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Yıl:2010; Cilt: 18; Sayı: 3>> Özet
TAM METİN
Kriz Dergisi; 2010;18(3):9-17
Türkiye’de leprası olan hastalarda psikiyatrik morbidite ve yetiyitimi
V Şentürk, A Sağduyu
Ankara Üniversitesi, Ankara
Amaç: Bu çalışmanın amacı Leprası olan hastalarda fiziksel ve psikolojik sorunlar nedeni ile oluşan psikiyatrik hastalıkları ve yetiyitimini araştırmaktır. Yöntem: Bu çalışma Türkiye’de bulunan tüm Lepra hastanelerinde Mart-Haziran 2001 döneminde yatarak tedavi gören Lepra hastaları ile yürütülmüştür. Bu çalışmaya 65 hasta dahil edimiştir. Değerlendirmede kullanılan ölçekler; Yapılandırılmış Tanısal Görüşme-Birinci Basamak Versiyonu, Kısa Yetiyitimi Anketi, Sosyodemografik ve Klinik Bilgi Anketleridir. Yaş, cinsiyet, hastanede kalış süresi, hastalığın aktif döneminde olmak, hastalık süresi, görünen ve görünmeyen deformitelerin varlığı, eşhastalıklar ve psikiayrik hastalıklar nedeni ile oluşan yetiyitimi gibi risk faktörleri de araştırılmıştır. Bu çalışma Leprası olan hastalarda psikiyatrik morbiditenin araştırılmasında ilk kez yapılandırılmış klinik görüşme anketinin kullanılması nedeni ile özellik taşımaktadır. Bulgular: ICD-10 tanı kriterlerine göre şimdiki depresif epizod (%12), yaygın aksiyete bozukluğu (%12) ve inatçı somatoform ağrı bozukluğu (%12) ve yineleyici kısa depresif epizod (%9) en sık görülen ruhsal hastalıklardı. Ruhsal hastalıklarda yetiyitiminin değerlendirildiği analizlerde yalnızca şimdiki depresif epizodu olan ve olmayan hastalar arasında yetiyimi istatistiksel olarak anlamlı farklı bulundu (p=0.04). Tartışma: Leprası olan yatan hastalarda depresyon görülme oranları genel toplumla benzerlik gösterirken diğer kronik hastalıklara oranla daha düşük bulunmuştur. Ancak yaygın anksiyete bozukluğu genel topluma oranla daha yüksek saptanmıştır. Hastalarda orta düzeyde işlevsellik kaybı olduğu tesbit edilmiştir. Hastaların çok düşük olan sosyoekonomik düzeyleri de dikkate alındığında psikiyatrik desteğin sosyal rehabilitasyonun bir parçası olarak düzenlenmesi gerekli görünmektedir. Anahtar sözcükler:
 Psychiatric disorders and disabilities among leprosy patients in Turkey
Objective: The aim of this study was to investigate psychiatric morbidities and disabilities due to physical and psychological problems among patients with Leprosy. Method: The study was conducted among all patients with Leprosy in the inpatient units of all the Leprosy hospitals in Turkey between March-June 2001. A total number of 65 inpatients with Leprosy were included in the study. The patients were assessed by the Composite Diagnostic Interview- Primary Health Care Version (CIDI-PHCV) and the Brief Disability Questionnaire (BDQ), and a Sociodemographic and Clinical Information Form (SCI). Risk factors such as age, gender, lenght of hospital stay, having active disease, duration of illness, having visible and nonvisible deformities, comorbidities, and disabilities for psychiatric disorders were also evaluated in the study. It was the first use of CIDI-PHCV to investigate psychiatric morbidity in patients with Leprosy. Results: The leading diagnostic distribution of the subjects according to ICD-10 criteria were current depressive episode (12%), generalized anxiety disorder (12%), persistent somatoform pain disorder (12%) and recurrent brief depressive episode (9%). When disability was evaluated for each diagnostic group of psychiatric disorders individually, only the difference between the disability scores of the patients with and without current depressive episode in accordance with ICD-10 was found to be significant (p=0.04). Conclusion: Rate of depression seen among patients with Leprosy was similar to general society and lower than other chronic diseases. But, anxiety disorder was more frequent in patients with Leprosy when compared to general population. The patients had moderate loss of functionality. By considering very low socioeconomic status of hospitalized patients with Leprosy in Turkey, psychiatric support should be positioned as a part of social rehabilitation system.

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