İlköğretim öğrencilerinde anksiyete ve duygudurum bozuklukları yaygınlığı ve sosyodemografik özellikler

Amaç: Çocukluk döneminde başlayan psikiyatrik bozukluklar, büyü- dükçe çocukta daha fazla işlev kaybına ve erişkin dönemde devam eden yıkımlara neden olabilmektedir. Çocuk ve ergenlerde psikiyatrik has- talıkların yaygınlığının ve hastalıklarla ilişkili risk faktörlerinin araştı- rıldığı az sayıda çalışma bulunmaktadır. Bu araştırmada Türkiye’de iyi belirlenmiş ve yeterli sayıdaki bir ilkokul örneklemiyle duygudurum bozuklukları (DDB) ve anksiyete bozukluklarının (AB) yaygınlığının saptanması amaçlanmıştır. Yöntem: İzmir İl Milli Eğitim Müdürlüğü tarafından resmi sınıflama- ya göre alt/orta/üst sosyoekonomik gruba göre belirlenen 12 okuldan, %5 hata payıyla, alfa (t) %1 olarak belirlenen 419 olgu rastgele örnek- lem alınması yöntemiyle seçildi. Araştırmada yer alan olgular 6-14 yaş aralığındaydı. 417 olguya ulaşıldı, yanıt oranı %99,5 olarak saptandı. 417 olgu yarı yapılandırılmış tanı görüşmesi olan Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Versiyonu (CDŞG-ŞY), Çocuklarda Davranışı Değer- lendirme Ölçeği (ÇDDÖ) ve Öğretmen Bilgi Formu (ÖBF) ölçekleri, bozulma ölçütü (impairment) kullanılarak değerlendirildi. Bulgular: Bozulma ölçütü göz önüne alınmadan yani sadece klinik gö- rüşme ile DDB ve AB yaygınlığı sırasıyla %2,9, %13,9 olarak saptandı. Bozulma ölçütü dikkate alındığında ise DDB ve AB yaygınlığı sırasıyla %1,4 ve %2,6 olarak bulundu. Sonuç: Çalışmamızda bulunan İzmir örneklemindeki DDB ve AB’nin yaygınlıkları batılı ülkelerde yapılmış olan çalışmalara oldukça benzer bulundu. Yazınla uyumlu olarak bozulma ölçütü dahil edildiğinde has- talık yaygınlığının belirgin olarak azaldığı saptandı.

Prevalence of Anxiety and Mood Disorders and Demographic Characteristics of Elementary School Students

Objective: Childhood psychiatric disorders can prevent individuals from reaching their full potential, and disrupt normal development. Empirical data on the prevalence and incidence of childhood psychiatric disorders are fundamental to understanding the etiology and natural history of such disorders. There have been fewer epidemiologic investigations aimed at estimating the prevalence, incidence, and associated risk factors of psychiatric disorders in children and adolescents, as compared to adults. This study aimed to assess the prevalence of mood disorders (MDs) and anxiety disorders (ADs) in a representative sample of elementary school children from Turkey, providing prevalence rates that were previously unavailable. Materials and Methods: In all, 12 schools were randomly selected and stratified according to socioeconomic status by the İzmir Directorate of National Education. The sample consisted of 419 randomly selected elementary school students, with a 5% margin of error and alpha (t) of 1%. The study included children aged 6-14 years. In total, 417 students were interviewed (total response rate of 99.5%). The 417 students were assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), Child Behavior Check List (CBCL), Teacher Report Form (TRF), and Impairment Criterion Scale (ICS). Results: The prevalence of MDs and ADs without considering impairment was 2.9% and 13.9%, respectively, versus 1.4% and 2.6% with considering impairment, respectively. Conclusion: The prevalence of MDs and ADs in the present study’s sample are similar to those reported from the Western studies. With the inclusion of diagnosis-specific impairment criteria the rates reduced slightly, as previously reported.

Kaynakça

Achenbach TM, Edelbrock C (1983) Manual for the Child Behavior Checklist /4-18 and Revised Child Behavior Profile. University of Vermont, Department of Psychiatry, Burlington VT.

Achenbach TM (1991) Manuel for the child behavior checklist 4-18. Profil: University of Vermont, Department of Psychiatry, Burlington VT.

Akçakın M (1985) Çocukların Davranışlarını Değerlendirme Ölçeği’nin tanıtımı ve güvenirlik çalışması. Türk Psikoloji Dergisi 5:3-6.

Bird HR, Canino G, Rubio-Stipec M ve ark. (1988) Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico. The use of combined measures. Arch Gen Psychiatry 45:1120-6.

Bor W, Najman JM, Andersen MJ ve ark. (1997) The relationship between low family income and psychological disturbance in young children: an Australian longitudinal study. Aust N Z J Psychiatry 31:664-75.

Boyle MH, Offord DR, Racine Y ve ark. (1993) Evaluation of the Diagnostic Interview for Children and Adolescents for use in general population samples. J Abnorm Child Psychol 21:663-81.

Brotman MA, Schmajuk M, Rich BA ve ark. (2006) Prevalence, Clinical Correlates, and Longitudinal Course of Severe Mood Dysregulation in Children. Biol Psychiatry 60:991-7.

Brooks-Gunn J, Duncan GJ (1997) The effects of poverty on children. Future Child 7:55-71.

Canino G, Shrout PE, Rubio-Stipec M ve ark. (2004) The DSM-IV rates of child and adolescent disorders in Puerto Rico: prevalence, correlates, service use, and the effects of impairment. Arch Gen Psychiatry 61:85-93.

Cartwright-Hatton S, McNicol K, Doubleday E (2006) Anxiety in a neglected population: prevalence of anxety disorders in pre-adolescent children. Clin Psychol Rev 26:817-33.

Cho SC, Kim BN, Kim JW ve ark. (2009) Full syndrome and subthreshold attention-deficit/hyperactivity disorder in a Korean community sample: comorbidity and temperament findings. Eur Child Adolesc Psychiatry 18:447-57.

Costello EJ, Angold A, Burns BJ ve ark (1996) The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders. Arch Gen Psychiatry 53:1129-36.

Costello EJ, Keeler GP, Angold A (2001) Poverty, race/ethnicity, and psychiatric disorder: a study of rural children. Am J Public Health 91:1494-8.

Costello EJ, Mustillo S, Erkanli A ve ark. (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837-44.

Costello EJ, Mustillo S, Keller G ve ark. (2004) Prevalence of psychiatric disorders in childhood and adolescence. Mental Health Services: a Public Health Perspective, 2. Baskı, BL Levin, J Petrila, KD Hennessy (Ed). Oxford, UK: Oxford University Press, s. 111-28.

Costello EJ, Egger H, Angold A (2005) 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. J Am Acad Child Adolesc Psychiatry 44:972-86.

Çuhadaroğlu F, Sonuvar B (1992) Adolesanlarda depresyon. Nöropsikiyatri Arşivi 29:145-50.

Eapen V, Al-Gazali L, Bin-Othman S ve ark. (1998) Mental health problems among school children in United Arab Emirates: prevalence and risk factors. J Am Acad Child Adolesc Psychiatry 37:880-6.

Eapen V, Al-Gazali L, Bin-Othman S ve ark. (1999) Child psychiatric disorders in the United Arab Emirates: functional status and implications for service provision. Prim Care Psychiatry 5:25-9.

Eapen V, Jakka ME, Abou-Saleh MT (2003) Children with psychiatric disorders: the A1 Ain Community Psychiatric Survey. Can J Psychiatry 48:402-7.

Erol N, Arslan BL, Akçakın M (1995) The adaption and standardization of the Child Behavior Checklist among 6-18 year old Turkish children. Eunethydis: European Approaches to Hyperkinetic Disorder, J Sergeant (Ed). Zurich: Fotoratar, s. 97-113.

Erol N, Şimşek Z (1998) Türkiye Ruh Sağlığı Profili: Çocuk ve Gençlerde Ruh Sağlığı: yeterlik alanları, davranış ve duygusal sorunların dağılımı. Birinci Basım, N Erol, C Kılıç, M Ulusoy, M Keçeci, Z Şimşek (Ed). Ankara: Eksen Tanıtım Ltd Şti., s. 25-75.

Erol N, Şimşek Z, Munir KM (2008) Çocuk ve Ergen Ruh Sağlığı Epidemiyolojisi. Çocuk ve Ergen Psikiyatrisi Temel Kitabı, FÇ Çetin, B Pehlivantürk,Ünal, R Uslu, E İşeri, T Türkbay, A Coşkun, S Miral, N Motavallı (Ed). Ankara: Hekimler Yayın Birliği, s. 782-800.

Ford T, Goodman R, Meltzer H (2003) The British Child and Adolescent Mental Health Survey 1999: The Prevalence of DSM-IV Disorders. J Am Acad Child Adolesc Psychiatry 42:1203-11.

Ghubash R, Hamdi E, Bebbington P (1992) The Dubai Community Psychiatric Survey: I. Prevalence and socio-demographic correlates. Soc Psychiatry Psychiatr Epidemiol 27:53-61.

Gökler B, Ünal F, Pehlivantürk B ve ark. (2004) 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 11:109-16.

Green H, McGinnity A, Meltzer H ve ark. (2005) Mental health of children and young people in Great Britain 2004. Great Britain, Gosport: Ashford Colour Press Ltd.

Gureje O, Omigbodun O (1995) Children with mental disorders in primary care: functional status and risk factors. Acta Psychiatr Scand 92:310-4.

Kaufman J, Birmaher B, Brent D ve ark. (1997) Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980-8.

Kovacs M, Devlin B (1998) Internalizing disorders in childhood. J Child Psychol Psychiatry 39:47-63.

Kroes M, Kalff AC, Kessels AG ve ark. (2001) Child psychiatric diagnoses in a population of Dutch schoolchildren aged 6 to 8 years. J Am Acad Child Adolesc Psychiatry 40:1401-9.

Lahey BB, Miller TL, Gordon RA ve ark. (1999) Developmental epidemiology of the disruptive behavior disorders. Handbook of Disruptive Behavior Disorders, HC Quay, AE Hogan (Ed). New York: Kluwer/Plenum, s. 23-48.

Lavigne J, Gibbons R, Christoffel K ve ark. (1996) Prevalence rates and correlates of psychiatric disorders among preschool children. J Am Acad Child Adolesc Psychiatry 35:204-14.

Leckman JF, Sholomskas D, Thompson WD ve ark. (1982) Best estimate of lifetime psychiatric diagnosis: a methodological study. Arch Gen Psychiatry 39:879-83.

Leung PW, Hung SF, Ho TP ve ark. (2008) Prevalence of DSM-IV disorders in Chinese adolescents and the effects of an impairment criterion: a pilot community study in Hong Kong. Eur Child Adolesc Psychiatry 17:452-61.

McArdle P, Prosser J, Kolvin I (2004) Prevalence of psychiatric disorder: with and without psychosocial impairment. Eur Child Adolesc Psychiatry 13:347-53.

Merikangas KR, Nakamura EF, Kesler RC (2009) Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci 11:7-20.

Merikangas KR, He JP, Brody D ve ark. (2010) Prevalence and Treatment of Mental Disorders Among US Children in the 2001–2004 NHANES. Pediatrics, 125:75-81.

Narrow WE, Regier DA, Goodman SH ve ark. (1998) A comparison of federal definitions of severe mental illness among children and adolescents in four communities. Psychiatr Serv 49:1601-8.

Öy B (1991) Çocuklar için depresyon ölçeği: geçerlilik ve güvenilirlik çalışması. Turk Psikiyatri Derg 2:132-6.

Polanczyk G, Jensen P (2008) Epidemiologic considerations in attention deficit hyperactivity disorder: a review and update. Child Adolesc Psychiatr Clin N Am 17:245-60.

Ravens-Sieberer U, Wille N, Erhart M ve ark. (2008) Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry 17 (Suppl. 1):22-33.

Roberts RE, Attkisson CC, Rosenblatt A (1998) Prevalence of psychopathology among children and adolescents. Am J Psychiatry 155:715-25.

Roberts RE, Roberts CR, Xing Y (2006) Prevalence of youth-reported DSM- IV psychiatric disorders among African, European, and Mexican American adolescents. J Am Acad Child Adolesc Psychiatry 45:1329-37.

Roberts RE, Roberts CR, Xing Y (2007) Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area. J Psychiatr Res 41:959-67.

Rutter M, Cox A, Tupling C ve ark. (1975) Attainment and adjustment in two geographical areas. I-- The prevalence of psychiatric disorder. Br J Psychiatry 126:493-509.

Sadock BJ, Sadock VA (2012a) Duygudurum Bozuklukları ve İntihar. Kaplan ve Sadock Çocuk ve Ergen Psikiyatrisi Kısaltılmış El Kitabı, Birinci Basım,Türkbay (Ed), Ankara. Güneş Tıp Kitabevleri, s. 132-46.

Sadock BJ, Sadock VA (2012b) Anksiyete Bozuklukları. Kaplan ve Sadock Çocuk ve Ergen Psikiyatrisi Kısaltılmış El Kitabı, Birinci Basım, T Türkbay (Ed), Ankara. Güneş Tıp Kitabevleri, s. 147-65.

Shaffer D, Fisher P, Dulcan MK ve ark. (1996) The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA Study: Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. J Am Acad Child Adolesc Psychiatry 35:865-77.

Steinhausen HC, Metzke CW, Meier M ve ark. (1998) Prevalence of child and adolescent psychiatric disorders: the Zürich Epidemiological Study. Acta Psychiatr Scand 98:262-71.

Sugawara M, Mukai T, Kitamura T ve ark. (1999) Psychiatric disorders among Japanese Children. J Am Acad Child Adolesc Psychiatry 38:444-52.

Swanson JM, Sergeant JA, Taylor E, Sonuga-Barke EJ, Jensen PS, Cantwell DP (1998) Attention deficit disorder and hyperkinetic disorder. Lancet 351:429-433.

Kaynak Göster

Türk Psikiyatri Dergisi
  • ISSN: 1300-2163
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1990

39.4b26.9b