SEDAT BATMAZ, Mesut YILDIZ, Emrah SONGUR

Gastrointestinal Symptoms in Psychiatry: Comparison of Direct Applications and Referrals

Amaç: Klink deneyim ve gözlemler psikiyatriye direkt başvuran hastalar ile gastroenteroloji kliniğinden refere edilen hastalar arasında bazı tutarsızlıklar bulunduğunu göstermiştir. Bu yüzden, çalışmamızda bu hastaların demografik ve klinik özellikleri ile ilgili farklılıkları araştırmayı hedefledik. Yöntem: Çalışmaya ardışık olarak yaşları 18-64 arası olan 115 hasta alınmıştır. Bu hastaların 61'i direkt olarak başvurmuş, 54'ü konsültasyon istenerek refere edilmiştir. Primer gastrointestinal şikayetler, psikiyatrik tanılar ve kişilik özellikleri sosyodemografik veri formuna kayıt edilmiş, psikiyatrik bozuklukların şiddeti Klinik Global İzlenim Ölçeği - Şiddet Alt Ölçeği ile değerlendirilmiştir. Bulgular: Psikiyatriye direkt olarak başvuran hastaların çoğu kadın, daha yaşlı, evli hastalardı ve gastrointestinal belirtilerinin daha ziyade psikolojik kökenli olduğunu belirtmişlerdir. Direkt olarak psikiyatriye başvuran hastalar daha ziyade karında doluluk/abdominal gerginlikten yakınırken, refere edilmiş olan hastalar daha sık olarak gaz, abdominal ağrı ve kabızlıktan şikayet etmekteydi. Direkt başvurularda daha ziyade depresif bozukluklar, travma ile ilişkili bozukluklar ve kişilik bozuklukları ile ilgili tanı konmuşken, refere edilenlerde daha sıklıkla psikotik bozukluklar tanısı konmuştur. Direkt olarak başvuran hastalar aynı zamanda kişilik özelliği olarak daha fazla impulsivite göstermiştir.Sonuç: Gastrointestinal belirtileri olan ve psikiyatriye doğrudan başvuran hastalar kimi demografik yönleri, birincil psikiyatrik tanıları ve kişilik özellikleri açısından gastroenteroloji kliniklerinden yönlendirilenlerden farklılaşmaktadır.

Psikiyatride gastrointestinal belirtiler: Direkt başvurular ile refere edilen olguların karşılaştırması

Gastrointestinal symptoms in psychiatry: comparison of direct applications and referralsObjective: Clinical experience and observations suggest that there are some discrepancies between patients who directly apply to psychiatry clinic, and who are referred from gastroenterology clinic to psychiatry clinic. Thus, we aimed to investigate differences related to the demographic and clinical characteristics of these patients. Method: The study included 115 consecutive patients aged between 18-65 years. Sixty-one of the patients applied directly to the psychiatry clinic, and 54 patients were referred for consultation to the psychiatry clinic. Primary gastrointestinal complaints, psychiatric diagnoses and personality features were recorded on the scoiodemographic data form, and the severity of psychiatric disorders were assessed by the Clinical Global Impression Scale - Severity Subscale. Results: Patients who directly applied to psychiatry clinic were more likely to be female, older, and married. They attributed their gastrointestinal symptoms also more likely to be of psychogenic origin. Patients who directly applied to psychiatry clinic suffered more likely from a sense of fullness/abdominal tension, while patients who were referred to psychiatry clinic more frequently complained of bloating, abdominal pain, and constipation. Patients who directly applied to psychiatry clinic were more frequently diagnosed with depressive disorders, trauma related disorders, and personality disorders, whereas referrals were more frequently diagnosed with psychotic disorders. Directly admitted patients were also more likely to exhibit impulsivity as a personality feature.Conclusion: Patients with gastrointestinal symptoms who directly presented to psychiatry differed from those who were referred from gastroenterology clinics on some of their demographic aspects, primary psychiatric diagnoses and personality traits.

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