Çocuk ve ergen psikiyatri servisinde yataklı tedavi etkinliğinin klinik değişkenler ve sosyodemografik özellikler ile ilişkisi
Küçük Resim Yok
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları servisinde yatırılarak tedavi edilen çocuk ve ergenlerde tedavi etkinliğinin sosyodemografik ve klinik özellikler ile ilişkisinin değerlendirilmesidir. Gereç ve Yöntem: Bu çalışma İnönü Üniversitesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları servisinde yapılmıştır. Çalışmaya 12-18 yaş aralığındaki yatırılarak tedavi edilen 42 olgu dahil edilmiştir. Katılımcılarla ÇDŞG-ŞY uygulanarak ve DSM 5 tabanlı psikiyatrik görüşme yapılarak psikiyatrik değerlendirmeleri yapılmıştır. ÇGDÖ ve HoNOSCA yataklı tedavi başlangıcı ve taburculukta uygulanarak yataklı tedavi sürecindeki iyileşmeleri belirlenmiştir. Sosyodemografik özellikler değerlendirilmiş ve YİYDDE, DDGÖ, PDÖ, ADÖ kullanılarak ölçüm yapılmıştır. Bulgular: Çalışmamızda yataklı tedavi ile ÇGDÖ puanlarında anlamlı artış ve HoNOSCA puanlarında anlamlı azalma olduğu bulunmuştur. Yataklı tedavi başlangıcı ve taburculuk arasında ÇGDÖ ve HoNOSCA puanlarındaki iyileşmeler ile YİYDDE alt ölçekleri (inhibisyon, set değiştirme, başlatma, çalışma belleği, planlama/organize etme, düzenli olma, izleme, davranışsal düzenleme indeksi, üstbiliş indeksi, global yönetici puanı) arasında ve ADÖ alt ölçekleri (roller, duygusal tepki verebilme, genel işlevsellik) arasında anlamlı negatif korelasyon olduğu bulunmuştur. Bipolar Afektif Bozukluk tanısı ile HoNOSCA puanlarındaki azalma arasında anlamlı pozitif korelasyon, Borderline Kişilik Bozukluğu ile ÇGDÖ ve HoNOSCA puanlarındaki iyileşme arasında anlamlı negatif korelasyon olduğu bulunmuştur. ÇGDÖ ve HoNOSCA puanlarındaki iyileşme ile yataklı tedavi başlangıcındaki ÇGDÖ puanları arasında anlamlı negatif korelasyon, yataklı tedavi başlangıcındaki HoNOSCA puanları arasında anlamlı pozitif korelasyon olduğu bulunmuştur. Sosyodemografik özellikler, yatış süresi, DDGÖ ve PDÖ puanları ile tedavi sonuçları arasında anlamlı ilişki saptanamadı. Sonuçlar: Sonuçlar değerlendirildiğinde çocuk ve ergen psikiyatrisinde yataklı tedavinin etkin bir tedavi yöntemi olduğu, tedavi başlangıcında daha düşük işlevselliğe ve daha fazla belirti düzeyine sahip hastaların tedavi ile daha fazla iyileşme gösterdikleri, tedavi öncesi yürütücü işlevler, aile işlevselliği ve tanıların tedavi sonuçlarını etkileyen faktörler olduğu anlaşılmaktadır. Sonuçlarımız yürütücü işlevleri ve aile işlevselliğinde daha fazla bozulma gösteren hastaların daha az iyileşme gösterdiğini düşündürmektedir. Yataklı tedavilerin etkin kullanımı için tedavi sonuçları ile ilişkili faktörlerin belirlenmesinin önemli olduğu, bu konuda yapılacak daha fazla ve büyük ölçekli çalışmalara ihtiyaç olduğu düşüncesindeyiz.
Aim: The aim of this study is to evaluate the relationship between the sociodemographic and clinical characteristics of treatment efficacy in children and adolescents hospitalized in the Child and Adolescent Mental Health service. Material and Method: This study was conducted in the İnonu University Child and Adolescent Mental Health Service. Forty-two inpatients between the ages of 12-18 were included in the study. Psychiatric evaluations were made with the participants by applying the K-SADS-PL and conducting a DSM-5 based psychiatric interview. The CGAS and HoNOSCA were administered at the beginning of the inpatient treatment and discharge, improvements in the inpatient treatment process were determined. Sociodemographic characteristics were evaluated and measurements were made by using the BRIEF, DERS, RST-PQ-C, FAD. Results: In our study, it was found that there is a significant increase in CGAS scores and a significant decrease in HoNOSCA scores with inpatient treatment. During inpatient treatment, It was found that there is a significant negative correlation between the improvment in CGAS and HoNOSCA scores and subscales of BRIEF (inhibition, shift, initiate, working memory, plan/organize, organization of materials, monitor, behavioral regulation index, metacognition index, global executive composite) and subscales of FAD (roles, affective responsiveness, general family functioning). It was found that there was a significant positive correlation between bipolar affective disorder diagnosis and decrease in HoNOSCA scores; significant negative correlation between Borderline Personality Disorder diagnosis and improvment in CGAS and HoNOSCA scores. It was found that there is a significant negative correlation between the improvment in CGAS and HoNOSCA scores and the CGAS scores at admission, and a significant positive correlation between the HoNOSCA scores at admission. There was no significant correlation between sociodemographic characteristics, length of stay, DERS scores, RST-PQ-C scores and treatment results. Conclusion: When the results are evaluated, it is understood that inpatient treatment is an effective treatment method in child and adolescent psychiatry; inpatients with lower functionality and higher symptom levels at the beginning of treatment show more improvement with treatment; pre-treatment executive functions, family functionality and diagnoses are the factors that affect treatment results. Our results suggest that patients with greater impairment in executive functions and family functionality show less improvement. We think that it is important to determine the factors associated with treatment outcomes for the effective use of inpatient treatments, and more large-scale studies are needed on this subject.
Aim: The aim of this study is to evaluate the relationship between the sociodemographic and clinical characteristics of treatment efficacy in children and adolescents hospitalized in the Child and Adolescent Mental Health service. Material and Method: This study was conducted in the İnonu University Child and Adolescent Mental Health Service. Forty-two inpatients between the ages of 12-18 were included in the study. Psychiatric evaluations were made with the participants by applying the K-SADS-PL and conducting a DSM-5 based psychiatric interview. The CGAS and HoNOSCA were administered at the beginning of the inpatient treatment and discharge, improvements in the inpatient treatment process were determined. Sociodemographic characteristics were evaluated and measurements were made by using the BRIEF, DERS, RST-PQ-C, FAD. Results: In our study, it was found that there is a significant increase in CGAS scores and a significant decrease in HoNOSCA scores with inpatient treatment. During inpatient treatment, It was found that there is a significant negative correlation between the improvment in CGAS and HoNOSCA scores and subscales of BRIEF (inhibition, shift, initiate, working memory, plan/organize, organization of materials, monitor, behavioral regulation index, metacognition index, global executive composite) and subscales of FAD (roles, affective responsiveness, general family functioning). It was found that there was a significant positive correlation between bipolar affective disorder diagnosis and decrease in HoNOSCA scores; significant negative correlation between Borderline Personality Disorder diagnosis and improvment in CGAS and HoNOSCA scores. It was found that there is a significant negative correlation between the improvment in CGAS and HoNOSCA scores and the CGAS scores at admission, and a significant positive correlation between the HoNOSCA scores at admission. There was no significant correlation between sociodemographic characteristics, length of stay, DERS scores, RST-PQ-C scores and treatment results. Conclusion: When the results are evaluated, it is understood that inpatient treatment is an effective treatment method in child and adolescent psychiatry; inpatients with lower functionality and higher symptom levels at the beginning of treatment show more improvement with treatment; pre-treatment executive functions, family functionality and diagnoses are the factors that affect treatment results. Our results suggest that patients with greater impairment in executive functions and family functionality show less improvement. We think that it is important to determine the factors associated with treatment outcomes for the effective use of inpatient treatments, and more large-scale studies are needed on this subject.
Açıklama
Anahtar Kelimeler
Psikiyatri, Psychiatry
