SAMİYE ÇİLEM BİLGİNER, Esra COP, Zeynep GÖKER, Özlem HEKİM, Ebru SEKMEN, ÖZDEN ŞÜKRAN ÜNERİ

Overview of Young People Attempting Suicide by Drug Overdose and Prevention and Protection Services

Amaç: Tamamlanmış intihar, tüm dünyada 15-29 yaş arası ölümlerin önde gelen ikinci nedenidir. Bu çalışmada, intihar amaçlı ilaç içen çocuk ve gençlere ilişkin karakteristik özellikler sunularak gençlik intiharlarına ve Türkiye'de bu konularda alınabilecek önlemlere dikkat çekmek amaçlanmıştır. Yöntem: Çalışmada bir yıllık sürede intihar amaçlı ilaç içerek bir eğitim ve araştırma hastanesine başvuruda bulunan hastaların dosya kayıtları geriye dönük incelenmiştir. Gençlere ait sosyodemografik veri ve psikiyatrik değerlendirme kayıtlarına ilişkin veri kaydedilmiştir. Bulgular: Çalışma tarihleri arasında 163 genç, intihar amaçlı ilaç içerek hastaneye başvurmuştur. Olguların %61.3'ünden (n=100) çocuk psikiyatrisi konsültasyonu istenmiştir. Olguların %90'ının ilk intihar girişimiydi. Tekrarlayan intihar girişiminde bulunan olgularda önceden psikiyatrik tanı bulunma sıklığı anlamlı olarak fazlaydı. Dürtüsel ve planlı intihar girişimlerin her ikisinde de en sık tercih edilen saatler akşam ve gece saatleriydi. Kadınlar en sık aile içi çatışmaya bağlı olarak, erkekler ise en sık duygusal ilişkisinde yaşanan sorunlara bağlı olarak intihar girişiminde bulunmuştu. Herhangi bir psikiyatrik tanı konmayan ve dışsallaştırma sorunları saptanan olguların tamamı dürtüsel intihar girişiminde bulunmuştu. İntihar amaçlı en sık tercih edilen ilaçlar nonsteroid antiinflamatuarlar, antidepresanlar, parasetamol, antibiyotikler ve antipsikotiklerdi. Olguların %22.5'i ise kendine ait ilaçları içerek intihar girişiminde bulunmuştu. Olguların %71'inde çocuk psikiyatrisi takibi sağlanamamıştır. Sonuç: Sayısı giderek artan intihar girişimlerini önlemek amacıyla toplumun dikkatinin bu konuya çekilmesi gerektiği düşünülmüştür. Özellikle aile odaklı koruyucu yaklaşımlar, gençlere yönelik okul tabanlı önleme çalışmaları ve ilaç emniyeti ile ilgili yeni yasal düzenlemeler bu yöndeki intihar girişimlerinin sıklığının azaltılmasında yardımcı olabilir.

İlaç içerek intihar girişiminde bulunan gençler ve koruyucu-önleyici hizmetlere genel bakış

Suicide is the second leading cause of death among 15-29 year-old-people in the world. The aim of this study is to present the characteristics of children and adolescents attempting suicide by drug overdose and to draw attention to preventive measures that can be taken in Turkey.Method: Records of the patients who admitted to a training and research hospital in one year period due to a suicide attempt by drug overdose were reviewed retrospectively. Sociodemographic data and psychiatric evaluation records of attempters were documented.Results: During the study period, 163 adolescents applied to the hospital with suicidal drug overdose. Child psychiatry consultation was ordered for 61.3% (n=100) of them. It was the first attempt of 90% of the cases. The frequency of having previous psychiatric diagnosis was significantly higher in patients with recurrent suicide attempts. In both impulsive and planned suicide attempts, the most preferred times were evening and night time. Women more often attempted suicide due to family conflict, while men attempted due to emotional relationship problems. All cases without psychiatric disorder or with externalizing problems attempted impulsive suicide. The most preferred drugs for suicide were, nonsteroidal anti-inflammatory drugs, antidepressants, paracetamol, antibiotics and antipsychotics. Of the all cases, 22.5% attempted suicide by self medications. It has not been possible to maintain pediatric psychiatric follow up of the 71% of the cases. Conclusion: It is considered that public attention should be drawn to the increasing number of adolescent suicide attempts in order to prevent this issue. Family-oriented protective approaches, school-based preventive programs and new legal regulations on drug safety could help to reduce the frequency of suicide attempts

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