Medine Yazıcı GÜLEÇ, Rumeysa Yeni ELBAY, Sena ŞAYAKÇI, Handan METERİS, Aytül Gürsu HARİRİ, Ahmet Ertan TEZCAN

Yatan psikiyatri hastalarında madde kullanımı ve hastalıklara göre dağılımı: Retrospektif bir çalışma

Amaç: Madde kullanım bozuklukları psikiyatrinin gün geçtikçe dikkati daha fazla çeken konularından biri olmaktadır. Psikiyatrik bozukluğu olan hastalarda da madde kullanımı dikkat çeken özelliktedir. Bu çalışmada, yatarak tedavi gören hastalarda madde kullanım oranları ve psikiyatrik hastalıklarla ilişkisinin gözden geçirilmesi amaçlanmaktadır. Yöntem: Bu çalışma, Ocak 2007-Şubat 2009 tarihleri arasında Sağlık Bakanlığı Erenköy Ruh ve Sinir Hastalıkları Eğitim Araştırma Hastanesi Psikiyatri Kliniklerine yatarak tedavi görmüş olan 5524 hastanın dosyası incelenerek yapılmış retrospektif bir çalışmadır. Bulgular: 5524 hasta’dan 203’ünün (%3.7) hayatının herhangi bir döneminde madde kullanmış olduğu tespit edildi. Madde kullanan hastalarda kötüye kullanım %22.2, bağımlılık %15.8 oranında iken, kullanan fakat tanı almayanlar ise %18.7 oranındaydı. Hayatı boyunca birkaç kez kullananların oranı %13.3, uzun süreli kullanıp bıraktığını söyleyenlerin oranı %30.0 idi. Tüm yatan hastalarda madde kullananların tanılarına bakıldığında, en yüksek madde kullanma oranlarının, sırasıyla, kısa psikotik bozukluk (%5.9), başka türlü adlandırılamayan psikotik bozukluğu (%3.9), bipolar afektif bozukluk (%3.5), şizofreni (%3.2), şizoafektif bozukluk (%2.6), depresif bozukluklar (%1.5), anksiyete bozuklukları (%1.2) olduğu saptanmıştır. En çok kullanılan maddenin ise esrar olduğu görülmüştür. Sonuç: Hasta grubunda madde kullanım oranları beklenenden düşük bulunmuştur. En yüksek oranlar psikotik bozukluklar ve bipolar bozuklukta görülürken, sonuçlarımız, başlangıçtaki psikiyatrik görünüme sonradan eklenmiş madde kullanımı hipotezini desteklemektedir.

Substance use among psychiatric inpatients and distribution according to disorders: A retrospective study

Objective: Substance abuse (SA) is an important issue that attracts more and more attention in the psychiatric area. It is also important that substance misusing take place in psychiatric patients. This study was performed to evaluate substance abuse ratio of inpatients and its relation with psychiatric manifestation. Method: This was a retrospective study evaluating files of all inpatients treated between January 2007 and February 2009 in Sağlık Bakanlığı Erenköy Mental Health Research and Training Hospital in the psychiatric wards. Results: A total of 5524 inpatients were evaluated. It was detected that 203 patients (3.7%) had abused a substance in their life period. Among the SA group, 22.2% were diagnosed as having abuse, 15.8% as dependency, and 18.7% had no diagnosis although they were using substance. According to patients in the remaining group, 13.3% of them used rarely and were not active, and 30% of them believed they were in remission. When the SA ratio of all inpatients according to their psychiatric disorders was investigated, it was found that 5.9% were brief psychotic disorder, 3.9% psychotic disorder not otherwise specified, 3.5% bipolar disorder, 3.2% schizophrenia, 2.6% schizoaffective disorder, 1.5% depressive disorder, and 1.2% anxiety disorder. The most commonly used substance was cannabis. Conclusions: It was found that the ratio of substance abuse was unexpectedly low among psychiatric inpatients. Our results showed that SA was most frequent among patients with psychotic and affective disorder. These results support also the model of primary mental illness with substance abuse at least in psychiatric wards.

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