Otizm spektrum bozukluğu tanısı ile takip edilen bireylerin ergenlik dönemindeki prognoz, prognoza etki eden faktörler ve yaşam kalitesi açısından değerlendirilmesi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Giriş: Otizm spektrum bozukluğu (OSB) sosyal, bilişsel ve iletişim alanında gecikme ve işlev bozukluğu ile giden nörogelişimsel bir bozukluktur. Yapılan araştırmalarda çocukluk döneminde OSB tanısı alan bireylerin büyük çoğunluğunun ergenlik döneminde de tanı kriterlerini karşıladığı ve tanının sabit kaldığı gösterilmiştir. Yapılan çalışmalarda OSB tanılı bireylerin akademik beceriler, sosyal ilişkiler, yakın arkadaşlık ilişkileri ve uyuma yönelik davranışlar gibi birçok alanda güçlük yaşadıkları belirlenmiştir. Bu nedenle bu dönemde uygun müdahalelerin yapılması ve gerekli desteğin sağlanması hem OSB tanılı bireyler hem de aileleri için oldukça önemlidir. Amaç: Çalışmamızda, OSB tanısı ile takip edilen bireylerin, ergenlik dönemindeki prognoz, prognoza etki eden faktörler, akademik başarı düzeyi, sosyal iletişim ve cevaplılık düzeyi açısından değerlendirilmesi ve hem olguların hem ebeveynlerinin yaşam kaliteleri ve ilişkili olduğu klinik ve sosyodemografik değişkenlerin incelenmesi amaçlanmıştır. Yöntem: Ege Üniversitesi Tıp Fakültesi Hastanesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalı polikliniklerinde OSB tanısı ile takip edilen, 15-18 yaş arası 84 olgu çalışmaya dahil edilmiştir. Olguların psikiyatrik tanıları "Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi–Şimdi ve Yaşam Boyu Versiyonu–DSM–5 Kasım 2016 –Türkçe Uyarlaması" ile belirlenmiştir. Otizm şiddetinin belirlenmesi için klinisyen tarafından Çocukluk Otizmini Derecelendirme Ölçeği (CARS) ve DSM-5 Klinisyen Tarafindan Puanlanan Otizm Spektrum ve Toplumsal İletişim Bozukluğu Şiddeti Ölçeği doldurulmuştur. Çalışmaya alınan hastaların yaş, cinsiyet, okul, aile, bakım bilgilerini sorgulayan sosyodemografik veri formu klinisyen tarafından doldurulmuştur. Arkadaşlık ilişkilerinin değerlendirilmesi için McGill Arkadaşlık Ölçeği olguların kendileri tarafından doldurulmuştur. Olguların yaşam kalitelerinin değerlendirilmesi için Çocuklar İçin Yaşam Kalitesi Ölçeği-Ergen Formu (ÇİYKÖ) olguların kendileri tarafından, ebeveyn formları ise ebeveynleri tarafından doldurulmuştur. Ebeveynlerin yaşam kalitesinin değerlendirilmesi için Otizmde Yaşam Kalitesi Ölçeği Anne-Baba Sürümü, olguların otistik belirtilerinin değerlendirilmesi için Otizm Spektrum Anketi-Ergen Formu (AQ), olguların sosyal alanda yaşadıkları güçlüklerin belirlenmesi için Sosyal Cevaplılık Ölçeği (Social Responsiveness Scale) olguların ebeveynleri tarafından doldurulmuştur. Bulgular: Çalışmamıza, 15-18 yaş arası 14 kız olgu (%16,7) ve 70 erkek olgu (%83,3) olmak üzere toplam 84 olgu alınmıştır. Olguların geçmiş ve mevcut tanıları gözden geçirildiğinde, sadece 4 olguda (%4,8) psikiyatrik komorbidite olmadığı belirlenmiş, olguların %95,2'sinin en az bir psikiyatrik bozukluk için tanı kriterlerini karşıladığı saptanmıştır. En sık görülen psikiyatrik bozukluklar DEHB (%86,9) ve özgül fobi (%34,5) olarak saptanmıştır. Olguların psikiyatrik tedavileri incelendiğinde, %85,7'sinin en az bir psikotrop ilaç kullandığı saptanmıştır. Değerlendirme sırasında yapılan K-SADS görüşmesine göre, olguların %94'ünün OSB tanısını karşıladığı, %6'sının ise tanıdan çıktığı görülmüştür. Otizm şiddeti, arkadaşlarıyla buluşma durumu, günlük teknoloji kullanım süresi ve fiziksel hastalık varlığı OSB tanılı olgularda yaşam kalitesi ile ilgili alt ölçek puanlarını etkileyen faktörler olarak saptanmıştır. Otizmde Yaşam Kalitesi Anketi-Ebeveyn Sürümü A bölümü puanları otizm semptom şiddeti ve baba eğitim düzeyi ile, B bölümü puanları otizm semptom şiddeti, olguların arkadaşlarıyla buluşma durumu, olguların total IQ düzeyleri ve olguların eğitim durumu ile, Yaşam Memnuniyeti bölümü puanları ise otizm semptom şiddeti ve annede psikiyatrik hastalık varlığı ile ilişkili olarak bulunmuştur. Tartışma: Çalışmamızdan elde edilen bulgular, literatürdeki OSB'de yüksek komorbidite oranları, tanısal süreklilik, zihinsel kapasitenin OSB üzerindeki etkileri, sosyal alandaki güçlükler ve hem olguların hem de ebeveynlerinin yaşam kalitesi ile ilişkili faktörler ile ilgili sonuçları destekler nitelikte bulunmuştur. Bu sonuçların, OSB tanılı ergenlerin güçlük yaşadıkları alanlarla ilgili gerekli düzenlemelerin yapılmasına ve daha etkin koruyucu önlemler geliştirilmesine katkıda bulunacağı düşünülmektedir. Anahtar kelimeler: Otizm Spektrum Bozukluğu ; prognoz; yaşam kalitesi ; ebeveyn yaşam kalitesi
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with delay and function impairment in social, cognitive and communication domains. In the studies, it has been shown that the majority of individuals diagnosed with ASD in childhood meet the diagnostic criteria in adolescence and the diagnosis remains stable. In the studies, it has been determined that individuals with ASD have difficulty in many areas such as academic skills, social relations, close friendship relations and adaptive behaviours. For this reason, carrying out appropriate interventions and providing the necessary support during this period are very important for both individuals with ASD and their families. Objective: In our study, it was aimed to evaluate the individuals who were being followed with the diagnosis of ASD in terms of prognosis in adolescence, the factors affecting prognosis, the level of academic achievement, the level of social communication and response, and also to study the quality of life of both patients and their parents and the related clinical and sociodemographic variables . Method: 84 cases between the ages of 15-18, who were being followed with the diagnosis of ASD in the polyclinics of Ege University Faculty of Medicine Hospital, Department of Child and Adolescent Mental Health and Diseases, were included in the study. Psychiatric diagnoses of cases were determined by "Schedule for Affective Disorders and Schizophrenia for School-Age Children (6-18 Years) - Present and Lifetime Version - 5 November 2016 - Turkish adaptation". In order to determine the severity of autism, The Childhood Autism Rating Scale (CARS) and DSM-5 The Clinician-Rated Severity of Autism Spectrum and Social Communication Disorders scale were filled by the clinician. The sociodemographic data form including age, gender, school, family and care information of the patients involved in the study was filled by the clinician. The McGill Friendship Questionnaire – Friendship Functions (MFQ-FF) was filled by the cases themselves for the evaluation of friendship relations. In order to evaluate the quality of life of the cases, Pediatric Quality Of Life Questionnare was filled by the cases themselves and the parental forms were filled by their parents. For evaluation of the parental quality of life "Quality of Life in Autism Questionnaire – Parent Version", for evaluation of autistic symptoms of cases "Autism Spectrum Quotient-Adolescent Version" and for the determination of the difficulties experienced in social domains "Social Responsiveness Scale" were filled by the parents of cases. Results: A total of 84 cases aged 15-18 years, including 14 female (16.7%) and 70 male (83.3%) were taken. When the past and present diagnoses of the cases were reviewed, it was determined that there was no psychiatric comorbidity in only 4 cases (4.8 %), and 95.2 % of the cases met the diagnostic criteria for at least one psychiatric disorder. The most common psychiatric disorders were ADHD (86.9%) and specific phobia (34.5%). When the psychiatric treatments of the cases were examined, 85.7 % were found to use at least one psychotropic medication. According to the K-SADS interview during the evaluation, 94 % of the cases met the diagnosis of ASD and 6 % of the cases were out of ASD diagnosis. Autism severity, meeting with friends, daily technology use and presence of physical illnesses were found as factors affecting the subscale scores related to the quality of life in cases with ASD. Quality of Life in Autism Questionnaire – Parent Version Part A scores were related with autism symptom severity and educational level of father, Part B scores were related with autism symptom severity, status of meeting with friends of the cases, total IQ levels of cases and educational status of cases, Life Satisfaction scores were related with autism symptom severity and the presence of psychiatric illness in mother . Discussion: The findings obtained from our study support the results in the literature in terms of high comorbidity rates in ASD, diagnostic stability, the effects of mental capacity on ASD, the difficulties in the social field and the factors related to quality of life of both cases and parents. These results are thought to contribute to make the necessary arrangements for the areas in which ASD diagnosed adolescents have difficulty and to develop more effective protective measures. Key words: Autism Spectrum Disorder; prognosis ; quality of life; parental quality of life
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with delay and function impairment in social, cognitive and communication domains. In the studies, it has been shown that the majority of individuals diagnosed with ASD in childhood meet the diagnostic criteria in adolescence and the diagnosis remains stable. In the studies, it has been determined that individuals with ASD have difficulty in many areas such as academic skills, social relations, close friendship relations and adaptive behaviours. For this reason, carrying out appropriate interventions and providing the necessary support during this period are very important for both individuals with ASD and their families. Objective: In our study, it was aimed to evaluate the individuals who were being followed with the diagnosis of ASD in terms of prognosis in adolescence, the factors affecting prognosis, the level of academic achievement, the level of social communication and response, and also to study the quality of life of both patients and their parents and the related clinical and sociodemographic variables . Method: 84 cases between the ages of 15-18, who were being followed with the diagnosis of ASD in the polyclinics of Ege University Faculty of Medicine Hospital, Department of Child and Adolescent Mental Health and Diseases, were included in the study. Psychiatric diagnoses of cases were determined by "Schedule for Affective Disorders and Schizophrenia for School-Age Children (6-18 Years) - Present and Lifetime Version - 5 November 2016 - Turkish adaptation". In order to determine the severity of autism, The Childhood Autism Rating Scale (CARS) and DSM-5 The Clinician-Rated Severity of Autism Spectrum and Social Communication Disorders scale were filled by the clinician. The sociodemographic data form including age, gender, school, family and care information of the patients involved in the study was filled by the clinician. The McGill Friendship Questionnaire – Friendship Functions (MFQ-FF) was filled by the cases themselves for the evaluation of friendship relations. In order to evaluate the quality of life of the cases, Pediatric Quality Of Life Questionnare was filled by the cases themselves and the parental forms were filled by their parents. For evaluation of the parental quality of life "Quality of Life in Autism Questionnaire – Parent Version", for evaluation of autistic symptoms of cases "Autism Spectrum Quotient-Adolescent Version" and for the determination of the difficulties experienced in social domains "Social Responsiveness Scale" were filled by the parents of cases. Results: A total of 84 cases aged 15-18 years, including 14 female (16.7%) and 70 male (83.3%) were taken. When the past and present diagnoses of the cases were reviewed, it was determined that there was no psychiatric comorbidity in only 4 cases (4.8 %), and 95.2 % of the cases met the diagnostic criteria for at least one psychiatric disorder. The most common psychiatric disorders were ADHD (86.9%) and specific phobia (34.5%). When the psychiatric treatments of the cases were examined, 85.7 % were found to use at least one psychotropic medication. According to the K-SADS interview during the evaluation, 94 % of the cases met the diagnosis of ASD and 6 % of the cases were out of ASD diagnosis. Autism severity, meeting with friends, daily technology use and presence of physical illnesses were found as factors affecting the subscale scores related to the quality of life in cases with ASD. Quality of Life in Autism Questionnaire – Parent Version Part A scores were related with autism symptom severity and educational level of father, Part B scores were related with autism symptom severity, status of meeting with friends of the cases, total IQ levels of cases and educational status of cases, Life Satisfaction scores were related with autism symptom severity and the presence of psychiatric illness in mother . Discussion: The findings obtained from our study support the results in the literature in terms of high comorbidity rates in ASD, diagnostic stability, the effects of mental capacity on ASD, the difficulties in the social field and the factors related to quality of life of both cases and parents. These results are thought to contribute to make the necessary arrangements for the areas in which ASD diagnosed adolescents have difficulty and to develop more effective protective measures. Key words: Autism Spectrum Disorder; prognosis ; quality of life; parental quality of life
Açıklama
05.09.2024 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır
Anahtar Kelimeler
Psikiyatri, Psychiatry
