Çocuk ve Ergenlerde Yatarak Psikiyatrik Tedavi Süreçlerine COVID-19 Pandemisinin Etkisi

Abstract

Amaç: Bu çalışma, COVID-19 pandemisinin çocuk ve ergen psikiyatrisi yatarak tedavi süreçlerine etkisini değerlendirmeyi amaçlamaktadır. Pandemi öncesi, pandemi dönemi ve pandemi sonrası olmak üzere üç farklı zaman diliminde servis başvuruları karşılaştırılarak, pandemi sürecinin psikiyatrik yatışlar üzerindeki etkisi analiz edilmiştir. Yöntem: 1 Nisan 2018 – 31 Ocak 2024 tarihleri arasında bir üniversite hastanesinin çocuk ve ergen psikiyatrisi servisinde yatarak tedavi gören toplam 768 hastanın klinik verileri geriye dönük olarak incelenmiştir. Sosyodemografik (yaş, cinsiyet) ve klinik değişkenler (tanı, yatış süresi, yatış sayısı, intihar girişimi öyküsü, eş tanı varlığı) üç dönem arasında karşılaştırılmıştır. Bulgular: Pandemi döneminde özellikle dikkat eksikliği ve hiperaktivite bozukluğu başta olmak üzere nörogelişimsel bozukluk tanılı hastaların yatış oranında istatistiksel olarak anlamlı bir artış gözlenmiştir (p<0.05). Depresif bozukluk, travma sonrası stres bozukluğu, bipolar bozukluk, obsesif kompulsif bozukluk, madde kullanım bozukluğu ve anksiyete bozuklukları tanılı hastaların yatış oranlarında pandemi döneminde artış gözlenmiş; ancak bu artışlar istatistiksel olarak anlamlı bulunmamıştır. Pandemi döneminde hastaların yaş ortalaması artarken, eş tanı oranı da önceki dönemlere kıyasla belirgin şekilde yükselmiştir. Ayrıca, pandemi ve sonrası dönemde yatış süresi anlamlı olarak kısalmıştır (p<0.05). Sonuç: COVID-19 pandemisi, çocuk ve ergenlerin ruh sağlığını olumsuz yönde etkilemiş, özellikle nörogelişimsel bozukluğu olan bireylerde yatarak tedavi ihtiyacını artırmıştır. Bulgular, pandemi gibi olağan dışı koşullarda dahi çocuk ve ergen ruh sağlığı hizmetlerinin sürdürülebilirliğinin korunmasının gerekliliğine işaret etmektedir. Bu nedenle, gelecekteki benzer kriz durumlarına hazırlık amacıyla çocuk ruh sağlığı hizmetlerinin güçlendirilmesi ve kırılgan gruplara yönelik destekleyici politikaların geliştirilmesi önem arz etmektedir.

Keywords

• Dikkat Eksikliği ve Hiperaktivite Bozukluğu
• Çocuk ve Ergen Psikiyatrisi
• Yataklı Servis
• Ruh Sağlığı Hizmetleri
• Nörogelişimsel Bozukluklar
• Pandemi

The Impact of the COVID-19 Pandemic on Inpatient Psychiatric Treatment Processes in Children and Adolescents

Abstract

Objective: This study aims to examine the impact of the COVID-19 pandemic on inpatient treatment processes in child and adolescent psychiatry by comparing three distinct periods: pre-pandemic, during the pandemic, and post-pandemic. Methods: Clinical data of a total of 768 patients who were hospitalized in the child and adolescent psychiatry inpatient unit of a university hospital between April 1, 2018, and January 31, 2024, were retrospectively reviewed. Sociodemographic variables (age, sex) and clinical variables (diagnosis, length of stay, number of admissions, history of suicide attempts, presence of comorbid diagnoses) were compared across three time periods. Results: During the pandemic period, a statistically significant increase was observed in the hospitalization rates of patients diagnosed with neurodevelopmental disorders, particularly attention-deficit/hyperactivity disorder (p < 0.05). Although hospitalization rates for patients diagnosed with depressive disorder, post-traumatic stress disorder, bipolar disorder, obsessive-compulsive disorder, substance use disorder, and anxiety disorders increased during the pandemic period, these increases were not statistically significant. The mean age of patients increased during the pandemic period, and the rate of comorbid diagnoses was markedly higher compared to previous periods. Additionally, the length of hospital stay was significantly shorter during the pandemic and post-pandemic periods (p < 0.05). Conclusion: The COVID-19 pandemic adversely affected the mental health of children and adolescents, particularly increasing the need for inpatient treatment among individuals with neurodevelopmental disorders. The findings highlight the necessity of maintaining the sustainability of child and adolescent mental health services world wide even under extraordinary circumstances such as a pandemic. Therefore, strengthening child mental health services and developing supportive policies targeted at vulnerable groups are crucial for preparedness in future similar crises.

Keywords

• Attention Deficit Hyperactivity Disorder
• Child and Adolescent Psychiatry
• Inpatient Care
• Mental Health Services
• Neurodevelopmental Disorders
• Pandemic

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