İzmir ili Konak merkez ilçede ilköğretim 1.sınıf, 2.sınıf,3.sınıf,4.sınıf ve 5.sınıf öğrencilerinde dikkat eksikliği ve hiperaktivite bozukluğu, karşıt olma karşı gelme bozukluğu ve davranım bozukluğu prevalansı

Amaç: Epidemiyolojik çalışmalar hastalıkların dağılımını, etiyolojisini ve risk faktörlerini anlamamıza yardımcı olmaktadır. Erişkinlere kıyasla çocuk ve ergenlerde psikiyatrik hastalıkların sıklığının ve hastalıklarla ilişkili risk faktörlerinin araştırıldığı çalışmalar daha azdır. Çalışmamızda İzmir ilinde ilkokul çağı öğrencilerinde DEHB, KOKGB ve DB sıklığını araştırmak amaçlanmıştır. Çalışmamızın ikinci amacı da DSM-IV ve önerilen DSM-5 kriterlerinin uygulanarak aynı örneklemde DEHB ve KOKGB prevalansını karşılaştırmaktır. Yöntem: Yöntem: İzmir İl Milli Eğitim Müdürlüğü tarafından resmi sınıflamaya göre alt/orta/üst sosyoekonomik gruba göre belirlenen 12 okuldan, %5 hata payıyla, alfa (t) %1 olarak belirlenen 419 olgu rastgele örneklem alınması yöntemiyle seçilmiştir. 417 olguya ulaşılabilmiş, yanıt oranı %99.5 olarak saptanmıştır. Böylece 6-14 yaş aralığındaki 417 olgu yarı yapılandırılmış tanı görüşmesi (K-SADS-PL), bozulma kriterleri ve ayrıca DEHB, KOKGB için önerilen DSM-5 Tanı Ölçütleri kullanılarak değerlendirilmiştir. Bulgular: Bozulma kriteri göz önüne alınmadan yani sadece klinik görüşme (K-SADS-PL) ile DEHB, KOKGB ve DB sıklığı sırasıyla 21.8%, 2.4%, 1.2% olarak bulunmuş, ek olarak bozulma kriteri de dikkate alındığında ise oranlar sırasıyla 12.7%, 1.2%, 1.9% olarak saptanmıştır. Önerilen DSM-5 Tanı Ölçütlerine göre yapılan değerlendirmede ise DEHB ve KOKGB prevalansı 22.8% ve 5% bulunurken; bozulma kriteri dikkate alındığında DEHB ve KOKGB prevalansı azalarak 12.7% ve 3.6% olarak saptanmıştır. Sonuç: Çalışmamızda elde edilen DEHB prevalansı (12.7%), dünya genelindeki çocuklar için ortalama (pooled) prevalans değeri olan 5.29% ile karşılaştırıldığında daha yüksek bulunmuştur. Bununla birlikte çalışmamızda bulunan DEHB sıklığı aynı bölgede yapılan boylamsal prevalans çalışması ile uyumlu bulunmuştur. Çalışmamızda KOKGB ve DB prevalansı, dünya genelindeki ortalama (pooled) prevalans değerleri olan 3.2% ve 3.3 ile karşılaştırıldığında daha düşük saptanmıştır. Literatürle uyumlu olarak; impairment (bozulma) kriteri dahil edildiğinde DEHB ve KOKGB sıklığının belirgin olarak azaldığı gözlenmiştir. DSM IV ve önerilen DSM-5 Tanı Ölçütleri bozulma kriteri dahil edilerek karşılaştırıldığında KOKGB sıklığı önerilen DSM 5 kriterleriyle daha fazla bulunurken, DEHB oranı iki tanı sistemi arasında fark saptanmamıştır

Prevalence of Psychiatric Disorders Among Turkish Children: The Effects of Impairment and Sociodemographic Correlates

WOS: 000368181400004PubMed ID: 25846701This study was designed to assess the prevalence of psychiatric disorders and the impact of impairment criteria on rates of diagnoses in a representative sample of elementary school children from a country in a region. We sampled 419 primary school children by using a one-stage design in Izmir, Turkey. The response rate was 99.5 % and 417 cases were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version and a scale to assess the impairment criterion. The results showed that 36.7 % of the sample met DSM-IV criteria independent of impairment and that 14.1 % of the population had one or more DSM-IV disorders when a measure of impairment specific to each diagnosis was considered. The most prevalent disorders were attention-deficit/hyperactivity disorder and anxiety disorders. This study provided the first estimates of the prevalence of specific DSM-IV-defined psychiatric disorders in Turkish population of children

Is the prevalence of ADHD in Turkish elementary school children really high?

WOS: 000356052100014PubMed ID: 26002410Previous findings in Turkish samples of children have suggested higher prevalence of ADHD than those detected in Western cultures. Methodological problems might explain these findings. Here, we aimed to re-check the prevalence rate of Attention-Deficit/Hyperactivity Disorder (ADHD) along with other childhood psychiatric disorders in a representative school sample of elementary school children in A degrees zmir, Turkey. The sample consisted of 419 randomly selected primary school children aged 6-14-year-old. We were able to interview 417 cases (99.5 % of the sample). Psychiatric diagnoses in children were assessed using the K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime Version) and an impairment criterion scale. The prevalence rates of ADHD were 21.8 and 12.7 % in children without and with impairment, respectively. The following major mental disorders were significantly more prevalent in ADHD cases than controls: oppositional defiant disorder (ODD) (9.4 versus 0 %), conduct disorder (15.1 versus 0 %), anxiety (17 versus 0.5 %), and mood (5.7 versus 0.8 %). Our results confirmed a substantially higher ADHD prevalence rate (more than double) than the suggested pooled worldwide prevalence, although similar to the one recently detected in a representative populational sample of children in the US (11 %). These findings, consistent with previous developmental epidemiology studies from Turkey, confirm that ADHD is highly prevalent in Turkish elementary school children.Eli LillyEli Lilly; Janssen-CilagJohnson & Johnson USAJanssen Biotech Inc; NovartisNovartis; ShireNo financial or material support was taken for the study. Dr. Luis Augusto Rohde was on the speakers' bureau/advisory board and/or acted as consultant for Eli Lilly, Janssen-Cilag, Novartis, and Shire in the last three years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last three years: Eli Lilly, Janssen-Cilag, Novartis, and Shire. Dr Ercan is on advisory boards for Eli Lilly, Turkey and Janssen, Turkey. The other authors have no biomedical financial interests or potential conflicts of interest to report

ADHD and its associations with pregnancy, birth, developmental and medical-related characteristics

This study aimed to examine possible associations between Attention-Deficit/Hyperactivity Disorder (ADHD) and pregnancy-related, birth-related, developmental, medical, and surgical history characteristics. The sample was derived from a non-referred community sample aged 6 to 14. 91 cases with ADHD and 264 without any psychopathology were compared in terms of psychological and physical problems in pregnancy, mode of delivery, birth complications, developmental stages, injuries, medical and surgical diseases. A semi-structured clinical interview was applied to diagnose the children. ADHD Rating Scale-IV (ADHD-RS-IV) was completed by the parents. Male gender, delay in talking time, and physical injury history predicted increased risks for ADHD. Although having any surgery, and in particular, tonsillectomy did not predict ADHD, inguinal hernia surgery alone predicted an increased risk for ADHD even when controlled for gender. Psychological problems during pregnancy were associated with elevated inattention (IN) and hyperactivity-impulsivity (HI) scores, but not associated with ADHD as a diagnosis. Elevated IN scores but not HI scores were associated with a physical injury history. Although the mode of delivery and physical disease history were not associated with ADHD, asthma increased the likelihood for higher HI scores. The findings have crucial clinical implications that address several points. The findings suggest ADHD may have associations with some negative neurodevelopmental, medical, and surgical history characteristics. The predictivity of inguinal hernia surgery for ADHD might depend on the exposure to general anesthesia at younger ages. Hence, children who had these features should carefully be screened for ADHD

Predicting aggression in children with ADHD

WOS: 000209640400014PubMed ID: 24860616Objective: The present study uses structural equation modeling of latent traits to examine the extent to which family factors, cognitive factors and perceptions of rejection in mother-child relations differentially correlate with aggression at home and at school. Methods: Data were collected from 476 school-age (7-15 years old) children with a diagnosis of ADHD who had previously shown different types of aggressive behavior, as well as from their parents and teachers. Structural equation modeling was used to examine the differential relationships between maternal rejection, family, cognitive factors and aggression in home and school settings. Results: Family factors influenced aggression reported at home (.68) and at school (.44); maternal rejection seems to be related to aggression at home (.21). Cognitive factors influenced aggression reported at school (.-05) and at home (-.12). Conclusions: Both genetic and environmental factors contribute to the development of aggressive behavior in ADHD. Identifying key risk factors will advance the development of appropriate clinical interventions and prevention strategies and will provide information to guide the targeting of resources to those children at highest risk

Validity of proposed DSM-5 ADHD impulsivity symptoms in children

WOS: 000385059900009PubMed ID: 26979524The American Psychiatric Association (APA) working group on Attention-Deficit/Hyperactivity Disorder (ADHD) proposed the inclusion of four new impulsivity symptoms. However, they were not included in DSM-5 due to the lack of sufficient evidence. The aim of this study is to investigate the performance of the proposed four ADHD impulsivity symptoms with respect to: (a) ADHD factor structure; (b) performance in predicting clinical impairment; (c) specificity for ADHD diagnosis and (d) best symptomatic threshold to predict clinical impairment. The sample comprised 416 children (31 ADHD subjects according to both DSM-IV and proposed DSM-5, 20 ADHD subjects according to just one diagnostic system and 365 controls) from 12 schools. Diagnoses were derived using semi-structured interviews and ADHD rating scales. Results from confirmatory factor analysis indicate that addition of the four new impulsivity items provided a slightly better factor structure if compared to models including only 18 items. Regression analyses showed that only one of the new impulsivity symptoms (impatient) was part of the list of best predictors of impairment. None of the four new impulsivity items was specifically associated with ADHD diagnosis. The best cutoff point in the hyperactivity/impulsivity dimension for predicting impairment did not change significantly. Overall, our findings suggest that the determination on how to best capture impulsivity dimension as part of the ADHD construct needs more investigation and that there is not enough evidence to include these four assessed impulsivity symptoms as part of the ADHD criteria.Shire; Eli-LillyEli Lilly; Janssen-CilagJohnson & Johnson USAJanssen Biotech Inc; NovartisNovartisLuis A. Rohde has received honoraria, has been on the speakers' bureau/advisory board and/or has acted as a consultant for Eli-Lilly, Janssen-Cilag, Novartis and Shire in the last 3 years. He receives authorship royalties from Oxford Press and ArtMed. He also received travel awards for taking part of 2014 APA and 2015 WFADHD meetings from Shire. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Eli-Lilly, Janssen-Cilag, Novartis, and Shire. Eyup Sabri Ercan is in charge of the advisory board of Lilly and Janssen-Cilag. The other authors have no biomedical financial interests or potential conflicts of interest to report