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Yıl:2022; Cilt: 29; Sayı: 2>> Özet
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Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2022;29(2):67-74
Sağlık Tedbiri Nedeniyle Takip Edilen Çocuk ve Ergenlerin Sosyo-demografik ve Klinik Özellikleri
B Güller, F Yaylacı
Dörtçelik Çocuk Hastalıkları Hastanesi, Bursa,
Amaç: Bu çalışmada sağlık tedbiri kararı nedeniyle çocuk psikiyatrisi polikliniğinde takip edilen olguların sosyo-demografik özellikleri, sağlık tedbiri çıkartılma nedenleri, psikiyatrik tanıları ve risk faktörlerinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde Mart 2018-Ocak 2021 yılları arasında sağlık tedbiri nedeniyle takip edilen olgulara ait sosyo-demografik ve klinik özellikler, ebeveynlere ait özellikler, tedbir kararları ve nedenleri geriye dönük olarak incelenmiştir. Bulgular: Çalışmaya ortalama 12.3±4.2 yaşında olan 135 çocuk (%55.6 kız) dahil edildi. Olguların %17.0'sinin örgün eğitime devam etmediği, sadece %21.5'inin psikiyatrik tanı almadığı görüldü. En sık tanılar travma sonrası stres bozukluğu (%14.1), dikkat eksikliği hiperaktivite bozukluğu (%11.1), davranış bozukluğu (%11.1) ve major depresif bozukluk (%11.1) olarak saptandı. Örgün eğitimi terk etme (P=0.000), düzensiz okul devamı (p=0.031), istismar mağduriyeti (p=0.033) ve psikiyatrik tanı varlığı (p=0.019) daha yüksek yaş grubunda anlamlı ölçüde sıktı. Babalarda ve annelerde sırasıyla %25.2 ve %21.5 oranlarında psikopatoloji bildirildi. Ebeveynlerden birinde psikopatoloji varlığı, daha yüksek oranda aile içi istismar (p=0.002) ve bakım tedbiri kararları (p=0.007) ile ilişkili bulundu. Sonuç: Çalışmamız tedbir kararı ile takip edilen çocuklarda yüksek oranda ruhsal bozukluk tanısı, okul hayatından uzaklaşma ve aile işlevselliğinde bozulma varlığını göstermektedir. Bu çocukların ruh sağlığını etkileyen ve koruyucu faktörlerin belirlenmesi amacıyla yapılan çalışmalar kısıtlıdır. Bu alanda geliştirilecek politikaların önleyici ve koruyucu nitelikte olması, toplumun genelini kapsayacak şekilde planlanması önemlidir
Socio-demographic and Clinical Characteristics of Children and Adolescents Followed for Court-mandated Treatment
Objectives: In this study, it was aimed to evaluate the socio-demogaphic features of cases followed up at the child psychiatry department due to mandation of courts (i.e. "health measures"), the reasons of court orders, psychiatric diagnoses and risk factors. Materials and Methods: Records of cases followed in our clinic between March 2018 and January 2021 under court-mandated treatment were evalated retrospectively for socio-demographic and clinical characteristics of youth, parental characteristics and reasons for mandated treatment. Results: One hundred thirty-five children (55.6% females) with a mean age of 12.3±4.2 years were included in the study. It was found that 17.0% of youth had left formal education while only 21.5 % did not fulfill criteria for a psychiatric diagnosis. Most common diagnoses were posttraumatic stress disorder (14.1%), attention deficit/ hyperactivity disorder (11.1%), conduct disorder (11.1%) and major depressive disorder (11.1%). Lack of attendance to formal education (p=0.000), irregular attendance to schools (p=0.031), being a victim of abuse (p=0.033) and presence of psychopathology (p=0.019) were significantly more common among older age group. Paternal and maternal histories of psychopathology were reported in 25.2% and 21.5%; respectively. Presence of mental illness in one of the parents was associated with elevated rates of domestic abuse (p=0.002) and court mandated foster placement (p=0.007). Conclusion: Our study shows the presence of elevated rates of mental disorders, lack of attendance to formal education and impaired family functioning among youth under court-mandated treatment. Studies conducted to determine the protective factors affecting the mental health of these children are limited. It is important that the policies to be developed in this area are preventive and protective and planned in a way that covers the overall of public.

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