BİR ÜNİVERSİTE HASTANESİ ERGEN POLİKLİNİĞİNDE OBSESİF KOMPULSİF BOZUKLUKTA EŞ TANILAR VE İNTİHAR DAVRANIŞI

Giriş: Hem klinik hem de epidemiyolojik çalışmalardan elde edilen veriler Obsesif kompulsif bozuklukta (OKB) eş tanı sıklığının %25 ile %65 arasında değiştiğini ortaya koymuştur. İntihar ise OKB’li olgularda olarak yakın zamanlı çalışmalarda yeni bir sorun alanı gösterilmiştir. Bununla birlikte ergen örneklemi üzerinde bu alanda yapılmış bir çalışmaya rastlanmamıştır. Bu bağlamda bu çalışmada, ergen OKB olgularında eş tanı ve intihar davranışı sıklığının belirlenmesi amaçlanmıştır. Yöntem: Çalışmaya 2015 yılında Ankara Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı Ergen Ünitesine başvuran ve OKB tanısı konmuş, ayaktan tedavi görmekte olan 15-22 yaş aralığındaki 70 olgu dahil edilmiştir. Bilgiler dosya taraması yöntemiyle hekim notları üzerinden geriye dönük elde edilmiştir. Bulgular: Olguların %35’i erkek, %65’i kadındır. Yaş ortalaması 19.6 (±2.3, 15-22) olarak saptanmıştır. Depresyon OKB’ye en sık eşlik eden eş tanı olmuştur (%23.2). Bunu anksiyete bozukluğu (%15.9), dikkat eksikliği ve hiperaktivite bozukluğu (%7.2), bipolar bozukluk (%5.8), mental retardasyon (%2.9), psikotik belirtiler (%2.9), DEHB-depresyon birlikteliği (%2,9) ve epilepsi (%1,4) izlemiştir. İntihar düşüncesi OKB grubunda %4.3 (n=3) oranında izlenmiş olup intihar girişimine rastlanmamıştır. İntihar düşüncesi yalnızca depresyonu olan grupta bulunmuştur. Tartışma ve Sonuç: Çalışmalarla uyumlu olarak ergen obsesif kompulsif bozukluklu bireylerde eş tanı yüksek olarak saptanmıştır. Bununla birlikte intihar düşüncesi OKB’li ergen olgularda literatürdeki sağlıklı ergenler ve erişkin OKB’li olgulardakine göre düşük bulunmuştur. Bu durum ergen grubuyla çalışırken eş tanının sorgulanmasının önemini gösterirken OKB’li ergen olgulardaki intihar düşüncesi sıklığının başka çalışmalarla da desteklenmesi gerekmektedir.

COMORBIDITY AND SUICIDAL BEHAVIOURS IN OBSESSIVE-COMPULSIVE DISORDERED ADOLESCENTS AT A UNIVERSITY HOSPITAL

Introduction: Data obtained from both clinical and epidemiological studies have shown that the frequency of comorbidities in obsessive-compulsive disorder (OCD) varies between 25% and 65%. Suicide has been shown as a new problem area in OCD cases in recent studies. Nevertheless, there was no study on adolescent subjects on this field. In this context, in this study, it was aimed to determine the frequency of comorbidity and suicidal behavior in adolescent OCD cases. Methods: Seventy patients in the 15-22 age range who were diagnosed with OCD and referred to the Adolescence Unit of the Department of Mental Health and Diseases, Ankara University Medical Faculty in 2015 were included in the study. The information was retrieved retrospectively on physician notes by file scanning method. Results: 35% of the cases were male and 65% were female. The mean age was 19.6 (± 2.3, 15-22). Depression was the most common comorbid diagnosis of OCD (23.2%) and followed by anxiety disorders (15.9%), attention deficit hyperactivity disorder (7.2%), bipolar disorder (5.8%), mental retardation (2.9%), psychotic symptoms (2.9%), ADHD-depression and epilepsy (1.4%). Suicide ideation was observed in 4.3% (n = 3) of OCD group and no suicide attempt was found. Suicidal ideation was only found in depression group. Conclusion: Consistent with previous studies in the literature, comorbidity was found to be high in individuals with obsessive-compulsive disorder. However, suicidal ideation wasfound to be lower in adolescent OCD cases than in healthy adolescents and adult OCD cases in the literature. It is important to question the comorbidity in our clinical practice while working with the adolescent group. Further research needed about frequency of suicidal thoughts and attempts in adolescents with OCD.

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