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Yıl:2018; Cilt: 5; Sayı: 3>> Özet
TAM METİN
The Journal of Neurobehavioral Sciences; 2018;5(3):187-189
Bipolar depresyonda antidepresan monoterapisi standart tedavi ile psikiyatrik malpraktis arasındaki ince çizgide nerede dolaşır?: intihar bakış açısından bir açımlama
YH Balcioğlu
Bakırköy Ruh Sağlığı ve Sinir Hastalıkları , İstanbul,
Tıpta malpraktis iddialarıyla en az karşı karşıya kalan branşlardan biri psikiyatridir. İntihar riskinin değerlendirilmesindeki hatalar psikiyatri uygulamalarında en sık karşılaşılan dava konularındandır. İntiharın tahmin edilmesi güç tanısal doğasına rağmen hukuk, psikiyatristlerden intiharı öngörebilmesini ve önlemesini bekler. Bipolar bozukluk, özellikle depresif hecmedeki yüksek intihar davranış oranlarıyla ilişkili bir affektif bozukluktur. Bu yüzden bipolar depresyonda standart terapötik yaklaşımların ana amacı intihar riskini azaltmaktır. Bipolar depresyonda tedavi seçenekleri klinisyen tarafından hastalığın şiddeti ve intihar riski göz önünde bulundurularak dikkatlice şekillendirilmelidir. Bu yazı, bipolar bozuklukta antidepresan kullanımının olası malpraktis açısından ne ölçüde uygun olduğunu kanıta dayalı klinik kılavuzlar ve güncel literatür ışığında tartışmayı amaçlamıştır.
To what extent antidepressant monotherapy stroll upon the pinstripe between standard of care and psychiatric malpractice in bipolar depression?: a commentary from the viewpoint of suicide
Psychiatry is one of the least facing profession to malpractice claim in medicine. Misevaluation of suicide risk is one of the most frequent issues for litigation in the practice of psychiatry. Psychiatrists are expected to foresee and prevent suicidality by the law, although suicide has an unpredictable diagnostic nature. Bipolar disorder (BPD) is an affective disorder associated with elevated rates of suicidal behaviour, particularly in depressive episodes. Therefore, the main target of standard therapeutic approaches in BPD depression is the reduction of suicide risk. Treatment options ought to be carefully formed by the clinician, in light of the determination of clinical severity and suicidal risk in bipolar depression. This article aimed to discuss to what extent use of antidepressants is appropriate in bipolar depression regarding possible malpractice in line with evidence-based clinical guidelines and actual literature

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