Bir Üniversite Hastanesi Psikiyatri Servisinde Tedavi Edilen Çocuk ve Ergenlerin Tanıları ve Sosyodemografik Özellikleri
Öz
Amaç: Bu çalışmanın amacı psikiyatri kliniğinde yatarak tedavi gören çocuk ve ergenlerin sosyodemografik özellikleri, yatışa neden olan semptomlar, yataklı birimde kalış süresi, tanı ve kullanılan psikotrop ilaçlar geriye dönük dosya taraması ile incelenmesiydi.
Materyal ve Metod: Harran üniversitesi tıp fakültesi psikiyatri anabilimdalı yataklı servisinde 1 Ağustos 2016 – 1 eylül 2018 tarihleri arasında yatarak tedavi gören on sekiz yaş altı hastaların (n:85) dosyaları geriye dönük olarak incelenmiştir. Olgulara ait veriler araştırmacı tarafından oluşturulan veri formu kullanılarak yaş, cinsiyet, ebeveyn yaşları, yatışa neden olan semptomlar, aldıkları tanılar, yatış süresi, çoklu yatışlarının olup olmadığı ve psikotrop kullanımı açısından değerlendirilmiştir. Olgulara ait tanılar ruhsal bozukluklar için tanımsal ve istatistiksel el kitabı 5. baskı (DSM-5) kriterlerine göre klinik görüşmeyle konulmuştur. İstatistiksel analiz için SPSS 23.0 (SPSS Inc., Chicago, USA) paket programı kullanıldı. İstatiksel anlamlılık düzeyi p<0.05 olarak belirlenmiştir.
Bulgular: Çalışmaya alınan hastaların 56'sı kız, 29’ı erkek cinsiyetteydi. Hastaların en fazla aldığı yatış tanısı Major Depresif Bozukluk’du (n: 30, %35,3). Hastaların ortalama yatış süreleri 20.6±19.6 gündü. 85 hastanın içinden 85’ü (%100) tedavi sürecinde bir psikotrop ajan kullanmıştır. Çalışmamızda en çok tercih edilen ilaç grubunun antipsikotikler olduğu gözlenmiştir (%87,6).
Sonuç: Yatışların en sık sebebini duygudurum bozuklukları oluşturmaktadır. Çalışmamızda yer alan hastaların tümünde servis yatışı sırasında psikotrop kullanılmıştır. Şizofreniform bozukluk ve madde ile ilişkili bozukluklar erkeklerde anlamlı düzeyde yüksekken, davranım bozukluğu ve sınırda kişilik bozukluğu kızlarda anlamlı düzeyde daha yüksek çıkmıştır. Çocuk ve ergenler için yataklı servislerin her ilde olmaması nedeniyle klinik pratikte erişkin psikiyatri servislerine yatırılarak tedavi uygulanmaktadır. Hastaların çocuk ve ergenler için yataklı servislerin olmadığı yerlerde erişkin psikiyatri servisine yatırılarak çocuk ve ergen psikiyatristi uzmanı tarafından takip edilmeleri, hastaların acil durumlarda tedavi edilmeleri ve tedavi için sıra beklememeleri açısından önem arz etmektedir.
Anahtar Kelimeler
Destekleyen Kurum
yok
Proje Numarası
yok
Kaynakça
- 1.Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ, et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2012; 69(4):372–80. 2. Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen HU, Rothenberger A, et al. Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry. 2008;17 (Suppl 1):22–33. 3. Merikangas KR, He JP, Brody D, Fisher PW, Bourdon K, Koretz DS. Prevalence and treatment of mental disorders among US children in the 2001-2004 NHANES. Pediatrics. 2010;125(1):75–81. 4. Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci. 2009;11(1):7–20. 5. Kessler RC, Avenevoli S, Costello J, Green JG, Gruber MJ, McLaughlin KA, et al. Severity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2012;69(4):381–9. 6. Barkmann C, Schulte-Markwort M. Prevalence of emotional and behavioral disorders in children and adolescents in Germany - a systematic literature review. Psychiatr Prax. 2004;31(6):278–87. 7. Ercan ES, Polanczyk G, Akyol Ardıç U, Yuce D, Karacetin G, Tufan AE, et al. The Prevalence of Childhood Psychopathology in Turkey: A Cross-Sectional Multicenter Nationwide Study (EPICPAT-T). Nord J Psychiatry. 2019; 73 (2):132-140. 8. Kessler RC, Chiu WT, Demler O, Walters EE. (2005) Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry. 2005;62(6): 617-27. 9.Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007; 20(4): 359–64. 10. Meagher SM, Rajan A, Wyshak G, Goldstein J. Changing trends in inpatient care for psychiatrically hospitalized youth: 1991-2008. Psychiatr Q. 2013; 84(2):159-68. 11. James A, Clacey J, Seagroatt V, Goldacre M. Adolescent inpatient psychiatric admission rates and subsequent one-year mortality in England: 1998-2004. J Child Psychol Psychiatry. 2010; 51(12): 1395-1404. 12. Coşkun M, Bozkurt H, Ayaydın H, Karakoç S, et al. Bir üniversite hastanesi psikiyatri servisinde yatarak tedavi edilen ergen hastaların klinik ve sosoyodemografik özellikleri. Turk J Child Adolesc Ment Health. 2012;19 (1): 17-24. 13. Arslan SH, Evlice YE, Alparslan NZ, Diler RS.Yatarak sağaltım gören ergenlerin sosyodemografik özellikleri: Yatış süresini etkileyen faktörler. Dusunen Adam The Journal of Psychiatry and Neurological Sciences.1996;9:44-49. 14. Usta MB, Ürer E, Aral A, Say GN, Karabekiroğlu K. Factors Effecting Length of Stay in Child Psychiatry Hospital Setting. J Clin Psy. 2017; 20(4): 263-67. 15. Eray Ş, Akkuzu N, Yıldırım Ö, Vural AP. Bir Çocuk Psikiyatri Kliniğinde Yatarak Tedavi Gören Çocuk ve Ergenlerin Klinik ve Sosyodemografik Özelliklerinin Değerlendirilmesi. Turk J Child Adolesc Ment Health 2018; 25: 223-35. 16. Özbaran B, Köse S, Yılmaz E, Aydın AN, Aydın C. Çocuk ve ergen psikiyatrisi uygulamasında yataklı servis deneyimi ve yatışın iyileşmeye katkısının değerlendirilmesi. Anadolu Psikiyatri Derg. 2016;17(2):120-26. 17. Guvenir T, Varoltas F, Ozbek A. Child and adolescent mental health inpatient services in Turkey: is there a need and are they effective? Arch Neuropsychiatry. 2009;46(4):143-9. 18. Şentürk Pilan B, Bilaç Ö, Orhon Z, Erkuran Özek H. Bir Ruh Sağlığı ve Hastalıkları Hastanesinin Çocuk ve Ergen Psikiyatrisi Kliniğinde Yatarak Tedavi Gören Hastalarda İlaç Kullanımı. Turk J Child Adolesc Ment Health 2017; 24: 207-18. 19. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5. Washington DC: AmericanPsychiatricAssociation Publishing, 2013. 20. Green J, Jacobs B, Beecham J, Dunn G, Kroll L, Tobias C, et al. Inpatient treatment in child and adolescent psychiatry-a prospective study of health gain and costs. J Child Psychol Psychiatry. 2007; 48(12):1259-67. 21. Park C, McDermott B, Loy J, Dean P. Adolescent admissions to adult psychiatric units: patterns and implications for service provision. Australas Psychiatry. 2011;19(4): 345-49. 22. Mayes DS, Calhoun SL, Krecko VF, Vesell VF, Hu J. Outcome following child psychiatric hospitalization. J Behav Health Serv Res. 2001; 28(1): 96-103. 23. Gavidia-Payne S, Littlefiield L, Hallgren M, Jepkins P, Coventry N. Outcome evaluation of a statewide child inpatient mental health unit. Aust N Z J Psychiatry. 2003; 37(2): 204-11. 24. Swadi H, Bobier C Hospital admission in adolescents with acute psychiatric disorders: how long should it be? Australas Psychiatry. 2005; 13(2): 165-68., 25. Tulloch S, Lelliott P, Bannister D, Andiappan M, O’Herlihy A, Beecham J et al. The costs, outcomes and satisfaction for inpatient child and adolescent psychiatric services (COSI-CAPS) study. London: National Coordinating Centre for NHS Service Delivery and Organisation R&D. Queen's Printer and Controller of HMSO. 2008:1-233.
The Diagnoses and Sociodemographic Characteristics of Children and Adolescents Treated in a University Hospital Psychiatry Inpatient Service
Öz
Background: The purpose of this study was to perform a retrospective file examination of the sociodemographic characteristics, symptoms leading to admission, length of stay in the inpatient unit, diagnoses, and psychotropic drugs used by children and adolescents who were treated in the psychiatric inpatient unit.
Materials and Methods: The records of patients aged under 18 (n=85) receiving treatment on an inpatient basis at the Harran University Medical Faculty Psychiatry Department inpatient unit between 1 August, 2016, and 1 September, 2018, were screened retrospectively. Case data were assessed using a data form produced by the author in terms of age, sex, parental ages, symptoms resulting in admission, diagnoses received, length of hospitalization, presence of multiple hospitalizations, and psychotropic drug use. Case diagnoses were based on clinical interviews using Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria. SPSS 23.0 software (SPSS Inc., Chicago, USA) was used for statistical analysis. Statistical significance was defined as p<0.05.
Results: Fifty-six of the patients included in the study were female and 29 were male. Major depressive disorder was the most frequent diagnosis among the patients (n: 30, 35.3%). The mean duration of hospitalization was 20.6±19.6 days. Eighty-five (100%) of the 85 patients had used one psychotropic agent during treatment. Antipsychotics were the most preferred drug group in our study (87.6%).
Conclusions: Mood disorders constituted the most common reason for hospitalization. Psychotropics were used by all patients during hospitalization. Schizophreniform disorder and substance-related disorders were significantly higher in boys, while rates of conduct disorder and borderline personality disorder were significantly higher in girls. Since child and adolescent in-patient units are not available in all provinces, in clinical practice treatment is administered on an inpatient basis in adult psychiatric units. It is important for patients to be followed-up by child and adolescent psychiatry specialists in terms of being treated under emergency conditions without having to wait in line for treatment by being hospitalized in adult psychiatric units in places where there are no in-patient ünits for children and adolescents.
Anahtar Kelimeler
Proje Numarası
yok
Kaynakça
- 1.Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ, et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2012; 69(4):372–80. 2. Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen HU, Rothenberger A, et al. Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry. 2008;17 (Suppl 1):22–33. 3. Merikangas KR, He JP, Brody D, Fisher PW, Bourdon K, Koretz DS. Prevalence and treatment of mental disorders among US children in the 2001-2004 NHANES. Pediatrics. 2010;125(1):75–81. 4. Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci. 2009;11(1):7–20. 5. Kessler RC, Avenevoli S, Costello J, Green JG, Gruber MJ, McLaughlin KA, et al. Severity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2012;69(4):381–9. 6. Barkmann C, Schulte-Markwort M. Prevalence of emotional and behavioral disorders in children and adolescents in Germany - a systematic literature review. Psychiatr Prax. 2004;31(6):278–87. 7. Ercan ES, Polanczyk G, Akyol Ardıç U, Yuce D, Karacetin G, Tufan AE, et al. The Prevalence of Childhood Psychopathology in Turkey: A Cross-Sectional Multicenter Nationwide Study (EPICPAT-T). Nord J Psychiatry. 2019; 73 (2):132-140. 8. Kessler RC, Chiu WT, Demler O, Walters EE. (2005) Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry. 2005;62(6): 617-27. 9.Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007; 20(4): 359–64. 10. Meagher SM, Rajan A, Wyshak G, Goldstein J. Changing trends in inpatient care for psychiatrically hospitalized youth: 1991-2008. Psychiatr Q. 2013; 84(2):159-68. 11. James A, Clacey J, Seagroatt V, Goldacre M. Adolescent inpatient psychiatric admission rates and subsequent one-year mortality in England: 1998-2004. J Child Psychol Psychiatry. 2010; 51(12): 1395-1404. 12. Coşkun M, Bozkurt H, Ayaydın H, Karakoç S, et al. Bir üniversite hastanesi psikiyatri servisinde yatarak tedavi edilen ergen hastaların klinik ve sosoyodemografik özellikleri. Turk J Child Adolesc Ment Health. 2012;19 (1): 17-24. 13. Arslan SH, Evlice YE, Alparslan NZ, Diler RS.Yatarak sağaltım gören ergenlerin sosyodemografik özellikleri: Yatış süresini etkileyen faktörler. Dusunen Adam The Journal of Psychiatry and Neurological Sciences.1996;9:44-49. 14. Usta MB, Ürer E, Aral A, Say GN, Karabekiroğlu K. Factors Effecting Length of Stay in Child Psychiatry Hospital Setting. J Clin Psy. 2017; 20(4): 263-67. 15. Eray Ş, Akkuzu N, Yıldırım Ö, Vural AP. Bir Çocuk Psikiyatri Kliniğinde Yatarak Tedavi Gören Çocuk ve Ergenlerin Klinik ve Sosyodemografik Özelliklerinin Değerlendirilmesi. Turk J Child Adolesc Ment Health 2018; 25: 223-35. 16. Özbaran B, Köse S, Yılmaz E, Aydın AN, Aydın C. Çocuk ve ergen psikiyatrisi uygulamasında yataklı servis deneyimi ve yatışın iyileşmeye katkısının değerlendirilmesi. Anadolu Psikiyatri Derg. 2016;17(2):120-26. 17. Guvenir T, Varoltas F, Ozbek A. Child and adolescent mental health inpatient services in Turkey: is there a need and are they effective? Arch Neuropsychiatry. 2009;46(4):143-9. 18. Şentürk Pilan B, Bilaç Ö, Orhon Z, Erkuran Özek H. Bir Ruh Sağlığı ve Hastalıkları Hastanesinin Çocuk ve Ergen Psikiyatrisi Kliniğinde Yatarak Tedavi Gören Hastalarda İlaç Kullanımı. Turk J Child Adolesc Ment Health 2017; 24: 207-18. 19. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5. Washington DC: AmericanPsychiatricAssociation Publishing, 2013. 20. Green J, Jacobs B, Beecham J, Dunn G, Kroll L, Tobias C, et al. Inpatient treatment in child and adolescent psychiatry-a prospective study of health gain and costs. J Child Psychol Psychiatry. 2007; 48(12):1259-67. 21. Park C, McDermott B, Loy J, Dean P. Adolescent admissions to adult psychiatric units: patterns and implications for service provision. Australas Psychiatry. 2011;19(4): 345-49. 22. Mayes DS, Calhoun SL, Krecko VF, Vesell VF, Hu J. Outcome following child psychiatric hospitalization. J Behav Health Serv Res. 2001; 28(1): 96-103. 23. Gavidia-Payne S, Littlefiield L, Hallgren M, Jepkins P, Coventry N. Outcome evaluation of a statewide child inpatient mental health unit. Aust N Z J Psychiatry. 2003; 37(2): 204-11. 24. Swadi H, Bobier C Hospital admission in adolescents with acute psychiatric disorders: how long should it be? Australas Psychiatry. 2005; 13(2): 165-68., 25. Tulloch S, Lelliott P, Bannister D, Andiappan M, O’Herlihy A, Beecham J et al. The costs, outcomes and satisfaction for inpatient child and adolescent psychiatric services (COSI-CAPS) study. London: National Coordinating Centre for NHS Service Delivery and Organisation R&D. Queen's Printer and Controller of HMSO. 2008:1-233.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Proje Numarası | yok |
| Yayımlanma Tarihi | 20 Ağustos 2020 |
| Gönderilme Tarihi | 12 Şubat 2020 |
| Kabul Tarihi | 20 Mayıs 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 17 Sayı: 2 |
Cited By
Which factors affect internalized stigmatization in adolescents with mental disorders?
Journal of Child and Adolescent Psychiatric Nursing
https://doi.org/10.1111/jcap.12391
Harran Üniversitesi Tıp Fakültesi Dergisi / Journal of Harran University Medical Faculty