Kader Semra KARATAŞ, Sinan SEVİNÇ, M. Feyzi ŞAHİN

Tamamlanmış İntiharlarda Psikolojik Otopsi Yöntemi İle İntihar Belirleyici Faktörlerinin Araştırılması

AMAÇ: intiharları değerlendirmek için kullanılan psikolojik otopsiyönteminde yarı yapılandırılmış görüşme formu oluşturulmuş,kişilerin adli kayıtları incelenmiş, psikiyatrik ve diğer sağlık bilgileriile birlikte sorgulayarak bireyleri intihara sürükleyen nedenlerindeğerlendirilmesi amaçlanmıştır. Psikolojik otopsi yönteminin dahayaygın kullanılması, kurumlar arası işbirliği sağlanarak sonuçlarınbir havuzda toplanması, intiharı önlemek için geliştirilecek ulusalstrateji ve evrensel veri bankası geliştirilmesi hedeflenmektedir.YONTEM: Kasım 2010 Kasım 2011 tarihleri arasında Adli TıpKurumu [ATK] Morg Ihtisas Dairesi'ne intihar şüphesi ile getirilenotopsi incelemesi sonucunda intihar olduğu tespit edilen olgularınyakınları ile görüşüldü. Kişiyi en iyi tanıyan yakını çalışma hakkındabilgilendirildikten sonra onamı alınanlar çalışmaya dahil edildi.Görüşmeciler tarafından çalışmaya alınan kişilerin yakınına, tanısaldeğerlendirme için DSM veya ICD ölçütleri kullanılarak oluşturulanyarı 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 tespitedildi. Olguların %45'inde psikiyatrik bir hastalık bulunduğu ve ensık olarak %55'inde depresif bozukluk olduğu saptandı. Predispozanfaktörlerden en sık neden %35 oranında kırsal alandan kentselalana göç olarak saptanırken ikinci sırada %25 oranlarında maddikayıplar ve ailesel sorunlar olduğu tespit edildi. Olguların %7,5'indeailesinde psikiyatrik hastalık bulunduğu %2,5'inde ailesinde intihargirişimi olduğu saptandı. Ölüm nedenleri arasında %60 ası,%15 ateşli silah yaralanması, %10 genel beden travması, %5 sudaboğulma, %5 zehirlenme, %2,5 elektrik çarpması, %2,5 kesici delicialet yaralanması olduğu saptandı.SONUÇ: Psikolojik otopsi sonucuna göre tamamlanmış intiharlardapredispozan faktörler; [göç, sosyoekonomik durumdakötüleşme], psikiyatrik hastalıklar ve suisidal plan varlığında bireylerdaha çok kendine zarar verme davranışı ve ölüm ile karşı karşıyakalmaktadır.

Research of Suicide Determinative Factors by Psychological Autopsy in Completed Suicides

OBJECTIVE: In psychological autopsy method, which wasused in order to evaluate suicides, semi-structured interviewform was created, criminal records of individuals are examinedand evaluating the causes that lead individuals to suicide is aimedby investigating with psychiatric and other medical informationof individuals. The aim is to use psychological autopsy more frequently,gather the results in pool through cooperation betweeninstitutions, form national strategy to prevent suicide and developuniversal data bank.METHOD: Between November 2010 and November 2011, therelatives of cases, which were brought to The Council of ForensicMedicine [ATK] Morgue Specialization Department and detected tohave completed suicide after the autopsy examination, were interviewed.Afterthe immediate relative was informed of the study, theapproved cases were included in the study. The relatives includedin the study by interviewer were systematically interrogated for diagnosticevaluation, by using semi-structured forms using the DSMor ICD criteria.RESULTS: 82.5% of the cases were male, and 17.5% werewomen. It was determined that 25% of the patients plotted suicide,and 22.5% had suicide notes. 45% of the cases had psychiatriccondition, and the most common one was depressive disorder,being 55%. The most common cause in predisposing factors wasdetermined to be migration from rural areas to urban areas withthe rate of 35%. Financial loss and family issues take the secondplace with the rate of 25%. It has been detected that 7.5% of thecases had psychiatric disease history, and 2.5% had suicide attempthistory in the family. It has been seen that 60% of the causesof death was hanging, 15% was gunshot injury, 10% was generalphysical trauma, 5% was drowning, 5% was intoxication, 2.5% waselectrocution, and 2.5% was sharp object injuries.CONCLUSION: According to the results of psychological autopsyon completed suicides, individuals' predisposing factors ofsuch as deterioration of socio-economic condition and migration,psychiatric diseases and presence of suicidal plans cause individualsto face more self-harm situations and death.

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