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Yıl:2021; Cilt: 28; Sayı: 1>> Özet
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Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2021;28(1):7-11
Bir Üniversite Hastanesi Çocuk ve Ergen Psikiyatrisi KliniğindeYatan Hastaların Sosyodemografik ve Tanısal Özellikleri
M Karadağ, N Türk, C Gökçen, Z Topal
Gaziantep Üniversitesi. Gaziantep
Amaç: Bu çalışmada bir çocuk ve ergen psikiyatrisi kliniğinde yatan hastaların incelenmesi amaçlanmıştır. Ülkemizde çocuk ve ergen yaş grubundaki yatarak tedavi sağlayan klinik sayısının az olması sebebiyle bu deneyim aktarımı önemli bir yere sahiptir. Gereç ve Yöntem: Çalışmanın verileri 2015-2019 yılları arasında Gaziantep Üniversitesi Tıp Fakültesi Çocuk ve Ergen Psikiyatrisi Servisi’ne yatan hastaların dosyaları geriye doğru taranarak elde edilmiştir. Toplamda 74 hastanın verilerine ulaşılmıştır. Kliniğimizde yatan hastaların yatış görüşmelerinde tanısal netlik açısından Ruhsal Bozuklukların Tanısal ve İstatistiksel El Kitabı-5 (DSM-5) tanı kriterleri ile değerlendirme yapılmaktadır. Çalışma örneklemimizdeki olguların DSM-5 kriterlerine göre belirlenmiş olan tanılarına, yapılan geriye dönük dosya taramalarından ulaşılmıştır. Bulgular: Hastaların %59,5’u (n: 44) kızlardan, geriye kalan %40,5’u (n: 30) erkeklerden oluşuyordu. Hastaların yaş ortalaması 14,9 idi [minimum (min): 8 yaş, maksimum (maks): 17 yaş]. DSM-5’ e göre yapılan görüşmelerde saptanan en sık tanı İki Uçlu ve İlişkili Bozukluk (n: 21, %28,4) olmuştur. Onu Depresif Bozukluklar (n: 18, %24,3), Şizofreni Spektrumu ve Diğer Psikotik Bozukluklar (n: 14, %18,9) ve diğer bozukluklar (n: 21, 28,4) izlemekteydi. Hastaların %33,8’inin (n: 25) yatış sırasında aktif intihar düşüncesi ya da planı bulunmaktaydı. Ayrıca yatan hastaların %24,3’üne (n: 18) yatış esnasında elektrokonvülsif terapi (EKT) uygulanmıştır. En çok kullanılan psikotrop ilaç antipsikotikler olmuştur (n: 70, %94,6). Antipsikotiklerin ardından en sık antidepresanlar kullanılmıştır (n: 35, %47,3). Ortalama yatış süresi 14,1 (min: 1 maks: 53) gündü. Hastaların yatış süreleri ve yaşları açısından cinsiyetler arasında fark olmadığı bulunmuştur. Ancak, yatan hasta sayısı açısından kız cinsiyette erkek cinsiyete göre belirgin fark vardı. Sonuç: Çocuk ve ergen yaş grubundaki psikopatolojilerin ciddiyeti azımsanamayacak kadar yüksektir. Ayrıca, çalışma sonuçlarından görüldüğü üzere çocuk ve ergen yaş grubunda da intihar düşüncesi oldukça sıktır. Bu sebeple Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları kliniğine başvuran olguların iyi taranması ve yatış ihtiyacı olanların belirlenmesi önem arz etmektedir. Hastaların yataklı serviste takip sürecinde farmakoterapi, psikoterapi ve gerek görüldüğü durumlarda EKT kullanım ihtiyacı da olabilmektedir. Çocuk ve ergen psikiyatri hekimlerinin EKT konusunda bilgi ve deneyiminin arttırılması açısından yataklı psikiyatri servislerinde daha fazla EKT’ye uygun koşullar sağlanmalı ve uygun hastalarda EKT uygulaması yapılmasından kaçınılmamalıdır
Sociodemographic and Diagnostic Characteristics of Inpatients in a University Hospital Child andAdolescent Psychiatry Clinic
Objectives: In this study, it was aimed to examine the patients hospitalized in a child and adolescent psychiatry clinic. In our country, this transfer of experience is important due to the small number of inpatient clinics in the child and adolescent age group. Materials and Method: The data was obtained by retrospective scanning of files of the inpatients admitted to the Child and Adolescent Psychiatry Clinic, Gaziantep University Hospital between 2015 and 2019. Data was obtained for 74 patients in total. In the hospitalization interviews of patients hospitalized in our clinic, The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) diagnostic criteria are evaluated in terms of diagnostic clarity. The diagnoses of the cases in our study sample determined according to the DSM-5 criteria were obtained through retrospective file scans. Results: 59.5% (n: 44) of the patients were female and the remaining 40.5% (n: 30) were male. The mean age was 14.9 years [minimum (min): 8 yas, maximum (max): 17 yas]. The most common diagnoses according to DSM-V were Bipolar and Related Disorders (n: 21, 28.4%), Depressive Disorders (n: 18, 24.3%) and Schizophrenia Spectrum and Other Psychotic Disorders (n: 14, 18.9%) respectively. 33.8% (n: 25) of the patients had active suicidalide plan during hospitalization. In addition, 24.3% (n: 18) of the inpatients received Electroconvulsive Therapy (ECT) during hospitalization. The most commonly administered psychotropic drugs were antipsychotics (n: 70, 94.6%) andantidepressants (n: 35, 47.3%) respectively. The mean length of stay was 14.1 days (min: 1 max: 53). There were no statisticallysignificant differences between genders in terms of hospitalization time and age. However, there was a significant difference in female gender compared to male gender in terms of the number of inpatients. Conclusion: The severity of psychopathologies in the child and adolescent age group is considerably high. In addition, as seen from the results of the study, suicidal ideation is quite common in the child and adolescent age group. For this reason, it is important to have a good assessment of the patients admitted to the child and adolescent mental health and diseases clinic and to identify those who need hospitalization. Patients may also need pharmacotherapy, psychotherapy and ECT when necessary in the follow-up in the inpatient service. In order to increase the knowledge and experience of pediatric and adolescent psychiatrists on ECT, more appropriate ECT conditions should be provided in inpatient psychiatric services and ECT application should not be avoided in appropriate patients.

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