Dikkat Eksikligi Hiperaktivite Bozuklugu Tanili Çocuklarda Yasam Kalitesi: Kesitsel Bir Çalisma/Quality of Life in Children with (Attention-Deficit Hyperactivity Disorder): A Cross-Sectional Study

ÖZET. Amac: Bu calismada Dikkat Eksikligi Hiperaktivite Bozuklugu (DEHB) tanisi konmus cocuk ve ergenlerde yasam kalitesi algilarinin degerlendirilmesi, bozuklugun siddeti ve estani varligi ile yasam kalitesi arasindaki iliskinin belirlenmesi ve sonuclarin saglikli kontrol grubu ile karsilastirilmasi amaclanmistir. Yöntemler: Okul Cagi Cocuklari Icin Duygulanim Bozukluklari ve Sizofreni Görüsme Cizelgesi Simdi ve Yasam Boyu Sekli-Türkce Uyarlamasi ve DSM-IV'e dayali görüsmelerle DEHB tanisi konan 8-16 yas araligindaki 49 cocuk ile kontrol grubu olarak yas ve cinsiyet acisindan eslestirilen saglikli 49 cocuk calismaya alinmistir. Tüm cocuklarin yasam kalitesi Cocuklar icin Yasam Kalitesi Ölcegi (CIYKÖ) Türkce versiyonu ile, DEHB tanili cocuklarin belirti siddeti Cocuk ve Ergenlerde Davranis Bozukluklari Icin DSM-IV'e Dayali Tarama ve Degerlendirme Ölcegi (CEDBÖ) ile degerlendirilmistir. Bulgular: DEHB tanili cocuklarin saglikli cocuklara oranla CIYKÖ'de okul islevselligi, psikososyal saglik ve ölcek toplam puaninlarindan istatistiksel olarak anlamli oranda düsük puan aldiklari saptanmistir. DEHB tanili cocuklarin ebeveynlerinin degerlendirmesinde ise Sziksel saglik toplam puani ve duygusal islevsellik puani disindaki diger alt alan puanlari ve ölcek toplam puaninda yasam kalitesi algilarinin saglikli cocuklarin ebeveynlerine göre anlamli oranda düsük oldugu görülmüstür. DEHB belirti siddeti ile CIYKÖ puanlari arasindaki iliskiye bakildiginda CEDBÖ toplam puani ile ebeveynlerin doldurdugu CIYKÖ psikososyal saglik toplam puani, sosyal islevsellik ve okul islevselligi puanlari arasinda negatif yönde orta düzeyde baginti saptanmistir. Estanisi olan 17 DEHB'li cocugun kendilerinin doldurdugu CIYKÖ'de Sziksel saglik toplam puani ve sosyal islevsellik puani disinda diger alt alan puanlari ve ölcek toplam puanindan, estanisi olmayan 32 cocuga göre istatistiksel olarak anlamli düzeyde düsük puanlar aldiklari görülmüstür. Ebeveynlerin doldurdugu CIYKÖ'ye göre ise estanisi olan ve olmayan cocuklar arasinda puanlar arasinda istatistiksel fark bulunmamistir. Sonuc: Kronik gidisli nöropsikiyatrik bir bozukluk olan DEHB'nin hem cocuk hem de ebeveyn bildirimlerinde yasam kalitesi algisini olumsuz yönde etkiledigi görülmektedir. DEHB'nin takip ve tedavi asamalarinda yasam kalitelerinin de degerlendirilmesinin cocuklarin zorlandiklari alanlarin saptanmasinda yol gösterici olacagi düsünülebilir. (Nöropsikiyatri Arsivi 2010; 47: 314-8). Anahtar kelimeler: Dikkat eksikligi hiperaktivite bozuklugu, yasam kalitesi, cocuk. ABSTRACT. Objective: The aim of this study was to evaluate quality of life in children and adolescents with attention-deficit hyperactivity disorder (ADHD), to determine the relationship between severity of the disorder and existence of comorbidity, and to compare the results with those in healthy control group. Methods: Forty-nine children aged 8-16 years and diagnosed with ADHD based on the Schedule for Affective Disorders and Schizophrenia for School-age Children-Turkish Version (K-SADS-PL-T) and interview for the Diagnostic and Statistical Manual of Mental Disorders-IV Edition (DSM-IV) were enrolled in the study as well as 49 healthy age- and gender-matched controls. Quality of life in all children was evaluated by the Pediatric Quality of Life Inventory (PedsQL), and symptom severity in children with ADHD was assessed by the Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S). Results: The ADHD samples showed significantly lower total scale score, school functioning and psychosocial health summary scores than the healthy children. The quality of life based on subscale scores and total scale scores, except physical health and emotional functioning scores, was found significantly lower in parents of children with ADHD than in parents of healthy children. When the relationship between ADHD symptom severity and PedsQL scores was evaluated, medium-level negative correlation was found between T-DSM-IV-S total scores and psychosocial health total score, social and school functioning scores for PedsQL filled out by parents. It was observed that 17 children with ADHD with comorbid diagnoses had significantly lower subscale scores and total scale scores for PedsQL filled out by children, except for physical health total scores and social functioning scores, compared to 32 children without comorbidity. As for the PedsQL filled out by the parents, no statistical difference was found between the scores of children with comorbidity and without comorbidity. Conclusion: ADHD, a chronic neuropsychiatric disorder, was seen to be affecting life quality negatively based on reporting by both children and parents. It can be assumed that evaluation of life quality during observation and treatment of ADHD may become a guide to finding areas, in which children have difficulties. (Archives of Neuropsychiatry 2010; 47: 314-8). Key words: Attention-deficit hyperactivity disorder, quality of life, children.

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