Bipolar disorder and diagnostic course of asperger syndrome in an adolescent: a case report/Ergende bipolar bozukluk ve asperger sendromu tani sureci: bir olgu sunumu

Asperger sendromu (AS) sosyal zorluklar, basmakalip davranis oruntusu, sinirli ilgi alanlari ile seyreden yaygin gelisimsel bozukluklardan biridir. Cocuklugun erken donemlerinden itibaren sosyal gelisimle ilgili problemler ve basmakalip, takintili davranis oruntusu fark edilse de, konusmada gecikme olmamasi, zekanin normal olmasi ve akademik becerilerin iyi olmasi gibi nedenlerle AS tanisinin konmasi gecikebilmektedir. AS olan bireylerde komorbid psikiyatrik bozukluklar sikca gozlenmektedir. Bazen klinige ilk basvuru sebebi bu komorbid psikiyatrik bozukluklar olabilmektedir. Siklikla ayrintili bir aile ve gelisim oykusu zemindeki yaygin gelisimsel bozuklugun taninmasinda yardimcidir. Ote yandan, AS olan bireylerin ailelerinde bipolar bozukluk oraninin yuksek oldugu bilinmekte, hatta bu iki bozuklugun ortak norobiyolojik temelleri olabilecegi dusunulmektedir. Bu yazida, ilk kez 13 yasindayken kaygi belirtileri ile klinige basvuran bir gencte serotonin geri alim inhibitoru tedavisi sirasinda gelisen hipomanik belirtiler sebebiyle fark edilen AS tanisinin tartisilmasi amaclanmaktadir. (NoropsikiyatriArsivi2010; 47:360-3) Anahtar kelimeler: Ergen, Asperger sendromu, bipolar bozukluk, tani Asperger syndrome (AS) is a developmental disorder that is on a diagnostic continuum with autism, and falls under the category of pervasive developmental disorders. Diagnosis may be delayed due to relatively normal speech development, normal intelligence and fair scholar skills, although problems in social development and obsessive, sometimes stereotyped, behavior pattern are recognized from early periods of childhood. Comorbid psychiatric disorders are frequently observed in cases of AS. Sometimes these comorbidities are the initial diagnoses subject to treatment. A detailed family and developmental history of the child is usually helpful for the recognition of the underlying developmental disorder. On the other hand, it is known that the prevalence of bipolar affective disorder in families of individuals with AS is higher than that of the general population, and it is hypothesized that these two disorders might have a common neurobiological basis. In this paper, we aim to discuss an adolescent who first presented with anxiety symptoms at the age of 13 and, with emerging hypomanic symptoms during the course of selective serotonin reuptake inhibitor treatment, which ultimately led to the underlying diagnosis of AS. (Archives of Neuropsychiatry 2010; 47:360-3) Key words: Adole