS Neurosci Ther 2011; 17:221-226.
  • Adler LA, Liebowitz M, Kronenberger W, Qiao M, Rubin R, Hollandbeck M et al. Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder. Depress Anxiety 2009; 26:212–221.
  • Chavira DA, Stein MB, Bailey K, Stein MT. Comorbidity of generalized social anxiety disorder and depression in a pediatric primary care sample. J Affect Disord 2004; 80:163-171.
  • Semerci B. Erişkin dikkat eksikliği/hiperaktivite bozukluğunda anksiyete ve tik bozuklukları birlikteliği. Türkiye Klinikleri Psikiyatri Özel Dergisi 2012; 5(1):54-59.
  • Edel MA, Rudel A, Hubert C, Scheele D, Brüne M, Juckel G et al. Alexithymia, emotion processing and social anxiety in adults with ADHD. Eur J Med Res 2010; 15:403-409.
  • Biederman J, Faraone SV, Spencer T, Wilens T, Norman D, Lapey KA et al. Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry 1993; 150:1792– 17
  • Sobanski E, Bruggemann D, Alm B, Kern S, Deschner M, Schubert T et al: Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 2007; 257:371–377.
  • Millstein RB, Wilens TE, Biederman J, Spencer TJ. Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD. J Atten Disord 1997; 2:159-166.
  • Schmitz M, Ludwig H, Rohde LA. Do hyperactive symptoms matter in ADHD-I restricted phenotype? J Clin Child Adolesc Psychol 2010; 39:741-748.
  • Fischer AG, Bau CHD, Grevet EH, Salgado CA, Victor MM, Kalil KL et al. The role of comorbid major depressive disorder in the clinical presentation of adult ADHD. J Psychiatric Res 2007; 41:991-996.
  • McIntyre RS, Kennedy SH, Soczynska JK, Nguyen HT, Bilkey TS, Woldeyohannes HO et al. Attention-deficit/hyperactivity disorder in adults with bipolar disorder or major depressive disorder: results from the international mood disorders collaborative project. Prim Care Companion J Clin Psychiatry 2010; 12: PCC.09m00861.
  • Nierenberg AA, Miyahara S, Spencer T, Wisniewski SR, Otto MW, Simon N et al. Clinical and diagnostic implications of lifetime comorbidity of attention-deficit/hyperactivity disorder in adults with bipolar disorder. data from the first 1000 STEP-BD participants. Biol Psychiatry 2005; 57:1467–1473.
  • Koyuncu A, Tutkunkardaş D, Binbay Z, Özyıldırım I, Ertekin E, Tükel R. The prevalence and clinical features of adult attention deficit hiperactivity disorder in social anxiety disorder. Eur Psychiatry 2012; 27(suppl 1): P-119.
  • Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E et al: The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005; 35:245–256.
  • Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36:980–988.
  • Gökler B, Ünal F, Pehlivantürk B, Kultur EC, Akdemir D, Taner Y. Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi Şimdi ve Yaşam Boyu Şekli- Türkçe uyarlamasının geçerlik ve güvenirliği. Çocuk ve Gençlik Ruh Sağlığı Dergisi 2004; 11:109-116.
  • Alpert KE, Uebelacker LA, McLean NE, Nierenberg AA, Pava JA, Worthington JJ et al. Social phobia, avoidant personality disorder and atypical depression: co-occurrence and clinical implications. Psychol Med 1997; 27:627-633.
  • Mannuzza S, Schneier FR, Chapman TF, Liebowitz MR, Klein DF, Fyer AJ. Generalized social phobia: reliability and validity. Arch Gen Psychiatry 1995; 52: 230-237.
  • Liebowitz MR, Gorman JM, Fyer AJ, Klein DF. Social phobia: review of a neglected anxiety disorder. Arch Gen Psychiatry 1985; 42:729-736.
  • Angst J, Gamma A, Sellaro R, Zhang H, Merikangas K. Toward validation of atypical depression in the community: results of the Zurich Cohort Study. J Affect Disord 2002; 72:125-138.
  • Matza LS, Revicki DA, Davidson JR, Stewart JW. Depression with atypical features in the National Comorbidity Survey: classification, descirption, and conseguences. Arch Gen Psychiatry 2003; 141:288-289.
  • Parker G, Roy K., Mitchell P, Wilhelm K, Malhi G, Hadzi-Pavlovic D. Atypical depression: a reappraisal. Am J Psychiatry 2002; 159:1470-1479.
  • Perugi G, Akiskal HS, Lattanzi L, Cecconi D, Mastrocinque C, Patronelli A et al. The high prevalence of ‘‘soft’’ bipolar (II) features in atypical depression. Compr Psychiatry 1998; 39:63–67.
  • Sullivan PF, Kessler RC, Kendler KS. Latent class analysis of lifetime depressive symptoms in the National Comorbidity Survey. Am J Psychiatry 1998; 155:1398-1406.
  • Posternak MA, Zimmerman M. Partial validation of the atypical features subtype of major depressive disorder. Arch Gen Psychiatry 2002; 59:70-76.
  • Van Ameringen M, Mancini C, Styan G, Donison D. Relationship of social phobia with other psychiatric illness. J Affect Disord 1991; 21:93-99.
  • Perugi G, Akiskal HS, Ramaciotti S, Nassini S, Toni C, Milanfranchi A et al. Depressive comorbidity of panic, social phobic, and obsessive-compulsive disorders re-examined: is there a bipolar II connection? Psychiatr Res 1999; 33:53-61.
  • Perugi G, Frare F, Toni C, Mata B, Akiskal HS. Bipolar II and unipolar comorbidity in 153 outpatients with social phobia. Compr Psychiatry 2001; 42:375-381.
  • Boylan KR, Bieling PJ, Marriott M, Begin H, Young LT, MacQueen GM. Impact of comorbid anxiety disorders on outcome in a cohort of patients with bipolar disorder. J Clin Psychiatry 2004; 65:1106-1113.
  • Freeman MP, Freeman SA, Susan L, McElroy SL. The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issues. J Affect Disord 2002; 68:1-23.
  • Henry C, Van den Bulke D, Bellivier F, Etain B, Rouillon F, Leboyer M. Anxiety disorders in 318 bipolar patients: prevalence and impact on illness severity and response to mood stabilizer. J Clin Psychiatry 2003; 64:331-335.
  • Keller MB. Prevalence and impact of comorbid anxiety and bipolar disorder. J Clin Psychiatry 2006; 67 (suppl 1):5-7.
  • McElroy SL, Altshuler LL, Suppes T, Keck PEJ, Frye MA, Denicoff KD et al. Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am J Psychiatry 2001; 158:420-426.
  • Pini S, Maser JD, Dell'Osso L, Abelli M, Muti M, Gesi C et al. Social anxiety disorder comorbidity in patients with bipolar disorder: a clinical replication.J Anxiety Disord 2006; 20:1148-1157.
  • Simon NM, Otto MW, Wisniewski SR, Fossey M, Sagduyu K, Frank E et al. Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for BD (STEP-BD). Am J Psychiatry 2004; 161:2222-2229.
  • Szadoczky E, Papp ZS, Vitrai J, Rihmer Z, Furedi J. The prevalence of major depressive and bipolar disorders in Hungary. Results from a national epidemiologic survey. J Affect Disord 1998; 50:153-162.
  • Tamam L, Ozpoyraz N. Comorbidity of anxiety disorder among patients with bipolar I disorder in remission. Psychopathology 2002; 35:203-210.
  • Tamam L. Bipolar bozukluk ile anksiyete bozukluğu birlikteliği: bir gözden geçirme. Turk Psikiyatri Derg 2007; 18:59-71 Klassen LJ, Katzman MA, Chokka P. Adult ADHD and its comorbidities, with a focus on bipolar disorder. J Affect Disord. 2010; 124:1-8.
  • Sentissi O, Navarro JC, Oliveira HD, Gourion D., Bourdel MC, Baylé FJ et al. Bipolar disorders and quality of life: the impact of attention deficit/hyperactivity disorder and substance abuse in euthymic patients. Psychiatry Res 2008; 161:36-42.
  • Tamam L, Tuğlu C, Karatas G, Ozcan S. Adult attention-deficit hyperactivity disorder in patients with bipolar I disorder in remission: preliminary study. Psychiatry Clin Neurosci 2006; 60:480–485.
  • Tamam L, Karakuş, G, Ozpoyraz N. Comorbidity of adult attention deficit hyperactivity disorder and bipolar disorder: prevalence and clinical correlates. Eur Arch Psychiatry Clin Neurosci 2008; 258:385–393.
  • Tamam L, Demirkol ME. Erişkin dikkat eksikliği/hiperaktivite bozukluğu ve duygudurum bozuklukları. Turkiye Klinikleri Psikiyatri Özel Dergisi 2012; 5(1):48-53.
  • Wingo AP, Ghaemi SN. A systematic review of rates and diagnostic validity of comorbid adult attentiondeficit/hyperactivity disorder and bipolar disorder. J Clin Psychiatry 2007; 68:1776–1784.
  • Sachs GS, Baldassano CF, Truman CJ, Guille C. Comorbidity of attention deficit hyperactivity disorder with early-and lateonset bipolar disorder. Am J Psychiatry 2000; 157:466–468.
  • Biederman J, Faraone S, Milberger S, Gershon J, Tsuang MT et al. A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry 1996; 53:437–446.
  • Carlson GA, Loney J, Salisbury H, Kramer JR, Arthur C. Stimulant treatment in young boys with symptoms suggesting childhood mania: a report from a longitudinal study. J Child Adolesc Psychopharmacol 2000; 10:175–184.
  • Sarısoy G, Pazvantoğlu O. Antidepresan tedavi ile hipomanik/manik kayma gösteren bipolar bozukluk hastalarında sosyodemografik ve klinik özellikler. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2013; 26:122-130.
  • Tondo L, Vazquez G, Baldessarini RJ. Mania associated with antidepressant treatment: comprehensive meta-analytic review. Acta Psychiatr Scand 2010; 121:404–414.
  • Himmelhoch JM. Social anxiety, hypomania and the bipolar spectrum: data, theory and clinical issues. J Affect Disord 1998; 50:203-213.
  • Holma KM, Melartin TK, Holma IA, Isometsä ET. Predictors for switch from unipolar major depressive disorder to bipolar disorder type I or II: a 5-year prospective study. J Clin Psychiatry 2008; 69:1267-1275.
  • Wehr TA, Goodwin FK. Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry 1987; 144:1403–1411.
  • Ghaemi SN, Rosenquist KJ, Ko JY, Baldessano CF, Kontos NJ, Baldesssarini RJ. Antidepressant treatment in bipolar vs. unipolar depression. Am J Psychiatry 2004; 161:163–165.
  • Akiskal HS, Walker P, Puzantian VR, King D, Rosenthal TL, Dranon M. Bipolar outcome in the course of depressive illness: phenomenologic, familial, and pharmacologic predictors. J Affect Disord 1983; 5:115–112.
  • Strober M, Carlson G. Bipolar illness in adolescents with major depression: Clinical, genetic, and psychopharmacologic predictors in a three-to four year prospective follow-up investigation. Arch Gen Psychiatry 1982; 39:549–555.
  • Akiskal HS, Mallya G. Criteria for the ‘‘soft’’ bipolar spectrum: treatment implications. Psychopharmacol Bull 1987; 23:68–
  • Akiskal HS, Pinto O. The evolving bipolar spectrum: prototypes I, II, III, and IV. Psychiatr Clin North Am 1999; 22:517–534. Akiskal HS. Classification, diagnosis and boundaries of bipolar disorders: a review. In Bipolar Disorder (Eds M Maj, HS Akiskal, JJ Lopez-Ibor, N Sartorius):124-129. West Sussex, Wiley, 2002.
  • Goldberg JF, Truman CJ. Antidepressant-induced mania: an overview of current controversies. Bipolar Disord 2003; 5:407– 4
  • Chun BJDH, Dunner DL. A review of antidepressant-induced hypomania in major depression: suggestions for DSM-V. Bipolar Disord 2004; 6:32–42, Angst J. Switch from depression to mania: a record study over decades between 1920 and 1982. Psychopathology 1985; 18:140–154.
  • Coryell W, Solomon D, Turvey C, Keller M, Leon AC, Endicott J et al. The long-term course of rapid-cycling bipolar disorder. Arch Gen Psychiatry 2003; 60:914–920.
  • Gijsman HJ, Geddes JR, Rendell JM, Nolen WA, Goodwin GM et al: Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. Am J Psychiatry 2004; 161:1537–1547.
  • Carlson GA, Finch SJ, Fochtman LJ, Qing Y, Qing W, Naz B. Antidepressant-associated switches from depression to mania in severe bipolar disorder. Bipolar Disord 2007; 9:851–859.
  • Sachs GS, Nierenberg AA, Calabrese JR, Marangell LB, Wisniewski SR, Gyulai L et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med 2007; 356:1711–1722.
  • Tutkunkardaş MD, Mukaddes NM . Dikkat eksikliği hiperaktivite bozukluğunda tedavi yaklaşımları. Turkiye Klinikleri J Pediatr Sci.2010; 6(2): 55-66.
  • Koyuncu A. Sosyal fobiklerde dikkat sorunları ve hiperaktivite . İstanbul, Liman Yayınları, 2012. Ahmet Koyuncu, Uzm. Dr., Batı Bahat Hastanesi, Küçükçekmece, İstanbul; Zerrin Binbay, Uzm. Dr., Kanuni Sultan Süleyman Hastanesi, İstanbul Yazışma Adresi/Correspondence: Ahmet Koyuncu, Batı Bahat Hastanesi, Küçükçekmece, İstanbul, Turkey. E-mail: ahmet_koyu@hotmail.com Yazar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The author reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no1/ Çevrimiçi yayım / Published online 26 Temmuz/July 26, 2013; doi: 10.5455/cap.20130726020101
Psikiyatride Güncel Yaklaşımlar-Cover
  • ISSN: 1309-0658
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2009
  • Yayıncı: Psikiyatride Güncel Yaklaşımlar
Arşiv
Sayıdaki Diğer Makaleler

Aleksitimi: Tedavi Girişimleri

Miray Şaşıoğlu, Çağla Gülol, Ahmet Tosun

Çocuk İstismarında Rehabilitasyon ve Tedavi Merkezleri

Serhat NASIROĞLU

Akut Psikiyatrik Bakımda Bir Profesyonel Kontrol Yöntemi: Hemşirelik Gözlemleri

Selma SABANCIĞULLARI, Arzu Anıl AÇIL, Saliha HALLAÇ

Bariatrik Cerrahinin Psikiyatrik ve Psikososyal Yönleri

Güzin Mukaddes Sevinçer, Halil Coşkun, Numan KONUK, Süleyman BOZKURT

Major Depresif Bozuklukta Nöroinflamatuvar Hipotez

Gülfizar Sözeri-Varma

Sosyal Anksiyete Bozukluğu Dikkat Eksikliği Hiperaktivite Bozukluğu Birlikteliği

Ahmet Koyuncu, Zerrin Binbay

Şizofrenide Şiddet

Hatice İmer ARAS

Göçün Psikososyal Boyutu

Ayla TUZCU, Kerime BADEMLİ