SIK GÖRÜLEN RUHSAL HASTALIKLARININ TEDAVİSİNDE ANKARA ÜNİVERSİTESİ TIP FAKÜLTESİ PSİKOSOMATİK SERVİSİ UYGULAMALARI: TANIMLAYICI BİR ÇALIŞMA

Year 2019, Volume: 27 Issue: 1, 12 - 27, 30.04.2019

Oğuzhan Herdi , Burak Karataş Esin Gezici Vesile Şentürk Cankorur Abdülkadir Çevik

Abstract

Sık görülen ruhsal hastalıklar olan
depresyon ve anksiyete bozuklukları toplumun %2-6’sını etkilemektedir. Sık
görülen ruhsal bozuklukların tedavisinde anemi, tiroid bozuklukları genel tıbbi
durumların santral sinir sistemi hastalıklarının ise klinik uygulamada akılda
tutulması önemlidir. Bu çalışmada sık görülen ruhsal hasatlıklar tanısıyla izlemde
olan ancak tedaviye yanıtın yetersiz olması veya yanıtın olmaması nedeniyle
Ankara Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı
Psikosomatik servisinde yatırılarak tedavileri düzenlenmiş hastaların dosya
verileri geriye dönük olarak incelenmiştir. Çalışmanın amacı tedaviye yanıtsız
bu hasta grubunun sosyo-demografik ve klinik özelliklerinin belirlenmesidir.

Ankara Üniversitesi Tıp Fakültesi
Psikosomatik servisine depresyon, anksiyete bozuklukları, obsesif kompulsif
bozukluk, somatofom bozukluklar gibi sık görülen ruhsal hastalık tanılarıyla
Eylül 2017- Haziran 2018 tarihleri arasında kabul edilen hastalar (n=60)
çalışmaya alınmıştır. Hastalar 12’şerli gruplar halinde yatırılarak 2 aylık kat
programı içerisinde yer alan aktiviteler ve grup ve bireysel terapiler ve ilaç
tedavileri uygulanarak takip edilmiştir. Sosyodemografik veriler, anamnezden
elde edilen klinik belirtiler, serum vitamin B12 ve TSH düzeyi ve kranial MR
raporları analizler için kullanılmıştır. İstatiksel analizler için SPSS 21.0
kullanılmış olup p<0,05 anlamlı kabul edilmiştir.

Depresif belirtiler en sık gözlenen
belirti grubudur. Taciz öyküsü ile kadın cinsiyet arasında, geçmişte şiddete
maruz kalmak ve depresif belirtiler arasında, ailede ruhsal hastalık varlığı ile
anksiyöz belirtiler arasında anlamlı ilişki tespit edilmiş olup diğer klinik
veriler ve sosyodemografik veriler arasında anlamlı ilişki tespit
edilmemiştir(sırasıyla p=0,025; 0,021; 0,012). Laboratuar verileri ile diğer
değişkenler arasında anlamlı bir ilişki tespit edilmemiş olup fronta beyaz
cevherde hiperintensite varlığı toplam belirti sayısı ile ilişkili bulunmuştur
(p=0,022).

Sonuç olarak psikiyatrik hasta grubunu
sadece ruhsal anlamda değil hem biyolojik yani organik hem de sosyal anlamda
bütüncül bir şekilde değerlendirmek hekimlik nosyonunun bir parçası haline
gelmelidir. Ancak bu şekilde bir yaklaşımla hastaların tedavisi bütüncül olarak
yapılmış olacaktır. 

Keywords

Depresyon, anksiyete

MEDICAL PRACTICES OF ANKARA UNIVERSITY FACULTY OF MEDICINE PSYCHOSOMATIC UNIT IN COMMON MENTAL DISORDERS: A RETROSPECTIVE CROSS-SECTIONAL STUDY

Abstract

Introduction: Depression and anxiety disorders which are counted as common mental disorders effect 2-6% of general population. In the treatment of common mental disorders, anemia, thyroid dysfunctions, general medical issues and central nervous system diseases must be kept in minds. In this paper, medical files of patients who had been hospitalized in Ankara University Faculty of Medicine, Psychosomatic Unite of Mental Health and Disorders Department cause of treatment resistance or insufficent treatment response were examinede retrospectively. Purpose of this study is identifying and sociodemographic and clinical features and exhibiting relationship between these in treatment resistant patients. Method: Patients that applied to Ankara University Faculty of Medicine Psychosomatic Unite between September 2017-June 2018 and were diagnosed as depression, anxiety disorders, obsessive-compulsive disorder or somatoform disorders were selected(n=60). Patients were hospitalized in twelve personed groups for 2 months and were treated with group and individual psychotherapies and psychotropic drugs. Sociodemographic data, clinical findings detected from medical files, serum vitamine B12 and TSH levels and cranial MRI reports were used for analysis. SPSS 21.0 was used and p<0,05 was accepted for significancy. Results: Depressive symptoms were the most observed symptoms. There were significant relationship with sexual abuse history and female sex, and physical abuse history and depressive symptoms (resptectively p=0,025; 0,021). And also there was significant relationship between anxiety symptoms and mental disorder in relatives(p=0,012). There was no relationship rest of clinical and sociodemographic data. There was no relationship between laboratuary data and the other variables but total symptom number was significantly related frontal white matter hiperintensity (p=0,022). Conclusion: In the end patient with mental disorder must be evaluated not only mental aspect but also biological and social aspects. The treatment of patients can be carried holistically if only that kind of evaluation is made.

Keywords

Depression, anxiety, psychosomatic

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