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Yıl:2011; Cilt: 12; Sayı: 3>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2011;12(3):221-225
Bir eğitim ve araştırma hastanesi çocuk psikiyatrisi polikliniğine yönlendirilen adli olgular
S Köse, Z Aslan, ŞS Başgül, S Şahin, Ş Yılmaz, S Çıtak, AE Tezcan
Ege Üniversitesi Tıp Fakültesi, Çocuk ve Ergen Psikiyatrisi ABD, İzmir
Amaç: Çocukluk çağında yaşanan stres verici yaşantılar, özellikle cinsel istismar, çocuğun psikolojisine ve yaşam kalitesine zarar vermektedir. Adli psikiyatrik değerlendirme, mahkeme karar süreci için bilgi sağlama ve bilirkişiliği içerdiği gibi, çocuktaki olası psikiyatrik bozukluğun saptanması ve çocuğun korunabilmesi açısından da önemlidir. Bu nedenle polikliniğimize adli makamlarca rapor düzenlenmesi amacıyla yönlendirilen çocukların incelenmesi amaçlanmıştır. Yöntem: Adli makamlarca Ocak 2007-Aralık 2009 tarihleri arasında haklarında rapor düzenlenmesi amacıyla hastanemizin çocuk psikiyatrisi polikliniğine yönlendirilen 4-18 yaşları arasındaki 73 olgunun (45 kız, 28 erkek) dosya bilgileri geriye dönük olarak incelenmiştir. Sosyodemografik özellikler, psikopatoloji, zeka düzeyi, doğum yeri, adli istekler ve zanlının özellikleri her olgu için ayrı bir kayıt formu tutularak değerlendirilmiştir. Sonuçlar: Olguların 65'i (%89) cinsel istismar sonrası değerlendirilmek üzere gönderilmiştir. Olguların %61.6'sı, cinsel istismar grubunun %66.2'si kızdır. Mahkeme isteklerinin %86.3'ü çocuğun ruhsal durumunun değerlendirilmesidir. Cinsel istismara uğramış çocuklarda saptanan psikiyatrik tanılar travma sonrası stres bozukluğu (%32.3), uyum bozukluğu (%20), akut stres bozukluğu (%16.9), depresif bozukluklardır (%13.8). Olguların %16.9'unda aktif psikiyatrik bozukluk saptanmamıştır. Zeka düzeyi 42 (%64.6) olguda normaldir. Cinsel istismar zanlılarının %20.4'ü 18 yaşından küçük, %26.4'ü yabancı, %56.6'sı tanıdık (9 olgu ensest mağduru%13.8) ve %17'si arkadaşlarının aracılığı ile tanışılan kişilerdir. Tartışma: Mahkemenin en sık isteği cinsel istismarın ardın-dan ruhsal durumun değerlendirilmesi olarak saptanmıştır. Cinsel istismar ardından değerlendirilen çocukların %83.1'inde aktif psikiyatrik bozukluk saptanmıştır. En sık saptanan tanı travma sonrası stres bozukluğudur ve bu bulgu literatür bilgileri ile tutarlıdır. Özellikle cinsel istismar gibi stres verici yaşam olaylarının çocukların ruh sağlığını olumsuz etkilediği açıktır.
The forensic cases applied to an education and research hospital?s child psychiatry department
Objective: The stressful experiences, especially sexual abuse, damage the child's psychology, mental health and quality of life. Forensic psychiatric evaluation includes the expertness, provides information for judicial decision and also is important to diagnose the psychiatric disorder of the child and protect him. Because of these reasons we were aimed to examine the characteristics of children applied to our department for criminal report. Methods: The files of 73 cases aged 4-18 [year]s have been examined retrospectively who referred to Erenkoy Psychiatry Hospital Child Psychiatry Outpatient Department between January 2007 and December 2009 for criminal reports. Beside the sociodemographic characteristics, psychopathology, intelligence levels and crime characteristics of these children were also examined. Results: The prosecutor's request was the evaluation of the psychiatric status in 86.3% of cases. Eighty-nine percent (65 cases) of 73 cases were applied for evaluation after sexual abuse. The rates of psychiatric diagnoses in sexually abused children were 32.3% posttraumatic stress disorder, 20% adjustment disorders, 16.9% acute stress disorder, 13.8% depressive disorders. We did not find any active psychiatric disorder in 16.9% of the cases. Intelligence Quotient were normal in 64.6% of the cases (n=42). 56.6% of the sexual offenders were acquaintance (9 incest cases-13.8%), 17% were friend-related people, 26.4% were stranger, 20.4 % were under 18 [year]s of age. Discussion: The psychiatric evaluation after sexual abuse was the most frequent request of the prosecutors?. 83.1% of the children had active psychiatric disorders that were evaluated because of sexual abuse. The most common diagnosis was posttraumatic stress disorder and this result is consistent with earlier findings. It is clear that stressful experiences especially sexually abuse damage the child's psychology, mental health and quality of life.

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