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Yıl:2014; Cilt: 1; Sayı: 2>> Özet
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Literatür Sempozyum; 2014;1(2):29-36
Majör Depresif Bozukluğu Olan Çocuk ve Ergenlerin Sosyodemografik Değişkenleri ve Risk Etmenleri
V Yıldırım, F Toros, MA Sungur, MF Yılmaz
Mersin Üniversitesi, Mersin
Amaç: Retrospektif olan bu çalışma, yaşları 2 ilâ 19 arasında değişen majör depresif bozukluk tanısı almış çocuk ve ergenlerin sosyodemografik özelliklerini ve klinik risk etmenlerini belirlemek için yapılmıştır. Yöntem: Bu çalışmada, 2001-2009 yılları arasında, Mersin Üniversitesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları polikliniğinde, klinik görüşme ve psikometrik incelemeler sonrası, DSM-IV-TR tanı ölçütlerine göre, majör depresif bozukluk (MDB) tanısı alan çocuk ve ergenlerin olgu değerlendirme formları ve psikometrik ölçekleri (Çocuklar için Depresyon Ölçeği (ÇİDÖ), Çocuklar için Sürekli Kaygı Ölçeği (ÇİSKÖ)) geriye dönük incelenerek, olguların sosyodemografik ve klinik özellikleri değerlendirilmiştir. Bulgular: Çalışmamıza alınan 657 olgunun, 401(%61.4)’i kız idi. Olguların yaş ortalamasın 13.23±3.21 yıldı. Anne ve babası arasında akrabalık oranları kızlarda %20.7 erkeklere %13.9 göre belirgin şekilde daha fazlaydı. Olguların %35.4’ünün eş tanısı yokken; %64.6’sının eş tanısı mevcuttu. Olguların %39.8’inin bir tane eş tanısı, %19.3’ünün iki eş tanısı, %5.3’inin üç eş tanısı mevcuttu. Olgulardaki en sık eş tanılar; kaygı bozuklukları (%26.3), yıkıcı davranış bozuklukları (%22.7), dışa atım bozuklukları (%4.1). olarak bulundu. Hastaların %92.1’inin ilk muayeneden sonra kontrole hiç gelmediği tespit edildi. ÇİSKÖ puanı üzerinde; özellikle üç etmenin belirgin etkisi vardı ki bunlar; çocuğun yaşı, anksiyete bozukluğu eş tanı olması, kız olması, çoklu logistik regresyon analizi ile belirlendi. ÇİDÖ puanı üzerinde puanı çocuğun yaşı ve babanın yaşı doğru orantılı fiziksel bir hastalık ile ters orantılı olarak saptandı. Diğer değişken ve risk etmenleri daha az etkiliydi.Tartışma ve Sonuç: Çalışmamızda kızlarda anne baba arasındaki akrabalığın fazla olması; genetik risk faktörlerinin cinsiyetle bağlantılı olduğunu desteklemektedir. Risk etmeni olan çocuklarda Çocuklar için Depresyon Ölçeği (ÇİDÖ) puan düzeyi, risk etmeni olmayanlara göre anlamlı bir şekilde daha yüksek bulundu. Bu etmenler, MDB’li çocukların tedavisi, relapsı, rekürrensleri ve koruyucu ruhsal sağlığı için faydalıdır. Birçok hastanın kontrole gelmemesi nedeniyle bu risk etmenlerini hastalar için göz önünde bulundurmak takibi kolaylaştırabilir.
Sociodemographic Variables and Risk Factors of Children and Adolescents With Depressive Disorder
Objective: This retrospective study was conducted to determine sociodemographic variables and clinical risk factors in child and adolescent patients (between age of 2 and 19) who were diagnosed with major depressive disorder. Methods: We have retrospectively assessed the sociodemographic and clinical features by investigating the files and psychometric inventory (Children's Depression Inventory (CDI), State-Trait Anxiety Inventory (STAI) of children and adolescents who were diagnosed primarily as major depressive disorder (MDD) according to DSM-IV-TR, at the outpatient clinic of child and adolescent psychiatry department of Mersin University, School of Medicine, between years 2001-2009. Findings: Of the 657 cases included in the study, 401 (61.4%) were girls. The mean age was 13.23±3.21 years. The rate of consanguineous marriage between parents was 20.7% among girls and this was significantly high according to boys at the rate of 13.9%. 35.4% of the subjects had no comorbidity while 64.6% had. 39.8% of the subjects had one comorbidity, %19.3 had two and 5.3% had three comorbidities. Anxiety disorder 26.3%, disruptive behavior disorder 22.7% and elimination disorders 4.1% have been found to be the most common comorbidities among our cases. After the first visit, 92.1% of the patients have never come for another follow-up examination It was determined by the multiple logistic regression analysis that the three main factors impacting STAI scores are the age of child, anxiety disorder comorbidity and the child's being girl. CDI score has a direct proportion with child’s and father’s age and has an inverse proportion with a physical illness. Other factors have less influence on it. Discussion and Conclusion: In our study, the higher rate of consanguineous marriage between girl's parents supports that genetic risk factors are related to sex. CDI score with risk factors has been found significantly higher than the ones without risk factors. It benefits for treating MDD in children, preventing relapses, recurrences and protective mental health. Most of the patients did not attend follow-up examinations, therefore those risk factors must be considered for a better patient monitoring.

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