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Bir bölge ruh sağlığı ve hastalıkları hastanesine yönlendirilen adli olguların değerlendirilmesi; Bolu örneği

Year 2022, Volume: 36 Issue: 2, 48 - 56, 01.08.2022

Abstract

Amaç: Bu çalışmada S.B. Bolu İzzet Baysal Ruh Sağlığı ve Hastalıkları Hastanesi’ne Türk Medeni Kanunu’nun 432’nci maddesi kapsamında gönderilen olguların sosyodemografik ve klinik özelliklerinin belirlenmesi amaçlanmıştır.
Yöntem: 654 adli olgu değerlendirilmeye alındı. Olguların sosyodemografik ve klinik bilgileri hastane kayıt sisteminden elde edildi.
Bulgular: Değerlendirilen 654 olgunun çoğunluğu erkek, bekar ve 30-61 yaş aralığında olup; 451 olguya TMK 432. madde kapsamında zorunlu tedavi (ZT) gerektiği, 141 olguya ZT gerekmediği yönünde bilirkişi raporu düzenlendiği, 62 olgunun yatış kararı ile gönderildiği öğrenildi. 2015-2018 yılları arasında daha çok ZT gerekmediği yönünde, 2019-2021 yılları arasında ZT gerektiği yönünde bilirkişi görüşü bildirildiği belirlendi (p=0,0001). ZT gerektiği yönünde rapor düzenlenen olgulara en sık psikotik bozukluk (%55,2), alkol/madde kullanım bozukluğu (%18,5) ve bipolar affektif bozukluk (%14,2) tanılarının konulduğu; ZT gerekmediği yönünde rapor düzenlenenlere ise en sık konulan tanıların alkol/madde kullanım bozukluğu (%30,5), psikotik bozukluk (%20,6) ve bipolar affektif bozukluk (%11,3) olduğu tespit edildi. Yatış kararı ile gönderilen olguların %32,3’ünün alkol/madde kullanım bozukluğu tanısı aldığı belirlendi.
Sonuç: Bu çalışma TMK 432. madde kapsamında her geçen yıl daha fazla olgunun psikiyatrik değerlendirmeye yönlendirildiğini, daha fazla olguya ZT gerektiği yönünde rapor düzenlendiğini, ZT gereken olgular arasında alkol/madde kullanım bozukluğu oranının yıllar içinde arttığını göstermektedir.

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References

  • Sugiura K, Pertega E, Holmberg C. Experiences of involuntary psychiatric admission decision-making: a systematic review and meta-synthesis of the perspectives of service users, informal carers, and professionals. Int J Law Psychiatry. 2020;Nov-Dec;73:101645.
  • Oliva F, Ostacoli L, Versino E, Portigliatti Pomeri A, Furlan P.M, Carletto S, & Picci, R. L. Compulsory psychiatric admissions in an Italian urban setting: Are they actually compliant to the need for treatment criteria or arranged for dangerous not clinical condition?. Frontiers in psychiatry. 2019; 9:740
  • Zhang S, Mellsop G, Brink J, & Wang X. Involuntary admission and treatment of patients with mental disorder. Neuroscience bulletin, 2015; 31(1): 99-112.
  • Demirdoğan S, Solmaz M. “Compulsory hospitalization” in psychiatry. J For Med. 2018;32(2):84-90.
  • Sert G, Özçelik H, Yıldırım G. Türkiye’de Akıl Hastalığı Olan Hastalarda Zorla Yatırma ve Zorla Tedavi/Hukuki ve Etik Sorunlar. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. 2019;9(3):393-404.
  • Aydın ER, Şehiraltı M. An Unresolved Issue: Involuntary/Compulsory Treatment of Patients with Psychiatric Disorders. J Psy Nurs. 2010;1(1):39-42.
  • https://www.echr.coe.int/documents/convention_tur.pdf Erişim tarihi: 5 Nisan 2022
  • Yalçınkaya V. TCK VE TMK kapsamında alkol ve uyuşturucu madde bağımlılarına uygulanan zorla tedavi ve etik boyutu. İstanbul Medipol Üniversitesi Sosyal Bilimler Enstitüsü. Yüksek Lisans Tezi. 2018.
  • Yılmaz Y, Saygılı İ, Yanartaş Ö, Baykaran M. B, Kesebir S, & Yildiz D Zorunlu Yatışta Psikiyatrik ve Hukuksal Süreç. Yeni Symposium. 2013;51(1):46-50.
  • Gültekin B. K, Çelik S, Tihan A., Beşkardeş A. F, & Sezer U. Bir Psikiyatri Hastanesinde İstemli ve İstem Dışı Yatışların Sosyodemografik ve Klinik Özellikleri. Nöro-Psikyatri Arşivi. 2013;50(3):216-21.
  • Örüm MH. Characteristics of cases hospitalized in a mental health and diseases hospital with in the scope of article 432 of the Turkish Civil Code. Bağımlılık Dergisi. 2021;22(3):226-35.
  • Habermeyer B, Wyder L, Roser P, & Vogel M. Coercion in substance use disorders: Clinical course of compulsory admissions in a Swiss psychiatric hospital. Swiss Medical Weekly. 2018;148.
  • Hustoft K, Larsen T. K, Auestad B, Joa I, Johannessen J. O & Ruud T. Predictors of involuntary hospitalizations to acute psychiatry. International Journal of Law and Psychiatry,2013; 36(2): 136-143.
  • https://hsgm.saglik.gov.tr/depo/birimler/tutun-mucadele-bagimlilik db/haberler/uyusturucu_eylem_plani/2018 2023_Uyusturucu_ile_Mucadele_Ulusal_Strateji_Belgesi_ve_Eylem_Plani.pdf. Erişim tarihi: 1 Mart 2022.
  • Lunzea K, Lermetb O, Andreevac V, & Harigad F. Compulsory treatment of drug addictions in Southeast Asian Countries International Journal of Drug Policy. 2018(69):10-5.
  • https://www.unodc.org/documents/southeastasiaandpacific//2012/03/drug detentioncentre/JC2310_Joint_Statement6March12FINAL_En.pdf. Erişim tarihi: 1 Mart 2022.
  • World Health Organization. International standards for the treatment of drug use disorders: revised edition in corporating results of field-testing. 2020. Erişim tarihi: 1 Mart 2022.
  • Petersson FJM, Berg KE, Skårner A. Locked Up and Locked Out: Client Perspectives on Personal Relationships While in Compulsory Drug Treatment. Contemporary Drug Problems. 2021;48(2):114-34.
  • Opsal A KØ, ClausenT. Readiness to change among involuntarily and voluntarily admitted patients with substance use disorders. Substance Abuse Treatment, Prevention, and Policy. 2019;14(1):1-10.
  • Huang K, Yu C, Chen X, Hao Y, Ding Y, Wu Z, & Wang X. A Quasi-Experimental Study on the Effectiveness of Compulsory and Voluntary Treatment Settings for 1,299 Drug Abusers in Hunan, China. Frontiers in Psychiatry. 2021;12.

Evaluation of forensic cases referred to a regional mental health and diseases hospital; Bolu sample

Year 2022, Volume: 36 Issue: 2, 48 - 56, 01.08.2022

Abstract

Objective: In this study, it was aimed to determine the sociodemographic and clinical features of the cases sent to Bolu İzzet Baysal Mental Health and Diseases Hospital within the scope of Turkish Civil Law 432 (TCL 432).
Methods: 654 forensic cases were evaluated. Sociodemographic and clinical features of the cases were obtained from the hospital registry system.
Results: The majority of 654 cases were male, single and between the ages of 30-61, and 451 cases were requiring compulsory hospitalization within the scope of TCL 432; 141 cases were reported as not requiring compulsory hospitalization, and 62 cases were sent with a hospitalization decision. It was determined as expert opinion that compulsory hospitalization was not required between 2015-2018, and more compulsory hospitalization was required between 2019-2021 (p=0.0001). The most common diagnoses with compulsory hospitalization were found to be as psychotic disorder (55.2%), alcohol/substance use disorder (18.5%) and bipolar affective disorder (14.2%); and on the other hand, the most common diagnozis within the reports not requiring compulsory hospitalization were found to be as alcohol-substance use disorder (30.5%), psychotic disorder (20.6%) and bipolar affective disorder (11.3%). It was found that 32.3% of the cases who were sent with the decision of hospitalization, had the diagnosis of alcohol/substance use disorder.
Conclusion: This study shows that within the scope of TCL 432, more and more cases are referred to psychiatric evaluation, more cases are reported that require compulsory treatment, and the rate of diagnosis of alcohol/substance use disorder among cases requiring compulsory treatment has increased over the years.

References

  • Sugiura K, Pertega E, Holmberg C. Experiences of involuntary psychiatric admission decision-making: a systematic review and meta-synthesis of the perspectives of service users, informal carers, and professionals. Int J Law Psychiatry. 2020;Nov-Dec;73:101645.
  • Oliva F, Ostacoli L, Versino E, Portigliatti Pomeri A, Furlan P.M, Carletto S, & Picci, R. L. Compulsory psychiatric admissions in an Italian urban setting: Are they actually compliant to the need for treatment criteria or arranged for dangerous not clinical condition?. Frontiers in psychiatry. 2019; 9:740
  • Zhang S, Mellsop G, Brink J, & Wang X. Involuntary admission and treatment of patients with mental disorder. Neuroscience bulletin, 2015; 31(1): 99-112.
  • Demirdoğan S, Solmaz M. “Compulsory hospitalization” in psychiatry. J For Med. 2018;32(2):84-90.
  • Sert G, Özçelik H, Yıldırım G. Türkiye’de Akıl Hastalığı Olan Hastalarda Zorla Yatırma ve Zorla Tedavi/Hukuki ve Etik Sorunlar. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. 2019;9(3):393-404.
  • Aydın ER, Şehiraltı M. An Unresolved Issue: Involuntary/Compulsory Treatment of Patients with Psychiatric Disorders. J Psy Nurs. 2010;1(1):39-42.
  • https://www.echr.coe.int/documents/convention_tur.pdf Erişim tarihi: 5 Nisan 2022
  • Yalçınkaya V. TCK VE TMK kapsamında alkol ve uyuşturucu madde bağımlılarına uygulanan zorla tedavi ve etik boyutu. İstanbul Medipol Üniversitesi Sosyal Bilimler Enstitüsü. Yüksek Lisans Tezi. 2018.
  • Yılmaz Y, Saygılı İ, Yanartaş Ö, Baykaran M. B, Kesebir S, & Yildiz D Zorunlu Yatışta Psikiyatrik ve Hukuksal Süreç. Yeni Symposium. 2013;51(1):46-50.
  • Gültekin B. K, Çelik S, Tihan A., Beşkardeş A. F, & Sezer U. Bir Psikiyatri Hastanesinde İstemli ve İstem Dışı Yatışların Sosyodemografik ve Klinik Özellikleri. Nöro-Psikyatri Arşivi. 2013;50(3):216-21.
  • Örüm MH. Characteristics of cases hospitalized in a mental health and diseases hospital with in the scope of article 432 of the Turkish Civil Code. Bağımlılık Dergisi. 2021;22(3):226-35.
  • Habermeyer B, Wyder L, Roser P, & Vogel M. Coercion in substance use disorders: Clinical course of compulsory admissions in a Swiss psychiatric hospital. Swiss Medical Weekly. 2018;148.
  • Hustoft K, Larsen T. K, Auestad B, Joa I, Johannessen J. O & Ruud T. Predictors of involuntary hospitalizations to acute psychiatry. International Journal of Law and Psychiatry,2013; 36(2): 136-143.
  • https://hsgm.saglik.gov.tr/depo/birimler/tutun-mucadele-bagimlilik db/haberler/uyusturucu_eylem_plani/2018 2023_Uyusturucu_ile_Mucadele_Ulusal_Strateji_Belgesi_ve_Eylem_Plani.pdf. Erişim tarihi: 1 Mart 2022.
  • Lunzea K, Lermetb O, Andreevac V, & Harigad F. Compulsory treatment of drug addictions in Southeast Asian Countries International Journal of Drug Policy. 2018(69):10-5.
  • https://www.unodc.org/documents/southeastasiaandpacific//2012/03/drug detentioncentre/JC2310_Joint_Statement6March12FINAL_En.pdf. Erişim tarihi: 1 Mart 2022.
  • World Health Organization. International standards for the treatment of drug use disorders: revised edition in corporating results of field-testing. 2020. Erişim tarihi: 1 Mart 2022.
  • Petersson FJM, Berg KE, Skårner A. Locked Up and Locked Out: Client Perspectives on Personal Relationships While in Compulsory Drug Treatment. Contemporary Drug Problems. 2021;48(2):114-34.
  • Opsal A KØ, ClausenT. Readiness to change among involuntarily and voluntarily admitted patients with substance use disorders. Substance Abuse Treatment, Prevention, and Policy. 2019;14(1):1-10.
  • Huang K, Yu C, Chen X, Hao Y, Ding Y, Wu Z, & Wang X. A Quasi-Experimental Study on the Effectiveness of Compulsory and Voluntary Treatment Settings for 1,299 Drug Abusers in Hunan, China. Frontiers in Psychiatry. 2021;12.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Forensic Medicine
Journal Section Research Articles
Authors

Ayşegül Koç 0000-0002-2686-4734

Ebru Karaca 0000-0001-9352-7378

Hülya Ensari 0000-0002-5047-0073

Publication Date August 1, 2022
Submission Date July 4, 2022
Published in Issue Year 2022 Volume: 36 Issue: 2

Cite

Vancouver Koç A, Karaca E, Ensari H. Bir bölge ruh sağlığı ve hastalıkları hastanesine yönlendirilen adli olguların değerlendirilmesi; Bolu örneği. J For Med. 2022;36(2):48-56.
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