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Yıl:2016; Cilt: 23; Sayı: 2>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2016;23(2):111-124
Bir Eğitim Araştırma Hastanesine Başvuran Obsesif-Kompulsif Bozukluk Tanılı Çocuk ve Ergenlerin Klinik ve Demografik Özellikleri
SD Tunas, Z Göker, G Dinç, ÖH Bozkurt, E Güney, ÖŞ Üneri
Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim Araştırma Hastanesi, Ankara
Amaç: Bu çalışmada Obsesif Kompulsif Bozukluk (OKB) tanılı çocuk ve ergenlerin sosyodemografik ve klinik özelliklerinin değerlendirilmesi amaçlanmıştır. Yöntem: Mayıs 2013-Aralık 2013 tarihleri arasında Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim Araştırma Hastanesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları polikliniğine başvuran olguların kayıtları geriye dönük incelenmiş, OKB tanılı toplam 93 olgu çalışmaya dahil edilmiştir. Olguların sosyodemografik özellikleri, obsesyon ve kompulsiyon içerikleri, eşlik eden diğer psikiyatrik bozukluklar ve bunların sosyodemografik özellikler ile arasındaki ilişki analiz edilmiş, p<0.05 değeri istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: Örneklemin yaş ortalaması 12.0±2.9 (4-17 yaş) olarak bulunmuştur. Olguların 49’unu (%52.7) kız çocukları oluşturmaktadır. Obsesyon ve kompulsiyonlar değerlendirildiğinde, 66 (%71) olguda obsesyon ve kompulsiyonların birlikte görüldüğü saptanmıştır. En sık gözlenen obsesyonların fiziksel zarar verme, zarar görme ya da saldırganlık (n=30, %39.8) ve bulaş, kirlenme, hastalık kapma ya da hastalanma ile uğraş (n=30, %39.8) olarak bulunmuştur. En sık görülen kompulsiyonların ise “yıkama, temizleme, belli bir düzen ile temizleme ya da kaçınma” (n=37, %39.8) kompulsiyonları olduğu saptanmıştır. Olguların %34.4’ünde OKB’ye eşlik eden dikkat eksikliği hiperaktivite bozukluğu ve anksiyete bozukluğu gibi psikiyatrik bozuklukların olduğu gözlenmiştir. Tedavinin %64.6’sını (n=60) serotonin geri alım inhibitörü (SSGİ= grubu ilaçlarla monoterapi ve %25.5 (n=22)’ini kombine farmakoterapilerin oluşturduğu saptanmıştır. Farmakoterapi uygulamasını yordayan etkenler; ergen yaş grubunda olmak ve bulaş, kirlenme, hastalık kapma ya da hastalanma ile uğraş obsesyonlarının varlığı olarak belirlenmiştir. Tartışma: Çalışma sonuçlarına göre OKB, çocuk ve ergen yaş grubunda kız ve erkek çocuklarını eşit şekilde etkileyen, ergen yaş grubunda anlamlı olarak daha fazla görülen bir bozukluk olup tedavisinde SSGİ monoterapisi çoğu kez ilk seçenek olarak kullanılmaktadır. Çalışma bulgularının genellenebilmesi için elde edilen niteliksel ve niceliksel veriler ileriye dönük, toplum örneklemini de içeren araştırma desenleri ile ele alan yeni çalışmalara ihtiyaç bulunmaktadır.
Clinical and Demographic Features of Children and Adolescents Diagnosed with Obsessive Compulsive Disorder Applied to A Training and Research Hospital
Objective: This study aimed to evaluate sociodemographic and clinical features of children and adolescents who were diagnosed with Obsessive-Compulsive Disorder (OCD). Method: Data of children and adolescents that have applied to Ankara Pediatric Hematology Oncology Training and Research Hospital were retrospectively evaluated between the dates May 2013 and December 2013, and a total of 93 cases diagnosed with OCD were included in the study. Sociodemographic features, context of obsessions and compulsions, presence of accompanying any comorbid psychiatric disorders and their probable effects on sociodemographic features were analyzed and p<0.05 was accepted as statistical significance level. Results: Mean age of the sample was 12.0±2.9 (4-17 years). Forty-nine of the cases (52.7%) were girls. Sixty-six (71%) had both obsessions and compulsions, whilst 27 of all (29%) had only obsession. There was not found purely compulsion in any case. Most commonly seen obsessions were as follows; giving physical harm, being harmed, aggression (n=30, 39.8%) and contamination, contracting a disease or getting ill (n=30, 39.8%). One obsession dominance was found in 73.1% of all cases (n=68) whereas in 26.9% of them (n=25) had one more than obsessions. Most frequently seen compulsions were "cleaning, washing, cleaning within a certain order and avoidance (n=37, 39.8%). One compulsion dominance had 51.5% of all cases (n=48), whilst 19.4% of cases (n=18) had one more compulsions. Comorbid psychiatric disorders such as ADHD and anxiety disorders have been found in 34.4% of all cases with OCD. SSRI monotherapy was used in 64.4% (n=60) of the cases whereas 25.5% (n=22) were treated with combined pharmacotherapeutic agents. Predictors of pharmacotherapeutic agent use were found as being in the adolescence period, having obsessions about contamination, contracting a disease or becoming ill or injured. Discussion: In the light of our results, OCD might be conceptualized as a disorder affecting both girls and boys evenly within childhood and adolescence, seen statistically higher in adolescence, and SSRIs mainly being used as the first- line treatment There is a need for further novel studies in the future with community-based designs including collected quantitative and qualitative data for generalization of these results.

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