Gunay EKBERLİ, Sevgin TANER, Serkan GUNES

Nörojen Mesane Tanılı Çocuklarda Psikiyatrik Belirtiler

Amaç: Bu çalışmada “nörojenik mesane” tanılı çocukların anksiyete ve depresyon açısından değerlendirilmesi amaçlanmıştır. Yöntemler: Adana Şehir Eğitim ve Araştırma Hastanesi Çocuk Ürolojisi ve Nefroloji polikliniklerinde Mayıs 2023-Temmuz 2023 tarihleri arasında takip edilen 33 nörojen mesaneli çocuk hasta ve aynı coğrafi bölgede bulunan devlet okullarından yaş/cinsiyet olarak eşleştirilmiş 20 sağlıklı kontrol çalışmaya dahil edilmiştir. Tüm katılımcılardan Hastane Anksiyete ve Depresyon Ölçeği, Conners Ebeveyn Derecelendirme Ölçeği ve Turgay DSM-IV Yıkıcı Davranış Bozuklukları Derecelendirme Ölçeği'ni doldurmaları istendi. Bulgular: Ebeveynlerin bildirdiği CPRS global skoru, hastalarda kontrollere göre daha yüksek olarak tespit edildi (p=0.012). Hastaların CPRS Hiperaktivite/Dürtüsellik ve Anksiyete alt ölçek puanları kontrollerden anlamlı olarak yüksekti. Ebeveynler tarafından bildirilen CPRS global puanı, KBH olan hastalarda olmayanlara göre daha yüksekti (p=0.033). KBH olan hastaların CPRS- Öğrenme sorunları alt ölçek puanı da olmayanlara göre daha yüksekti (p=0,023). DSM-IV Toplam puanı ve DSM-IV dikkatsizlik puanı KBH olan hastalarda olmayanlara göre daha yüksekti. Hastane Anksiyete ve Depresyon Ölçeği-çocukların bildirdiği anksiyete alt ölçeği, tekerlekli sandalye bağımlılığı olmayan hastalarda, olanlara göre daha yüksekti (p=0,002). Tekerlekli sandalye bağımlılığı olmayan hastaların CPRS-davranım bozukluğu, CPRS-Hiperaktivite/Dürtüsellik alt ölçek puanları, DSM-IV hiperaktif/dürtüsel alt ölçek puanı tekerlekli sandalye bağımlılığı olan hastalara göre daha yüksekti (p=0,016, p=0,009, p=0,043).

Anahtar Kelimeler:

nörojen mesane, anksiyete, depresyon, psikiyatri, pediatri

Psychiatric Symptoms in Children with Neurogenic Bladder

Background: This study aimed to evaluate children with ‘’neurogenic bladder’’ diagnosis in terms of anxiety and depression. Methods: Thirty-three pediatric patients with NB followed in Adana City Training and Research Hospital Pediatric Urology and Nephrology outpatient clinics from May 2023 to July 2023 and 20 healthy controls who were age and sex-matched, from public schools located in the same geographic area were included in the study. All participants were requested to complete the Hospital Anxiety and Depression Scale, Conners' Parent Rating Scale and Turgay DSM-IV Disruptive Behavior Disorders Rating Scale. Results: Global score of the CPRS reported by parents, was higher in patients than controls (p=0.012). CPRS Hyperactivity/Impulsivity and Anxiety subscale scores of the patients were significantly higher than controls. Global score of the CPRS reported by parents, was higher in patients with CKD than without (p=0.033). CPRS- Learning problems subscale of the patients with CKD was also higher than the patients without (p=0.023). DSM-IV Total score and the DSM-IV inattention score was higher in patients with CKD than without. Hospital Anxiety and Depression Scale-anxiety subscale reported by children was higher in patients without wheelchair dependence than the patients with (p=0.002). CPRS-conduct disorder and CPRS-Hyperactivity/ Impulsivity subscale scores of the patients without wheelchair dependence was higher than the patient with (p=0.016, p=0.009). DSM-IV hyperactive/impulsive subscale score of the patients without wheelchair dependence was higher than the patients with (p=0.043). Conclusion: Children with NB are at risk for physical, neurocognitive, psychosocial, and family challenges. Anxiety and depression symptoms should not be underestimated. For long-term appropriate management of such vulnerable patients psychological support is required.

Keywords:

neurogenic bladder, anxiety, depression, psychiatri, pediatrics,

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