Phenomenology and Psychiatric Comorbidity in Pediatric Bipolar Disorder/Pediyatrik Bipolar Bozuklukta Fenomenolojik Özellikler ve Psikiyatrik Komorbidite

Abstract Aim: We aimed to investigate phenomenology and psychiatric comorbidity in a clinical sample of young patients with bipolar disorder (BD). Materials and Methods: Young patients who had been followed up after diagnosis with BD in a faculty clinic were included in the study. Data regarding phenomenology and clinical characteristics of mood episodes were gathered from medical records of the subjects, clinical interviews with the subjects and parents, and the follow-up data of the subjects. Psychiatric assessment was conducted by using a semi-structured diagnostic instrument. Results: Nineteen males (63%) and eleven females (37%) who were aged between 11 and 18 years (14.87±1.94 years) were included in the study. Their primary diagnoses were BD type I (n=22; 73%), BD type II (n=3; 10%), and BD–Not Otherwise Specified (n=5; 17%). More than half of the subjects (53%) had developed psychotic symptoms (i.e. perceptual and/or thought disturbances) during mood episodes. Nine subjects (30%) had attempted suicide once or twice. The frequency of diagnostic categories from which criteria for at least one disorder met was as follows: anxiety disorders (n=28; 93%), attention deficit hyperactivity disorder (n=23; 77%), depressive disorders (n=16; 53%), tic disorders (n=15; 50%), oppositional defiant disorder (n=8; 27%), and substance use disorders (n=7; 23%) Discussion and Conclusion: Compared to the adult form of the illness, some developmental differences may be observed in pediatric BD. BD in young subjects is highly comorbid with other psychiatric disorders, particularly anxiety, depressive disorders, and attention deficit hyperactivity disorder. Young subjects with BD should carefully be assessed for comorbid psychiatric disorders for differential diagnosis and treatment planning. Keywords: bipolar; mood; children; adolescents; phenomenology; comorbidity Ozet Amac: Bipolar bozuklugu (BB) olan cocuk ve ergenlerden olusan bir klinik orneklemde fenomenolojik ozellikleri ve psikiyatrik komorbiditeyi arastirmak amaclanmistir. Gerec ve Yontemler: Bir fakulte hastanesi kliniginde BB tanisiyla takip edilen cocuk ve ergenler calismaya dahil edilmistir. Duygudurum episodlarina ait fenomenolojik ve klinik ozellikler, hasta dosyalarinin incelenmesi, hasta ve ailelerle yapilan gorusmeler ve klinik takiplerden elde edilen bilgilerden derlenmistir. Psikiyatrik degerlendirme araci olarak yari yapilandirilmis bir tanisal gorusme formu kullanilmistir. Bulgular: Yaslari 11 ile 18 arasinda degisen (14.87±1.94 yas) 19 erkek (%63) ve 11 kadin (%37) hasta calismaya dahil edildi. Birincil tanilari BB tip I (n=22; %73), BB tip II (n=3; %10) ve baskaturlu- adlandirilamayan BB (n=5; %17) seklindeydi. Olgularin yarisindan fazlasinda (%53) psikotik semptomlar vardi. Dokuz olguda (%30) bir veya iki kez intihar girisimi oykusu vardi. En az bir bozukluk icin tani kriterlerinin karsilandigi komorbid bozukluk tani gruplarinin sikligi soyleydi: anksiyete bozukluklari (n=28; %93), dikkat eksikligi hiperaktivite bozuklugu (n=23; 77%), depresif bozukluklar (n=16; %53), tik bozukluklari (n=15; %50), karsi olma karsi gelme bozuklugu (n=8; %27) ve madde kullanim bozukluklari (n=7; %23). Tartisma ve Sonuc: Pediyatrik BB’de hastaligin eriskin formuna kiyasla bazi gelisimsel farkliliklar gorulebilir. Pediyatrik BB ozellikle anksiyete, depresif bozukluklar ve dikkat eksikligi hiperaktivite bozuklugu olmak uzere diger psikiyatrik bozukluklarla yuksek komorbidite gostermektedir. BB’li cocuk ve ergenler ayrici tani ve tedavinin planlanisi acisindan psikiyatrik komorbidite icin ayrintili bir sekilde degerlendirilmelidir. Anahtar Sozcukler: bipolar; duygudurum; cocuklar; ergenler; klinik ozellikler; komorbidite