Tamamlanmış İntiharlarda Psikolojik Otopsi Yöntemi İle İntihar Belirleyici Faktörlerinin Araştırılması

Öz

AMAÇ: İntiharları değerlendirmek için kullanılan psikolojik otopsi yönteminde yarı yapılandırılmış görüşme formu oluşturulmuş, kişilerin adli kayıtları incelenmiş, psikiyatrik ve diğer sağlık bilgileri ile birlikte sorgulayarak bireyleri intihara sürükleyen nedenlerin değerlendirilmesi amaçlanmıştır. Psikolojik otopsi yönteminin daha yaygın kullanılması, kurumlar arası işbirliği sağlanarak sonuçların bir havuzda toplanması, intiharı önlemek için geliştirilecek ulusal strateji ve evrensel veri bankası geliştirilmesi hedeflenmektedir. YÖNTEM: Kasım 2010 - Kasım 2011 tarihleri arasında Adli Tıp Kurumu ATK Morg İhtisas Dairesi’ne intihar şüphesi ile getirilen otopsi incelemesi sonucunda intihar olduğu tespit edilen olguların yakınları ile görüşüldü. Kişiyi en iyi tanıyan yakını çalışma hakkında bilgilendirildikten sonra onamı alınanlar çalışmaya dahil edildi. Görüşmeciler tarafından çalışmaya alınan kişilerin yakınına, tanısal değerlendirme için DSM veya ICD ölçütleri kullanılarak oluşturulan yarı yapılandırılmış formlar aracılığıyla sistematik sorgulama yapıldı. BULGULAR: Olguların %82,5 erkek, %17,5 kadın idi. Hastaların %25’nin intiharı planladığı, %22,5’nun intihar notu olduğu tespit edildi. Olguların %45’inde psikiyatrik bir hastalık bulunduğu ve en sık olarak %55’inde depresif bozukluk olduğu saptandı. Predispozan faktörlerden en sık neden %35 oranında kırsal alandan kentsel alana göç olarak saptanırken ikinci sırada %25 oranlarında maddi kayıplar ve ailesel sorunlar olduğu tespit edildi. Olguların %7,5’inde ailesinde psikiyatrik hastalık bulunduğu %2,5’inde ailesinde intihar girişimi olduğu saptandı. Ölüm nedenleri arasında %60 ası, %15 ateşli silah yaralanması, %10 genel beden travması, %5 suda boğulma, %5 zehirlenme, %2,5 elektrik çarpması, %2,5 kesici delici alet yaralanması olduğu saptandı. SONUÇ: Psikolojik otopsi sonucuna göre tamamlanmış intiharlarda predispozan faktörler; göç, sosyoekonomik durumda kötüleşme , psikiyatrik hastalıklar ve suisidal plan varlığında bireyler daha çok kendine zarar verme davranışı ve ölüm ile karşı karşıya kalmaktadır.

Anahtar Kelimeler

• Psikolojik otopsi
• tamamlanmış intihar
• yarı yapılandırılmış görüşme formu
• depresif bozukluklar
• göç
• madde kötüye kullanımı

Research of Suicide Determinative Factors by Psychological Autopsy in Completed Suicides

Öz

OBJECTIVE: In psychological autopsy method, which was used in order to evaluate suicides, a semi-structured interview form was created, criminal records of individuals are examined and evaluating the causes that lead individuals to suicide is aimed by investigating with psychiatric and other medical information of individuals. The aim is to use psychological autopsy more frequently, gather the results in a pool through cooperation between institutions, form a national strategy to prevent suicide and develop a universal data bank. METHOD: Between November 2010 and November 2011, the relatives of cases, which were brought to The Council of Forensic Medicine ATK Morgue Specialization Department and detected to have completed suicide after the autopsy examination, were interviewed. After the immediate relative was informed of the study, the approved cases were included in the study. The relatives included in the study by interviewer were systematically interrogated for diagnostic evaluation, by using semi-structured forms using the DSM or ICD criteria. RESULTS: 82.5% of the cases were male, and 17.5% were women. It was determined that 25% of the patients plotted suicide, and 22.5% had suicide notes. 45% of the cases had a psychiatric condition, and the most common one was depressive disorder, being 55%. The most common cause in predisposing factors was determined to be migration from rural areas to urban areas with the rate of 35%. Financial loss and family issues take the second place with the rate of 25%. It has been detected that 7.5% of the cases had a psychiatric disease history, and 2.5% had suicide attempt history in the family. It has been seen that 60% of the causes of death was hanging, 15% was gunshot injury, 10% was general physical trauma, 5% was drowning, 5% was intoxication, 2.5% was electrocution, and 2.5% was sharp object injuries. CONCLUSION: According to the results of psychological autopsy on completed suicides, individuals’ predisposing factors of such as deterioration of socio-economic condition and migration, psychiatric diseases and presence of suicidal plans cause individuals to face more self-harm situations and death.

Anahtar Kelimeler

• Psychological autopsy
• completed suicide
• semi-structured interview form
• depressive disorders
• migration
• substance abuse

Kaynakça

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