HANDE AYRALER TANER, FATİH HİLMİ ÇETİN, Yasemen IŞIK, Elvan İŞERİ

Cinsel istismara uğrayan çocuk ve ergenlerde psikopatoloji ve ilişkili risk etkenleri

Amaç: Bu çalışmada cinsel istismara uğrayan çocuklarda istismar ile ilgili özellikler, istismar sonrası erken dönem- de gelişen psikiyatrik bozukluklar ve psikiyatrik bozukluklarla ilişkili etkenlerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmaya 2011 ve 2012 yıllarında adli makamlar tarafından değerlendirme amacıyla doğrudan Gazi Üniversitesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalına doğrudan gönderilen çocuk ve ergen cinsel istismar olgularına ait veriler geriye dönük olarak dosya taramasıyla değerlendirilmiştir. Olgulara konulmuş olan tanılar DSM-IV-TR sistemine göre belirlenmiştir. Sonuçlar: Araştırmaya 107 istismar mağduru çocuk ve ergen alınmıştır. Olguların 90ı (%84.1) kız, 17si (%15.9) erkektir. İstismar öncesi olguların 26sının (%24.2) psikiyatrik öyküsünün olduğu saptanmıştır. Olguların istismar sonrası aldıkları tanılar değerlendirildiğinde, %77.6sın en az bir psikiyatrik tanı konmuş olduğu belirlenmiştir. İstismar öncesi psikiyatrik bozukluğu bulunması, istismarcının aile dışı önceden tanınan biri olması, ensest, istismarın birçok kez gerçekleşmesi, penetrasyonun bulunması ve fiziksel şiddetin etmesinin psikopatoloji gelişimi arasında artı yönde ilişkili olduğu saptanmıştır. Çoklu lojistik regresyon analizinde cinsel istismar öncesi herhangi bir psikiyatrik tanı almış olma, yineleyen istismara uğramış olma ve cinsel istismara fiziksel şiddetin eşlik etmesi durumlarının birlikte görüldüğü durumlarda istismar sonrası herhangi bir psikopatoloji gelişme riskinin 175 kat arttığı saptanmıştır. Tartışma: Çocukluk çağı cinsel istismarı sıklıkla ruhsal sorunlara neden olan bir travmadır. Bununla ilişkili etkenlerin belirlenmesi çocuk cinsel istismar olgularının izleme ve tedavisinde yön gösterici olacaktır. (Anadolu Psikiyatri Derg 2015; 16(4):294-300)

Psychopathology in abused children and adolescents and related risk factors

Objective: The aim of this study was to investigate the factors releated to sexual abuse, developing early psycho- pathologies after sexual abuse and the factors releated to these psychopathologies. Methods: In this study, the sexually abused children and adolescents who were referred to Gazi University Child and Adolescent Psychiatry Department for criminal reports between 2011 and 2012 were assesed retrospectively. Psychiatric diagnosis were made by using DSM-IV-TR diagnostic criterias. Results: The study included 107 sexually abused children. The sample consisted of 90 girls (84.1%) and 17 boys (15.9%). The number of participants who had a history of sexual abuse was 26 (24.2%). After the abuse, 77.6% of the patients were found to have a psychiatric diagnosis. It was also determined that having a psychiatric disorder history before the abuse, being abused by a known person out of the family, incest, multiple abuses, sexual abuse with penetration and accompanying physical violence is posi- tively releated to having a psychopathology after the abuse. It was detected in multipl logistic regretion analysis that cases which had all of these three factors as having any psychiatric diagnosis before sexual abuse, being abused repeatedly and accompanying physical violence with sexual abuse, had the risk of having a psychopathology after the abuse 175 times higher than the others. Discussion: Early childhood sexual abuse often leads to mental health problems. Determining the factors associated with child sexual abuse and psychiatric disorders will be guiding at the follow-up and treatment of child sexual abuse cases. (Anatolian Journal of Psychiatry 2015; 16(4):294-300)

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