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

Öz

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. 

Anahtar Kelimeler

• 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

Kaynakça

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