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Çocuk ve Ergenlerde Tip 1 Diyabetes Mellitus ile DEHB ve DEHB Şiddeti arasında Bir İlişki Var mı?: Vaka Kontrol Çalışması

Yıl 2020, Cilt: 42 Sayı: 2, 165 - 172, 17.03.2020
https://doi.org/10.20515/otd.515037

Öz



Çalışmamızda çocuk ve ergenlerde
tip 1 diyabetes mellitus (DM) ile dikkat eksikliği hiperaktivite bozukluğu (DEHB)
ve DEHB şiddetiyle ilişkinin araştırılmasını amaçladık. Çalışmaya 6-18 yaş
arası, tip 1 DM tanısı ile takip edilen olgular (n:80) ve sağlıklı çocuklar (n:80)
alındı. Katılımcılara DSM-5(
Amerikan Psikiyatri Birliği Ruhsal
Bozuklukların Tanısal ve istatistiksel El Kitabı'nın beşinci baskısı)
tanı ölçütlerinin göz önünde bulundurulduğu psikiyatrik
değerlendirme, bilgi formu,  Okul Çağı
Çocukları (6-18) için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi -
Şimdi ve Yaşam Boyu şekli - Türkçe Uyarlamasının(ÇDŞG-ŞY-T) DEHB ile ilgili
kısmı, DuPaul DEHB ölçeği, Conners Öğretmen Derecelendirme Ölçeği(CÖDÖ)  ve Conners aile Derecelendirme Ölçeği (CADÖ)
uygulandı. İki grup DEHB ve DEHB şiddeti açısından karşılaştırıldı. Tip 1 DM tanılı
olguların 16’sı, kontrol grubundan ise 5’i DEHB tanısı aldı ve vaka grubunda
DEHB tanısı oranı daha yüksek çıktı (Ki-Kare p<0,05). DEHB ölçek puanları
arasında istatistiksel olarak anlamlı farklılık bulundu. Olgu grubunda DEHB
tanısı alanların HbA1c ortalamaları, almayanlara göre daha yüksekti (p=0,020). Olgu grubunda
DEHB tanısı alanların HbA1c ile CÖDÖ dikkat kısmı dışındaki tüm ölçek puan
parametreleri, DEHB tanısı almayanlara göre daha yüksek bulundu (p=0,020). Olgu
grubunda DEHB’li olanların, olmayanlara göre diyabet tanısı ile geçirilen süre,
hastaneye yatış sayısı ve ketoasidoz atak sayıları daha fazlaydı (p<0.05). Çalışmamızda
DEHB tanısı açısından kontrol ve olgu grupları arasında anlamlı fark vardı ve
DEHB ile tip 1 DM arasında bir ilişki olması muhtemeldir. Bu ilişkinin net bir
şekilde açıklanabilmesi için daha ayrıntılı ve ileri çalışmalara ihtiyaç
vardır.

Kaynakça

  • 1. Paule MG, Rowland AS, Ferguson SA, Chelonis JJ, Tannock R, Swanson JM, Castellanos FX. Attention deficit/hyperactivity disorder: characteristics, interventions and models. Neurotoxicol Teratol 2000; 22:631-651.
  • 2. Kaplan HI, Saddock BJ, Greeb JA. Kaplan and Saddock’s Synopsis of Psychiatry: behavioural sciences clinical psychiatry. 7thed. Baltimore, USA: Williams and Wilkins; 1994.
  • 3. Gül H, Öncü B. Environmental Factors in the Etiology of Attention Deficit Hyperactivity Disorder. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2018;10:138-175
  • 4. Bayali MK, Tahiroğlu A, Yolga FS, Avci A, Yüksel BA. Diabetes camp activity. Anatolian Journal of Psychiatry 2006; 7:218-22
  • 5. Butwicka A, Frisén L, Almqvist C, Zethelius B, Lichtenstein P. Risks of Psychiatric Disorders and Suicide Attempts in Children and Adolescents With Type 1 Diabetes: A Population-Based Cohort Study. Diabetes Care 2015; 38:453-4596. Chen HJ, Lee YJ, Yeh GC, Lin HC. Association of attention deficit/hyperactivity disorder with diabetes: a population-based study. Pediatr Res. 2013;73:492-6.
  • 7. Lin SY, Lin CL, Hsu WH, Lin CC, Fu YC. Association of attention deficit hyperactivity disorder with recurrent hypoglycemia in type 1 diabetes mellitus. Pediatr Diabetes. 2018 Jun 25. doi: 10.1111/pedi.12716.
  • 8. Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-Turkish version (K-SADS-PL-T). Turk J Child Adolesc Mental Health. 2004; 11:109–116.(Article in Turkish with an abstract in English).
  • 9. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N.Schedule for affective disorders and schizophrenia for school age children-present and lifetime version (K-SADS-PL):initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36:980-988.
  • 10. Dupaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale IV: checklists, norms and clinical interpretation. New York (NY): Guilford; 1998.
  • 11. Conners CK. A teacher rating scale for use in drug studies with children. Am J Psychiatr 1969: 126: 884-888.
  • 12. Şener Ş, Dereboy Ç, Dereboy İF, Sertcan Y. Conners öğretmen derecelendirme ölçeği Türkçe uyarlaması-I. Çocuk ve Gençlik Ruh Sağlığı Dergisi,1995; 2:131-141. (Article in Turkish with an abstract in English).
  • 13. Dereboy Ç, Şenol S, Şener Ş, Sertcan Y. Conners ana baba derecelendirme ölçeği uyarlama çalışması. X. Ulusal Psikoloji Kongresi, 1998
  • 14. Kovacs M, Goldston D, Obrosky D, Bonar LK. Psychiatric disorders in youths with IDDM: rates and risk factors. Diabetes Care 1997; 20:36-44.
  • 15. Şahin N, Öztop DB, Yılmaz S, Altun H. Assessment of Psychopathology, Quality of Life, and Parental Attitudes in Adolescents with Type 1 Diabetes Mellitus. Arch Neuropsychiatr 2015; 52: 133-8
  • 16. Bruehl H, Sweat V, Tirsi A, Shah B, Convit A.Obese adolescents with type 2 diabetes mellitus have hippocampal and frontal lobe volume reductions. Neurosci Med 2011; 2:34-42.
  • 17. Hershey T, Perantie DC, Warren SL, Zimmerman EC, Sadler M, White NH. Frequency and timing of severe hypoglycemia affects spatial memory in children with type 1 diabetes. Diabetes Care 2005; 28:2372-2377
  • 18. Sommerfield AJ, Deary IJ, McAulay V, Frier BM. Moderate hypoglycemia impairs memory functions in healthy adults. Neuropsychology 2003;17: 125–132.
  • 19. Ryan CM, van Duinkerken E, Rosano C. Neurocognitive consequences of diabetes. Am Psychol 2016; 71:563-576.
  • 20. Lunnetta M, Damanti A. R, Fabbri G, Lombardo M, Di MauroL M, Mughini L. Evidence by magnetic resonance imaging of cerebral alterations of atrophy type in young insulin-dependent diabetic patients. J Endocrinol Invest 1994; 17: 241-245.
  • 21. Bade-White PA, Obrzut JE. The Neurocognitive Effects of Type 1 Diabetes Mellitus in Children and Young Adults With and Without Hypoglycemia. J Dev Phys Disabil 2009; 21:425-440.
  • 22. Yazıcı K, Yazıcı AE. Neuroanatomical and Neurochemical Basis of Impulsivity. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2010;2:254¬-280
  • 23. LevittKatz LE, Swami S, Abraham M, Murphy KM, Jawad AF, Mc Knight-Menci H, Berkowitz R. Neuropsychiatric disorders at the presentation of type 2 diabetes mellitus in children. Pediatric Diabetes 2005: 6: 84-89.
  • 24. Kapellen TM, Reimann R, Kiess W, Kostev K. Prevalence of medically treated children with ADHD and type 1 diabetes in Germany - Analysis of two representative databases. J Pediatr Endocrinol Metab. 2016; 29:1293-1297.
  • 25. Hannonen R, Tupola S, Ahonen T, Riikonen R. Neurocognitive functioning in children with type-1 diabetes with and without severe hypoglycemia. Dev Med Child Neurol 2003; 45: 262–268.

Is There a Relation between Type 1 Diabetes Mellitus and ADHD and Severity of ADHD in Children and Adolescents? A Case-Control Study

Yıl 2020, Cilt: 42 Sayı: 2, 165 - 172, 17.03.2020
https://doi.org/10.20515/otd.515037

Öz



Our aim in this study was to
investigate the relation between type 1 diabetes mellitus (DM) and attention
deficit-hyperactivity disorder (ADHD) and severity of ADHD in children and
adolescents. Cases (n:80) and healthy children (n:80) aged 6-18 and
followed-up with Type 1 DM were included in the study. Psychiatric evaluation
in the light of DSM-5 (
The Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition
diagnostic criteria), an information form, the ADHD section of the Schedule for
Affective Disorders and Schizophrenia for School-Age Children (6-18)
(K-SADS-PL-T), the DuPaul ADHD Rating Scale, the Conners Teaching Rating
Scale (CTRS), and the Conners Parental Rating Scale (CPRS) was applied to the
participants. The two groups were compared in terms of ADHD and ADHD severity. Sixteen
of the cases with type 1 DM, and 5 of the control group were diagnosed with
ADHD, the rate of ADHD being higher in the case group (chi-square p<0.05). A
statistically significant difference was determined between the ADHD scale
scores. Mean HbA1c in cases diagnosed with ADHD in the case group was higher
than in undiagnosed cases (p=0.020). All scale parameters, apart from HbA1c and
the attention part of the CTRS, were higher in cases diagnosed with ADHD in the
case group than in cases not diagnosed with ADHD(p=0.020). Duration of exposure
to diabetes, and numbers of hospitalizations and ketoacidosis attacks were
higher in cases with ADHD in the case group than in those without ADHD (p<0.05).
There was a significant difference in terms of ADHD between the control and
case groups in our study, and there is a probable association between ADHD and
type 1 DM. Further, more detailed studies are needed to provide a clear
explanation of that relation.

Kaynakça

  • 1. Paule MG, Rowland AS, Ferguson SA, Chelonis JJ, Tannock R, Swanson JM, Castellanos FX. Attention deficit/hyperactivity disorder: characteristics, interventions and models. Neurotoxicol Teratol 2000; 22:631-651.
  • 2. Kaplan HI, Saddock BJ, Greeb JA. Kaplan and Saddock’s Synopsis of Psychiatry: behavioural sciences clinical psychiatry. 7thed. Baltimore, USA: Williams and Wilkins; 1994.
  • 3. Gül H, Öncü B. Environmental Factors in the Etiology of Attention Deficit Hyperactivity Disorder. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2018;10:138-175
  • 4. Bayali MK, Tahiroğlu A, Yolga FS, Avci A, Yüksel BA. Diabetes camp activity. Anatolian Journal of Psychiatry 2006; 7:218-22
  • 5. Butwicka A, Frisén L, Almqvist C, Zethelius B, Lichtenstein P. Risks of Psychiatric Disorders and Suicide Attempts in Children and Adolescents With Type 1 Diabetes: A Population-Based Cohort Study. Diabetes Care 2015; 38:453-4596. Chen HJ, Lee YJ, Yeh GC, Lin HC. Association of attention deficit/hyperactivity disorder with diabetes: a population-based study. Pediatr Res. 2013;73:492-6.
  • 7. Lin SY, Lin CL, Hsu WH, Lin CC, Fu YC. Association of attention deficit hyperactivity disorder with recurrent hypoglycemia in type 1 diabetes mellitus. Pediatr Diabetes. 2018 Jun 25. doi: 10.1111/pedi.12716.
  • 8. Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-Turkish version (K-SADS-PL-T). Turk J Child Adolesc Mental Health. 2004; 11:109–116.(Article in Turkish with an abstract in English).
  • 9. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N.Schedule for affective disorders and schizophrenia for school age children-present and lifetime version (K-SADS-PL):initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36:980-988.
  • 10. Dupaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale IV: checklists, norms and clinical interpretation. New York (NY): Guilford; 1998.
  • 11. Conners CK. A teacher rating scale for use in drug studies with children. Am J Psychiatr 1969: 126: 884-888.
  • 12. Şener Ş, Dereboy Ç, Dereboy İF, Sertcan Y. Conners öğretmen derecelendirme ölçeği Türkçe uyarlaması-I. Çocuk ve Gençlik Ruh Sağlığı Dergisi,1995; 2:131-141. (Article in Turkish with an abstract in English).
  • 13. Dereboy Ç, Şenol S, Şener Ş, Sertcan Y. Conners ana baba derecelendirme ölçeği uyarlama çalışması. X. Ulusal Psikoloji Kongresi, 1998
  • 14. Kovacs M, Goldston D, Obrosky D, Bonar LK. Psychiatric disorders in youths with IDDM: rates and risk factors. Diabetes Care 1997; 20:36-44.
  • 15. Şahin N, Öztop DB, Yılmaz S, Altun H. Assessment of Psychopathology, Quality of Life, and Parental Attitudes in Adolescents with Type 1 Diabetes Mellitus. Arch Neuropsychiatr 2015; 52: 133-8
  • 16. Bruehl H, Sweat V, Tirsi A, Shah B, Convit A.Obese adolescents with type 2 diabetes mellitus have hippocampal and frontal lobe volume reductions. Neurosci Med 2011; 2:34-42.
  • 17. Hershey T, Perantie DC, Warren SL, Zimmerman EC, Sadler M, White NH. Frequency and timing of severe hypoglycemia affects spatial memory in children with type 1 diabetes. Diabetes Care 2005; 28:2372-2377
  • 18. Sommerfield AJ, Deary IJ, McAulay V, Frier BM. Moderate hypoglycemia impairs memory functions in healthy adults. Neuropsychology 2003;17: 125–132.
  • 19. Ryan CM, van Duinkerken E, Rosano C. Neurocognitive consequences of diabetes. Am Psychol 2016; 71:563-576.
  • 20. Lunnetta M, Damanti A. R, Fabbri G, Lombardo M, Di MauroL M, Mughini L. Evidence by magnetic resonance imaging of cerebral alterations of atrophy type in young insulin-dependent diabetic patients. J Endocrinol Invest 1994; 17: 241-245.
  • 21. Bade-White PA, Obrzut JE. The Neurocognitive Effects of Type 1 Diabetes Mellitus in Children and Young Adults With and Without Hypoglycemia. J Dev Phys Disabil 2009; 21:425-440.
  • 22. Yazıcı K, Yazıcı AE. Neuroanatomical and Neurochemical Basis of Impulsivity. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2010;2:254¬-280
  • 23. LevittKatz LE, Swami S, Abraham M, Murphy KM, Jawad AF, Mc Knight-Menci H, Berkowitz R. Neuropsychiatric disorders at the presentation of type 2 diabetes mellitus in children. Pediatric Diabetes 2005: 6: 84-89.
  • 24. Kapellen TM, Reimann R, Kiess W, Kostev K. Prevalence of medically treated children with ADHD and type 1 diabetes in Germany - Analysis of two representative databases. J Pediatr Endocrinol Metab. 2016; 29:1293-1297.
  • 25. Hannonen R, Tupola S, Ahonen T, Riikonen R. Neurocognitive functioning in children with type-1 diabetes with and without severe hypoglycemia. Dev Med Child Neurol 2003; 45: 262–268.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

İsmail Akaltun 0000-0002-9938-9276

Tayfun Kara 0000-0002-2156-3457

Atilla Çayır 0000-0001-9776-555X

Hamza Ayaydın 0000-0003-4909-0070

Yayımlanma Tarihi 17 Mart 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 42 Sayı: 2

Kaynak Göster

Vancouver Akaltun İ, Kara T, Çayır A, Ayaydın H. Is There a Relation between Type 1 Diabetes Mellitus and ADHD and Severity of ADHD in Children and Adolescents? A Case-Control Study. Osmangazi Tıp Dergisi. 2020;42(2):165-72.


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