Psychiatric Comorbidity and Sleep Problems in Children and Adolescents With Attention Deficit Hyperactivity Disorder in Relation to Attention Deficit Hyperactivity Disorder Presentation, Age and Gender

Abstract

Bu çalışmada, DEHB tanılı çocuk ve ergenlerden oluşan klinik bir örneklemde psikiyatrik komorbidite, uyku problemleri ve bunların DEHB görünümü, yaş ve cinsiyetle olan ilişkilerinin incelenmesi amaçlanmış. Gereç ve Yöntem: Çalışmaya 6-17 yaş arası 154 katılımcı dahil edildi. Psikiyatrik bozuklukları değerlendirmek amacıyla yarı yapılandırılmış bir klinik görüşme gerçekleştirildi. İçselleştirme ve uyku sorunlarını değerlendirmek için Çocuklar için Anksiyete Bozuklukları Tarama Ölçeği (ÇATÖ), Çocuk Depresyon Envanteri (ÇDE) ve Çocuk Uyku Alışkanlıkları Anketi (ÇUAA) kullanıldı. Bulgular: Katılımcılar arasında komorbid hastalık (%78) ve uyku problemleri (%97) sıklıkları oldukça yüksekti. DEHB bileşik görünüm erkeklerde daha sık olarak tespit edildi (p<0,001) ve karşıt olma-karşı gelme bozukluğu, enürezi ve enkoprezi bileşik görünümdeki olgularda daha sıktı (p<0,05). Dikkatsizlik görünümündeki olgularda ise sosyal anksiyete bozukluğu ve yaygın anksiyete bozukluğu görülme sıklıkları bileşik görünümdeki olgulara göre daha fazlaydı (p<0,05). Erkeklerle karşılaştırıldığında, kızlarda sosyal anksiyete bozukluğu (p=0,03) ve depresyon (p=0,021) daha sık olarak görülmekteydi. Katılımcıların %96,7'si ÇUAA'nde kesme puanı olan 41'in üzerinde skora sahipti (50,51±5,86). Bileşik görünümdeki olguların ÇUAA skorları dikkatsizlik görünümündeki olgulardan anlamlı olarak daha yüksekti (p<0,05). ÇUAA skorları ile toplam yaşam boyu psikiyatrik hastalık sayısı ve ABSTRACT Objective: This study aimed to investigate psychiatric comorbidity and sleep problems and their relationships with ADHD presentation, age and gender in a clinical sample of children and adolescents with ADHD. Material and Method: One hundred fifty-four subjects aged 6-17 were included in the study. A semi-structured diagnostic interview was conducted to screen psychiatric disorders. The Child Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders (SCARED) and Children's Sleep Habits Questionnaire (CSHQ) were used to investigate internalizing difficulties and sleep problems. Results: Overall high rates of comorbid disorders (78%) and sleep problems (97%) were found. ADHD-C was significantly more frequent in males and ADHD-I was more frequent in females (p<0.001). While oppositional defiant disorder (ODD), enuresis and encopresis were more frequent in subjects with ADHD-C (p<0.05), generalized anxiety (GAD) and social anxiety (SAD) disorders were more frequent in subjects with ADHD-I (p<0.05). Females, compared to males, had more frequent diagnoses of depression (p=0.021) and SAD (p=0.03). The majority of subjects (96.7%) scored above the cut off score of 41 in CSHQ (50.51±5.86). The ADHD-C group had significantly higher CSHQ total scores than the ADHD-I group (p<0.05). There was a significant positive correlation between CSHQ total scores and the Comorbidity and sleep problems in ADHD İstanbul Tıp Fakültesi Dergisi • J Ist Faculty Med 2020;83(4):363-72 number of lifetime comorbid diagnoses (p=0.006), self-reported anxiety (p=0.009) and depressi...

The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review

“…Seventeen studies investigated the prevalence of social anxiety in adolescents and adults with ADHD. Of these, only three studies were conducted with adolescents ( Coskun et al, 2020 ; Marmorstein, 2007 ; Yüce et al, 2013 ), the rest with adults. Studies that investigated diagnostic SAD in adolescents and adults with diagnostic ADHD (in clinical samples) reported prevalence rates of .04% ( Secnik et al, 2005 ), 3.3% ( Pehlivanidis et al, 2020 ), 9% ( O’Rourke et al, 2020 ), 14.2% ( Anker et al, 2018 ), 14.66% ( Coskun et al, 2020 ), 20% ( Wilens et al, 2005 ), 31% ( Rucklidge et al, 2016 ), 34.2% ( Yüce et al, 2013 ), 38.2% ( Gorlin et al, 2016 ), 39.7% ( Edel et al, 2010 ), and 46.7% ( Moore et al, 2016 ).…”

“…Of these, only three studies were conducted with adolescents ( Coskun et al, 2020 ; Marmorstein, 2007 ; Yüce et al, 2013 ), the rest with adults. Studies that investigated diagnostic SAD in adolescents and adults with diagnostic ADHD (in clinical samples) reported prevalence rates of .04% ( Secnik et al, 2005 ), 3.3% ( Pehlivanidis et al, 2020 ), 9% ( O’Rourke et al, 2020 ), 14.2% ( Anker et al, 2018 ), 14.66% ( Coskun et al, 2020 ), 20% ( Wilens et al, 2005 ), 31% ( Rucklidge et al, 2016 ), 34.2% ( Yüce et al, 2013 ), 38.2% ( Gorlin et al, 2016 ), 39.7% ( Edel et al, 2010 ), and 46.7% ( Moore et al, 2016 ). Studies that investigated diagnostic SAD in adults with subdiagnostic ADHD reported prevalence rates of 2.9% (community sample: Park et al, 2011 ) and 30% (incarcerated adults: Einarsson et al, 2009 ).…”

“… Umeda et al (2021) also examined the culture-specific hikikomori (social withdrawal) and reported a prevalence of 9.7% in adults with diagnostic ADHD (compared to 1.5% in adults without ADHD). Three studies reported that social anxiety was more common for individuals with the inattentive form of ADHD than the combined form ( Coskun et al, 2020 ; Gorlin et al, 2016 ; Yüce et al, 2013 )—all three studies included clinical samples of adults. In sum, prevalence ratings of SAD/subdiagnostic social anxiety in adolescents and adults with diagnostic/subdiagnostic ADHD ranged from 0.4% to 46.7% across the reviewed studies.…”