MUSTAFA KAYHAN BAHALI, Yolga Ayşegül TAHİROĞLU, Ayşe AVCI

Okul reddi olan çocuk ve ergenlerin klinik özellikleri

Amaç: Okul reddi yakınması ile başvuran çocukların klinik özelliklerinin değerlendirilmesi ve gözden geçirilen kaynaklar ışığında tartışılmasıdır. Gereç ve Yöntem: Polikliniğimize okul reddi yakınması ile başvuran 55 çocuk çalışmaya alınmıştır. Çocukların anne-babalarına çalışmanın amacı anlatılmış ve onayları alınmıştır. Çocuk ve anne-baba ile ayrıntılı klinik görüşmeler yapılmıştır. Anne-babalara sosyodemografik bilgi formu, Ayrılma Anksiye-tesi Bozukluğu Belirti Tarama Listesi uygulanmıştır. Verilerin değerlendirilmesinde tanımlayıcı istatistikler kullanılmıştır. Bulgular: Okul reddi yakınması ile polikliniğimize başvuran çocuklar arasında erkek çocukların oranının daha fazla olduğu; çocukların yaş ortalamasının 9.1±3.0 yıl olduğu; ilkokula başlama (5-7 yaş), ortaokula başlama (10-11 yaş) gibi önemli geçiş dönemlerinde daha sık görüldüğü; ailelerin çoğunun tek ya da iki çocuklu aileler olduğu; ailenin ilk çocuğunda daha sık görüldüğü; en sık görülen ruhsal bozukluğun ayrılma anksiyetesi bozuklu-ğu olduğu ve ayrılma anksiyetesi bozukluğu olan çocuklarda en sık görülen eş tanının diğer bir anksiyete bozuklu-ğu olduğu saptanmıştır. Sonuç: Okul reddi bireyin sosyal, duygusal ve eğitim yaşamında kalıcı olabilecek etkileri nedeniyle önemli bir sorun olarak ele alınmalıdır. Olguların erken dönemde tanınması ve sağaltımı ruhsal bozuklukların gelişimini engelleyebilecektir. Günümüzde okul reddi alanındaki tartışmalar halen sürmektedir. Bu nedenle, çocuk ve ergen nüfusunda, okul reddinin etiyolojisi, epidemiyolojisi, alt tipleri ve tanı ölçütlerinin belirlenmesi, klinik gidişi ve sağaltımına yönelik yapılacak ileri çalışmalara gereksinim duyulmaktadır.

The clinical features of children and adolescents with school refusal

Objective: To assess the clinical features of children with school refusal and discuss them in the light of the resources reviewed. Methods: Fifty-five children with school refusal have been included in the study. Firstly, we gave information about study and got informed consent. Detailed clinical interviews were made with child and parents. A sociodemographic information form and a Symptom Check List for Separation Anxiety Disorder were applied to the parents. Definitive statistics were employed in the evaluation of the data. Results: It was found that among children who presented with complaints of school refusal the number of boys was higher; the average age of children was 9.1¬±3.0; school refusal was more frequently seen in children who go through important transition periods such as starting primary school (5-7 years) and junior high school (10-11 years); most of the families had either one child or two children; school refusal was more frequently seen in the first child of the family; the most frequently seen psychiatric disorder was separation anxiety disorder; and the most frequently seen accompanying diagnosis in children with separation anxiety disorder was another anxiety disorder. Conclusions: School refusal should be considered as an important problem due to its effects that could be permanent in the social, emotional, and educational life of the affected individual. The early identification and treatment of the cases will inhibit the development of psychiatric disorders. Today there is still ongoing controversy regarding school refusal. Thus, in child and adolescent population, future studies are needed to determine the etiology, epidemiology, subtypes, diagnosis, clinical course, and treatment of school refusal

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