Dergi Ara >>
Yıl:2004; Cilt: 5; Sayı: 3>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2004;5(3):148-153
Yatarak tedavi gören madde bağımlılığı (alkol ve alkol dışı) tanısı konan hekimlerin özellikleri
N Ünsalan, A Kalyoncu, Ö Pektaş, H Mırsal, M Beyazyürek
Maltepe Üniversitesi Tıp Fakültesi Psikiyatri ABD, İSTANBUL
Amaç: Bu çalışmanın amacı, bağımlılık kliniğine yatarak tedavi için başvuran hastalar arasından bir meslek grubu olan
hekimlerdeki bağımlılık özelliklerini araştırmaktır. Yöntem: Çalışmaya 1997–2002 yılları arasında, kliniğimizde DSM-IV
tanı ölçütlerine göre Madde Kullanım Bozukluğu (bağımlılık/kötüye kullanım) tanısı ile yatarak tedavi gören toplam 4879
hasta içinden, mesleği hekim olan 41 hasta alınmıştır. Hastaların sosyodemografik özellikleri, kullandıkları maddeler,
kullanım şekilleri, ek psikiyatrik ve dahili hastalıkları saptanarak tanımlayıcı oranlar değerlendirilmiştir. Bulgular: Çalışmaya
28 erkek (%68.3), 13 kadın (%31.7) hasta alınmıştır. Çalışmaya alınanların yaş ortalaması 38.0±10.61’dir. Madde kullanım
bozukluğu olan hekimlerin genel hastane örneklemi içindeki oranı %0.84’tür. Çalışmaya alınan hekim hastaların 25’i uzman
hekim (%61), 16’sı pratisyen hekimdir (%39). İlk kullanım yaşları alkol için 17.1±2.3, meperidin için 32.2±5.4 ve diğerleri
(ilaç, kokain, esrar) için 28.4±4.8 yıl olarak bulunmuştur. Meperidin kullananlarda ilk kullanım gerekçesi, ameliyat ve/veya
trafik kazası sonrası gibi tıbbi bir gerekçedir. İlaç kullananlarda da benzer şekilde ilk kullanımın hekim önerisiyle olduğu
bildirilmiştir. Hastaların %78’i (n=32) tedaviye gelmelerinde iş yerinden aldıkları uyarıların etkili olduğunu bildirmişlerdir.
Hastaların %58’i (n=24) daha önce ayaktan tedavi olduklarını belirtmiştir. Tartışma: İlk dikkati çeken bulgu cinsiyet
dağılımının genel bağımlılık verilerine göre kadınlar açısından fazla olmasıdır. Klinik örneklemi içindeki hekim oranı ise
“düşük” olarak değerlendirilmiştir. Alkol kullanım yaşı genel veriler ile koşut olarak değerlendirilmiştir. Kullanım gerekçeleri
bir rasyonalizasyonun sonucu değil ise hekimlerde meperidin bağımlılığının tıbbi bir kullanımla çok yüksek olasılıkla
ilişkili olduğunu düşündürmektedir. Tanımlayıcı ve ön çalışma niteliğinde olan çalışmamızın bulguları ülkemizdeki hekim
bağımlılar ile ilgili olarak daha sonraki çalışmalarımız için önemli ipuçları sunmaktadır.
Characteristics of inpatient physicians diagnosed with substance use disorders (alcohol and other substances)
Objective: The aim of this study was to investigate the dependence characteristics of a specific occupational category:
physicians. Methods: Forty-one physicians who had been diagnosed with substance use disorders (abuse/dependence) by DSM-IV diagnostic criteria, between 1997–2002 were included in this study. These physicians were selected from a
total of 4879 similarly diagnosed patients. All patients treated in our clinic were evaluated according to inpatient
sociodemographic characteristics, substances abused and methods of use. Comorbid psychiatric and physical disorders of
patients were determined in detail and verifying rates were evaluated. Results: Twenty-eight male (63%) and thirteen
female (31.7) patients were included in this study. The mean age of patients was 38.0±10.61. The rate of dependent
physicians in the general hospital population was 0.84%. Twenty-five (61%) of the patients admitted to the study were
specialist physicians and sixteen (39%) were general practitioners. Age of first use was; 17.1±2.3 for alcohol, 32.2±5.4
for meperidin and 28.4±4.8 for all others (drugs, cocaine and cannabis). The initial reason for meperidin use was a
medical one, such as pain relief after an operation or accident. Similarly, in the case of drug users, it was reported that
first use was advised by a physician. 78% (n= 32) of patients reported that the warnings they had received from their
offices were effective in leading them to seek treatment. It was discovered that 58% of those studied had previously
received outpatient treatment. Discussion: The first finding that attracted attention was that according to general
dependence data, gender distribution was weighted toward females. The rate of physicians in the clinical population was
evaluated as “low”. The age of onset of alcohol use was evaluated as being consistent with that of the general population.
If the reason-for-use was not the result of a rationalization, it is thought that in physicians, meperidin dependence is
closely related to medical use. The findings of our verifying study provide very important indications for future studies
of dependent physicians in our country.

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