Dergi Ara >>
Yıl:2005; Cilt: 12; Sayı: 3>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2005;12(3):115-120
Fiziksel Hastalıkla Birlikte Zeka Geriliği Olan Çocuklarda Psikopatoloji
BG Kılıç, A Aysev
Ankara Üniv. Tıp Fak. Çocuk Ruh Sağlığı ve Hast. ABD, Ankara
Amaç: Zeka geriliğinde fiziksel ve ruhsal sorunların birlikte varoluş sıklığı yüksektir. Fakat bu grupta
tanı atlamalarının sık olduğu bildirilmektedir. Bu çalışmada Çocuk Ruh Sağlığı ve Hastalıkları Anabilim
Dalı'na bir yıllık bir dönemde konsültasyonla yönlendirilip ilk kez zeka geriliği saptanan olguların
sosyodemografik özelliklerinin, konsültasyon istem nedenlerinin ve psikiyatrik tanılarının incelenmesi
amaçlanmıştır. Yöntem: Konsültasyon istemiyle 1.1.2004 - 1.1.2005 tarihleri arasında çocuk psikiyatrisi
kliniğine yönlendirilip ilk kez Zeka Geriliği/Gelişimsel Gerilik saptanan, daha önce psikiyatrik bir tanı
almamış 74 olgu çalışmanın örneklemini oluşturmuştur. Tüm olgularda psikiyatrik tanılar DSM-IV ve DC:
0-3 tanı sınışamaları ölçütlerine bağlı kalınarak iki uzman çocuk psikiyatristi tarafından konmuştur.
Sonuçlar: Örneklemdeki 74 çocuğun yaş ortalaması 8.34 ± 4.07'dir (15 ay- 18 yaş). Kızlar örneklemin
% 51.4'ünü (n=38), erkekler % 48.6'sını (n=36) oluşturmaktadır. Zeka Geriliği olan olguların % 74.3'ünde
(n= 55) konsültasyon sadece çocuğun gelişimsel düzeyinin belirlenmesi amacıyla istenmiştir. Örnekleme
giren olguların % 46'sının (n=34) ek bir psikiyatrik tanı aldığı saptanmıştır. Tüm Zeka Geriliği düzeylerinde
(hafif-orta-ağır) yaklaşık % 50 oranında Eksen I tanısı konulduğu ve gruplar arasında fark olmadığı
belirlenmiştir. Sadece psikometrik değerlendirilme istemiyle konsülte edilen 55 olgunun 19'unun (% 34.5),
gelişimsel değerlendirme dışı nedenler ile konsültasyon istenen 19 olgunun 15'inin (% 78.9) ek bir
psikiyatrik tanı aldığı bulunmuştur. Tartışma: Gelişimsel sorunları olan bu grupta, psikiyatrist olmayan
hekimlerin konsültasyon isteme nedenleri ile çocukların aldıkları Eksen I tanıları gözden geçirilerek,
sonuçlar konsültasyon-liyezon hizmetlerinin daha verimli sunulması bağlamında tartışılmıştır.
Psychopathology In Children With Medical Diseases Comorbid With
Objective: Both psychological and physical problems are reported to be frequent in children with mental
retardation, however these diagnoses are often remained unrecognized. In this study we aimed to assess
the sociodemographic features, psychiatric diagnoses, and reasons for referral to child psychiatry
department in children who were referred to our Child and Adolescent Psychiatry Clinic and were
diagnosed for the first time as mental retardation in a one [year] period. Method: Seventy four cases with
no prior psychiatric diagnosis who were referred to child psychiatry department between 1.1.2004 -
1.1.2005 and diagnosed as having mental retardation were included in this study. Psychiatric diagnoses
were based on DSM-IV criteria and DC: 0-3 classification system and confirmed by two child psychiatrists.
Results: Mean age of the sample was 8.34 ± 4.07 (Range: 15 [month]s- 18 [year]s), and girls constituted
51.4 % (n=38) of the sample, while boys constituted 48.6 % (n=36). In 74.3 % (n= 55) of the cases, the
main reason for consultation request was just to determine the developmental level of the child. Of all
cases, 46 % (n=34) had a comorbid psychiatric diagnosis. In all mental retardation IQ levels (mildmoderate-
severe) percentage of patients with Axis I diagnoses were about 50 % and there were no
differences between groups. Additional psychiatric diagnoses were present in 34.5 % of cases who were
referred for only psychometric assessment, this was 78.9 % in patients who were referred for other
reasons. Discussion: In this group with developmental problems, results of Axis I diagnoses of patients
and reasons for referral of non-psychiatrist clinicians were discussed in the context of making a more
effective usage of consultation liaison services.

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