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Yıl:2009; Cilt: 10; Sayı: 3>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2009;10(3):217-225
Yatan hastalar için istenen çocuk ve ergen psikiyatrisi konsültasyonlarının değerlendirilmesi
N Emiroğlu, Ş Aras, Ş Yalın, Ö Doğan, A Akay
Dokuz Eylül Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları ABD, İzmir
Amaç: Bedensel hastalığı olan çocuklarda psikopatoloji ve bununla bağlantılı işlevsel bozulma sık görülmektedir. Dünyada ve ülkemizde, bu olguların çocuk psikiyatrisi ile işbirliği içinde tedavi gereksinimlerinin karşılanmasında zaman zaman sınırlılıklar olabilmektedir. Bu çalışmada, Dokuz Eylül Üniversitesi Tıp Fakültesi (DEÜTF) Hastanesi�nin çeşitli servislerinde yatarak tedavi gören çocuk hastalar için bir yıl içinde istenen psikiyatri konsültasyonları-nın değerlendirme ve izleme sürecinin araştırılması amaçlanmıştır. Gereç ve yöntem: DEÜTF Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları�na danışılan olguların değerlendirme bulguları yarı yapılandırılmış konsültasyon formuna kaydedilmektedir. Bu çalışmada 2006 yılında istenen konsültasyonlar geriye dönük olarak değerlendi-rilmiştir. Konsültasyonların hangi birimlerden istendiği, konsültasyon nedenleri, çocuklardaki ruhsal ve bedensel hastalık tanıları, psikiyatrik tedavi ve izlem sürecine ilişkin veriler incelenmiştir. Bulgular: Bir yıllık sürede yatarak tedavi gören çocuk ve ergenlerin 109�u (2.3%) için psikiyatri konsültasyonu istenmiştir. Konsül-tasyon istenenlerin çoğu kızdır (59.6%) ve 12 yaş veya üzeri yaştadır (52.3%). En sık konsültasyon nedeni depresif belirtilerdir (30.3%). Olguların 81.7%�sinde en az bir psikiyatrik bozukluk saptanmış olup en sık konulan tanı �uyum bozukluğu�dur (24.8%). Olguların yüzde 38.5�ine psikotrop ilaç başlanmıştır ve erkeklerde psikotrop ilaç kullanımı kızlardan fazladır. Konsültasyon sonucunda ayaktan çocuk psikiyatrisi izlemi önerilen 74 olgunun 29�u (39.2%) ayaktan tedaviyi sürdürmüştür. Sonuç: Bu çalışmada, hastanede yatarken psikiyatri konsültasyonu istenen çocuk ve ergenlerde yüksek oranda psikopatoloji saptanmıştır. Etkili psikiyatri konsültasyonu hizmetleri sağlanabilmesi için çocukların yatarak tedavi gördüğü servislerle daha fazla işbirliğine gereksinim olduğu düşünülmüştür.
Evaluation of the child and adolescent psychiatric inpatient consultations
Objective: Psychopathology and functional impairment were frequently determined in children with psychical disease. There are limitations about requirement of treatment needs of these patients in our country and the world. We aimed to investigate assessment and follow-up period of child patients who were treated in various inpatient units of Dokuz Eylül University School of Medicine (DEUSM). Methods: The assessment findings of patients, who were consulted at the Department of Child and Adolescent Psychiatry at the DEUSM, were saved in their semi-structured consultation forms. The consultation demands in 2006 were assessed retrospectively. The data about which units demanded consultation; consultation reasons, patients� physical and mental diagnoses, psychiatric treatments and follow-up period were investigated. Results: Psychiatric consultations were demanded for 109 (2.3%) child and adolescent patients who were treated in inpatient units for one- [year] period. The children consulted were primarily females (59.6%) and in the 12 or older age group (52.3%). Most prominent consultation reason was found as depressive appearance (30.3%). At least one psychiatric disorder was determined in 81.7% of patients. Most frequent psychiatric diagnoses were found as adjustment disorder (24.8%). Psychotropic medications were prescribed for 38.5 percent of cases. Twenty-nine (39.2%) of 74 patients who were referred to outpatient treatment were admitted to child psychiatry outpatient clinic. Conclusion: In this study, the high rates of psychopathology were found in children and adolescents who were demanded psychiatric consultation during their treatment in inpatient units. It was thought that there is a need for more collaboration with children�s inpatient units in order to provide more effective psychiatric consultation services.

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