The relationship of a co-diagnosis of attention deficit hyperactivity disorder with empthy and self esteem in patients with social anxiety

SUMMARY Title: The Relationship of A Co-Diagnosis of Attention Deficit Hyperactivity Disorder with Empthy and Self Esteem in Patients with Social Anxiety Objective and hypothesis: The aim of this study is the comparative examination of the empathy and self esteem levels, as well as the sociodemographic and clinical features of the SAD and SAD+ADHD groups. We have two hypotheses: There is a relationship between a co-diagnosis of attention deficit hyperactivity disorder and empathy in patients with social anxiety disorder and there is a relationship between a co-diagnosis of attention deficit and hyperactivity disorder and self-esteem in patients with social anxiety disorder. Method: This research is an analytical cross sectional study. The collection of research data was carried out between February 2017 and October 2017 at the Aydın Adnan Menderes University Research and Practice Hospital Psychiatry Policlinic and Psychiatry Inpatient Department. The universe of the study was all SAD and SAD+ADHD patients who were admitted to the polyclinic or were being followed up during the period of finding participants for the study. A total of 28 patients, including 13 SAD patients and 15 SAD+ADHD patients, were included in the study. The Sociodemographic Clinical Data Form, Structured Clinical Interview for DSM-IV Axis I Disorders(SCID-I), Rosenberg Self Esteem Scale, Empathy Scale, Wender-Utah Rating Scale, Beck Depression Inventory, Beck Anxiety Inventory, Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version Turkish version, Liebowitz Social Anxiety Scale, and DSM-IV based Adult ADD/ADHD Diagnostic and Evaluation Inventory were applied to all participants. The Type-1 error level was taken as 5%. Results: The Sociodemographic comparison of SAD and SAD+ADHD patients did not reveal any significant difference other than a history of migration. The SAD+ADHD group had a higher rate of history of migration, while this rate was lower in the SAD group. We found empathy and self-esteem levels to be lower in the SAD+ADHD group compared to the SAD group. This difference was statistically significant for empathy, but not for self-esteem. There was a negative correlation between social anxiety level and self-esteem. Similarly, there was a negative correlation between empathy and ADHD. Self-esteem was found to be significantly lower in SAD patients with childhood ADHD compared to those without childhood ADHD. The age of onset of SAD was younger and the period between the onset of the disorder and start of treatment was shorter in the SAD+ADHD group compared to the SAD group. There was also a higher number of depressive symptoms and co-diagnosis and a higher rate of smoking in the SAD+ADHD group. When the ADHD subtypes were examined, attention deficit was the predominant type. Conclusion: This study revealed that there is a correlation between SAD with a co-diagnosis of ADHD and empathy and self esteem, and that a co-diagnosis of ADHD worsens the prognosis of SAD. For this reason,we think that it is important and necessary to provide empathy training and treatment interventions to ADHD patients starting in childhood and to improve the social functioning of these patients, and we anticipate that these interventions will increase functioning in further periods, improve prognosis, and reduce the risk of developing a social anxiety disorder. In this regard, in the new studies with larger samples where the treatment process and clinical process can be followed are needed. Key words: Social Anxiety, Attention Deficit Hyperactivity Disorder , Self Esteem, Empathy Contact address: Adnan Menderes UniversityFaculty of Medicine, Department ofPsychiatry, Aydın, Tel: 0256444 12 56- 4119.