Çocuk ve Ergen Psikiyatrisi Yataklı Tedavi Kliniğinde İzlenen Hastalarda Psikiyatrik Bozukluklar

Abstract

Amaç: Çocuk Ergen Psikiyatrisi yataklı kliniğinde izlenen çocuk ve ergenlerin yatış endikasyonlarının ve yatışları süresince konulan psikiyatrik komorbid tanıların araştırılmasıdır.Yöntem: Çocuk ergen ruh sağlığı ve hastalıkları yataklı kliniğinde iki yıllık sürede yatışı yapılmış olan hastaların hastane dosyaları ve Çocuk Psikiyatrisi Kişisel Kartları geriye dönük olarak incelendi. Bulgular: Belirlenen zaman aralığında klinikte 245 olgunun en az bir gece yattığı, olguların yaş aralığının 6-18 (14.5±2.2) olduğu saptandı. Olguların 140’ı kız (%57.1), 105’i erkekti (42.9%). Yatış endikasyonu olan en sık beş tanı sırasıyla majör depresif bozukluk (n= 57, %23.3), bipolar afektif bozukluk (n= 49, %20), yıkıcı davranım bozukluğu (n=36, %14.7), şizofreni açılımı kapsamında ve psikozla giden bozukluklar (n=26, %10.6) ve travma sonrası stres bozukluğu (n=19, %7.8) idi. Tartışma: Ülkemizde kısıtlı yatak sayısı nedeniyle, çocuk ve ergenlerde yaşamı tehdit eden durumlara yatış önceliği verildiği görülmektedir. Yatan hastaların çok büyük bir kısmında komorbid psikiyatrik bozukluklar görülmekte ve tablonun şiddetlenmesinde rol oynamaktadır.

Keywords

• Çocuk
• Ergen
• Psikiyatri
• Yatış
• Komorbidite

Thanks

Yazarlar bu çalışmadaki hasta ve ailelerine teşekkür eder.

Primary Diagnosis of the Inpatients in an Children and Adolescents Psychiatry Clinic and Their Comorbid Psychiatric Diagnosis

Abstract

Objective: The aim of this study is to investigate the indications for hospitalization of children and adolescents followed in the Child Adolescent Psychiatry inpatient clinic and the psychiatric comorbid diagnoses made during their hospitalization. Method: Hospital files and Child Psychiatry Personal Cards of patients who were admitted to our clinic during the two-year period between 2017 and 2018 were examined retrospectively. Results: It was determined that 245 cases stayed in the clinic for at least one night during the specified time period, and the age range of the cases was 6-18 (14.5±2.2). 140 of the cases were girls (57.1%) and 105 were boys (42.9%). The five most common diagnoses that are indications for hospitalization were major depressive disorder (n= 57, 23.3%), bipolar affective disorder (n= 49, 20%), disruptive behavior disorder (n= 36, 14.7%), schizophrenia and psychosis disorders (n=26, 10.6%) and post-traumatic stress disorder (n=19, 7.8%). Discussion: In our country, due to the limited number of beds, it is seen that priority is given to hospitalization for life-threatening situations in children and adolescents. Comorbid psychiatric disorders are observed in the majority of inpatients and play a role in exacerbating the condition.

Keywords

• Adolescent
• Child
• Comorbidity
• Hospitalization
• Psychiatry

References

1. Allwood, M. A., Dyl, J., Hunt, J. I., & Spirito, A. (2008). Comorbidity and service utilization among psychiatrically hospitalized adolescents with posttraumatic stress disorder. Journal of Psychological Trauma, 7(2), 104-121.
2. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Arlington. 5th ed.; 2013
3. Burgić-Radmanović, M., & Burgić, S. (2010). Comorbidity in children and adolescent psychiatry. Psychiatria Danubina, 22(2), 298–300.
4. Ceylan, M. F., Erdogan, B., Tural Hesapcioglu, S., & Cop, E. (2017). Effectiveness, Adverse Effects and Drug Compliance of Long-Acting Injectable Risperidone in Children and Adolescents. Clinical drug investigation, 37(10), 947–956. https://doi.org/10.1007/s40261-017-0555-7
5. Cichoń, L., Janas-Kozik, M., Siwiec, A., & Rybakowski, J. K. (2020). Clinical picture and treatment of bipolar affective disorder in children and adolescents. Obraz kliniczny i leczenie choroby afektywnej dwubiegunowej u dzieci i młodzieży. Psychiatria polska, 54(1), 35–50. https://doi.org/10.12740/PP/OnlineFirst/92740
6. Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., Angold, A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch. Gen. Psychiatry 2003, 60, 837–844.
7. Erskine, H. E., Ferrari, A. J., Nelson, P., Polanczyk, G. V., Flaxman, A. D., Vos, T., Scott, J. G. (2013) Epidemiological modelling of attentiondefcit/hyperactivity disorder and conduct disorder for the Global Burden of Disease Study 2010. J Child Psychol Psychiatry 54(12):1263–1274. https://doi.org/10.1111/jcpp.12144
8. Findling, R. L., Stepanova, E., Youngstrom, E. A., & Young, A. S. (2018). Progress in diagnosis and treatment of bipolar disorder among children and adolescents: an international perspective. Evidence-based mental health, 21(4), 177–181. https://doi.org/10.1136/eb-2018-102912

9. Fristad, M. A., Nick, E. A. (2017) Bipolar disorder during childhood and adolescence. In: DeRubeis RJ, Strunk DR. ed. The Oxford Handbook of Mood Disorders. Oxford–New York: Oxford University Press;. 287–298.
10. Green, J., Jacobs, B., Beecham, J., Dunn, G., Kroll, L., Tobias, C., & Briskman, J. (2007). Inpatient treatment in child and adolescent psychiatry--a prospective study of health gain and costs. Journal of child psychology and psychiatry, and allied disciplines, 48(12), 1259–1267. https://doi.org/10.1111/j.1469-7610.2007.01802.x
11. Green, J.M. (2002). Provision of intensive treatment: Inpatient units, day units and intensive outreach. In M. Rutter & E. Taylor (Eds.), Child and Adolescent Psychiatry (pp. 1038–1050). Oxford: Blackwell.
12. Imran, N., Bodla, Z. H., Asif, A., Shoukat, R., & Azeem, M. W. (2021). Pakistan’s First Child & Adolescent Psychiatry Inpatient Unit: Characteristics of admitted patients and response to treatment over a 7-year period. Pakistan journal of medical sciences, 37(2), 305–311. https://doi.org/10.12669/pjms.37.2.2611
13. Jaunay, E., Consoli, A., Greenfield, B., Guilé, J. M., Mazet, P., & Cohen, D. (2006). Treatment refusal in adolescents with severe chronic illness and borderline personality disorder. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie canadienne de psychiatrie del’enfant  et de l’adolescent, 15(3), 135–142.
14. Li, F., Cui, Y., Li, Y., Guo, L., Ke, X., Liu, J., Luo, X., Zheng, Y., & Leckman, J. F. (2022). Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals. Journal of child psychology and psychiatry, and allied disciplines, 63(1), 34–46. https://doi.org/10.1111/jcpp.13445
15. Masroor, A., Patel, R. S., Bhimanadham, N. N., Raveendran, S., Ahmad, N., Queeneth, U., Pankaj, A., & Mansuri, Z. (2019). Conduct Disorder-Related Hospitalization and Substance Use Disorders in American Teens. Behavioral sciences (Basel, Switzerland), 9(7), 73. https://doi.org/10.3390/bs9070073
16. Mojtabai, R., Olfson, M., & Han, B. (2016). National Trends in the Prevalence and Treatment of Depression  in Adolescents and Young Adults. Pediatrics, 138(6), e20161878. https://doi.org/10.1542/peds.2016-1878
17. Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A. B. National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Arch. Gen. Psychiatry. 2007; 64(9): 1033–1039.
18. Park, B. E., Lee, J. S., Kim, H. Y., Bae, J. N., Kim, W. H., Kim, H. Y., Rim, M. R., Kang, S. G., & Choi, S. H. (2019). The Influence of Depression and School Life on the Quality of Life of Korean Child and Adolescent Patients with Attention-Deficit/Hyperactivity Disorder:A Comparison of the Perspectives of the Patients and Their Caregivers. Soa--ch’ongsonyon chongsin uihak = Journal of child & adolescent psychiatry, 30(1), 2–8. https://doi.org/10.5765/jkacap.180027
19. Rapoport, J. L., & Gogtay, N. (2011). Childhood onset schizophrenia: support for a progressive neuro developmental disorder. International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience, 29(3), 251–258. https://doi.org/10.1016/j.ijdevneu.2010.10.003
20. Salmanian, M., Mohammadi, M. R., Hooshyari, Z., Mostafavi, S. A., Zarafshan, H., Khaleghi, A., Ahmadi, A., Alavi, S. S., Shakiba, A., Rahgozar, M., Safavi, P., Arman, S., Delpisheh, A., Mohammadzadeh, S., Hosseini, S. H., Ostovar, R., Hojjat, S. K., Armani, A., Talepasand, S., & Amiri, S. (2020). Prevalence, comorbidities, and sociodemographic predictors of conduct disorder: the national epidemiology of Iranian children and adolescents psychiatric disorders (IRCAP). European child & adolescent psychiatry, 29(10), 1385–1399. https://doi.org/10.1007/s00787-019-01448-9
21. Strålin, P., & Hetta, J. (2019). First episode psychosis and comorbid ADHD, autism and intellectual disability. European psychiatry : the journal of the Association of European Psychiatrists, 55, 18–22. https://doi.org/10.1016/j.eurpsy.2018.09.007
22. Sun, C. F., Mansuri, Z., Trivedi, C., Vadukapuram, R., & Reddy, A. (2022). Homicidal ideation and psychiatric comorbidities in the inpatient adolescents aged 12-17. Frontiers in psychiatry, 13, 933524. https://doi.org/10.3389/fpsyt.2022.933524
23. Suntharalingam, S., Johnson, D., Suresh, S., Thierrault, F. L., De Sante, S., Perinpanayagam, P., Salamatmanesh, M., & Pajer, K. (2022). Rates of Dual Diagnosis in Child and Adolescent Psychiatric Inpatients: A Scoping Review. Journal of addiction medicine, 16(1), 101–109. https://doi.org/10.1097/ADM.0000000000000818
24. Traut, A., Kaminer, D., Boshoff, D., Seedat, S., Hawkridge, S., & Stein, D. J. (2002). Treatment utilisation and trauma characteristics of child and adolescent inpatients with posttraumatic stress disorder. Curationis, 25(4), 67–72. https://doi.org/10.4102/curationis.v25i4.809
25. Tural Hesapcioglu, S., Kasak, M., Abursu, H., Kafali, S., Ceylan, M. F., & Akyol, M. (2024). A systematic review and network meta-analysis on comparative efficacy, acceptability, and safety of treatments in acute bipolar mania in youths. Journal of affective disorders, 349, 438–451. https://doi.org/10.1016/j.jad.2024.01.067