ARİF ÖNDER, Aslı Sürer ADANIR, Canem KAVURMA, Öznur BİLAÇ, Gülçin BÖLÜK UZUNOĞLU, ŞERMİN YALIN SAPMAZ, Özge GİZLİ ÇOBAN

Bir çocuk ve ergen psikiyatrisi kliniğinde yatarak tedavi gören hastalarda fiziksel tespitin tanı ve ilaç kullanımı ile ilişkisi

Amaç: Bu çalışmanın amacı Türkiye’nin sayılı kapalı çocuk ve ergen yataklı servislerinden olan birimimizde fiziksel tespite alınan hastaların tanı, ilaç kullanımı gibi özelliklerini ve tespitin tedavi üzerine olan etkilerini değerlendir- mektir. Yöntem: Bir ruh sağlığı ve hastalıkları hastanesi çocuk ve ergen psikiyatrisi yataklı biriminde 2016 yılında yatarak tedavi görmüş 203 hastanın tıbbi kayıtları geriye dönük incelenmiştir. Yatış süresi boyunca en az bir kez tespite alınan hastalar alınmayan hastalar ile tanı, psikofarmakolojik ilaç kullanımı, eş tanı varlığı, yatış süresi ve taburculuk şekli açısından karşılaştırılmıştır. Sonuç: Tespite alınan ve alınmayan grup karşılaştırıldığında, tespite alınan grupta çok daha fazla sayıda ilaç kullanıldığı saptanmıştır. Tespite alınan grupta antipsikotik, benzodiya- zepin, duygudurum düzenleyici ve haloperidol-biperiden enjeksiyonu kullanımının anlamlı derecede daha fazla olduğu saptanmıştır. Tespite alınan hastalarda eş tanı konma oranı anlamlı derecede fazladır. Tespite alınan grupta alınmayan gruba göre majör depresyon, davranım bozukluğu ve bipolar bozukluk daha sık saptanmıştır. Tespite alınan hastalarda alınmayanlara göre kendine zarar verme davranışı anlamlı derecede daha yüksek belirlenmiştir. İki grubun yatış süreleri benzer olmakla birlikte, tespite alınan grupta ailenin imza karşılığı tedavi bitmeden hastayı teslim almasına daha sık rastlanmıştır. Tespite alınan grupta tedavi sonucu klinik global izlem düzelme puanları daha düşük saptanmıştır. Tartışma: Tespite alınan grupta tanı, uygulanan tedavi ve taburculuk şekli açısından birçok farklılık vardır. Tespit sayılarını azaltmak için daha fazla strateji oluşturulması gereklidir. (Anadolu Psikiyatri Derg 2019; 20(5):530-538)

The relationship between physical restraint and the diagnosis and drug use in the patients receiving inpatient treatment in a child and adolescent psychiatry clinic

Objective: The aim of this study is to evaluate the characteristics such as the diagnosis and medication of the physically restrained patients in our inpatient unit, which is one of the few inpatient units for children and adolescents in Turkey, and the effect of the physical restraint on the treatment of them. Methods: The medical records of 102 inpatients treated in our mental health hospital during the year 2016 had been retrospectively reviewed. Patients who were restrained at least once during the hospitalization period were compared with patients who were not, in terms of diagnosis, medication, presence of comorbidity, duration of hospitalization and the way of discharge. Results: Comparing the groups that were restrained and not restrained, it was found that multiple drug use was more common in the restrained group. The use of antipsychotics, anxiolytics and mood stabilizer drugs and haloperidol-biperiden injections were found to be significantly higher in the restrained group. The rate of multiple psychiatric diagnoses was significantly higher and major depression, conduct disorder, bipolar disorder and self- injurious behaviors were more frequent in the restrained group. Although the duration of hospitalization for both groups was similar, discharge with the request of the family or caregivers before the end of treatment was more frequent in the restrained group. Clinical global improvement scores were lower in the restrained group. Discus- sion: There are many differences in terms of diagnosis, medication and the way of discharge between the re- strained and non-restrained groups. More strategies are needed to reduce the restriction rates. (Anatolian Journal of Psychiatry 2019; 20(5):530-538)

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