Presentation on theme: "Clinical and socio-demographic features of cases receiving treatment in inpatient service of child and adolescent psychiatry: Our first findings OBJECTİVE."— Presentation transcript:
Clinical and socio-demographic features of cases receiving treatment in inpatient service of child and adolescent psychiatry: Our first findings OBJECTİVE Children and adolescents with severe mental problems to the extent not be treated under polyclinic conditions may require to be hospitalized and evaluated in detail while under supervision, have an arranged treatment, get the side effects of drugs observed and have an opportunity to advanced examination and treatment. Studies revealed that there has been an increasing rate of hospitalization in psychiatry services during childhood and adolescence. Children and adolescents aged between 4-18 years who were hospitalized in USA between 1991 and 2008 due to psychiatric problems were assessed in terms of hospitalization duration, clinical profile and drug use. It is observed that although hospitalization duration of children and adolescents has decreased especially during last 10 years (from 44 days to 10 days on average), number of their hospitalization has increased approximately three times and their use of psychotropic drugs has increased eight times (Meagher et all, 2013) Turkey has a limited number of inpatient psychiatry services aimed at children and adolescents. The purpose of this article was to share the first 9-month data of our inpatient psychiatry service that has just been opened for children and adolescents. DİSCUSSİON Socio-demographic data, hospitalization durations, disease group diagnosis, usage of single or multiple drugs of inpatients who hospitalized and received treatment in inpatient service in a child and adolescent psychiatry were retrospectively assessed in this study. Results obtained complied with the literature. In a study conducted by Coşkun et al. (2009), clinic and socio- demographic data of pediatric and adolescent patients hospitalized in an adult psychiatry were examined and average age of cases was 16.4±1.5 and their hospitalization duration was 22.2±17.48. The most frequently used drug group was antipsychotic drugs and use of multiple drugs was 65.5%. Similarly, in a study conducted by Taş et al. (2007), it was determined that antipsychotic drugs were used in all of inpatients in a Child and Adolescent Psychiatry in Turkey and the most frequently used drug group was antipsychotics. It was also observed that similar to our study, use of multiple drugs was applied more for the treatment in this study. Some of international studies have had similar results (Najjar et al. 2004, Thomas et al. 2006). In the study conducted by Coşkun et al. (2009), the most frequently determined diagnosis groups were mood disorders, psychotic disorders, and dissociative disorders; however, mood disorders and psychotic disorders were determined at an equal rate in our study. On the other hand, in a study conducted by Güvenir et al. (2009), inpatients followed up in a Child and Adolescent Psychiatry had mood disorders and psychotic disorders at most. Furthermore, Meagher et al. (2012) examined clinical profiles of 233 cases admitted to inpatient wards of Child and Adolescent Psychiatry in Boston region in USA in 1991, 1998, and 2008. In their study, mood disorders were the most frequent diagnosis group for all of three years. More inpatient services are required in this field in order to determine essential position of inpatient services in the child and adolescent psychiatry by using higher number of patients and more efficient data (hospitalization-discharge diagnosis, parents' educational and socio-economic level, psychiatric disorder in first degree and second-degree relatives, efficiency of psychotherapeutic methods). Turkey has not still had a sufficient number of inpatient services of child and adolescent psychiatry. Thus, we think that the increase of studies on the clinical and socio- demographic features of children and adolescents receiving treatment in these services, as well as sharing the experiences will significantly contribute to literature and clinical practices. Ömer Uçur, Pelin Çon Bayhan, Yunus Emre Dönmez, Büşra Öz, Arzu Çalışkan Demir, Dilşad Miniksar Yıldız, Fatih Yıldırım, Özlem Özel Özcan, Nusret Soylu Department of Child and Adolescent Psychiatry, Inonu University Faculty of Medicine, Malatya, Turkey METHOD Files of 68 patients (42 girls, 26 boys), who were hospitalized and treated in the inpatient service of İnönü University Turgut Özal Medical Center Child and Adolescent Psychiatry for 9 months, were examined retrospectively. Data were obtained through retrospective analysis of file records about follow-up and treatment process of patients, who applied through polyclinic and emergency department, after they were hospitalized. SPSS for Windows 16 packaged software was used to conduct the statistics of the study.. RESULTS T he age average of cases was determined as 15.15± 2.53 (min:3.70, max:17.80). The disease group causing the most frequent hospitalization was psychotic disorders (12 schizophrenia, 4 brief psychotic disorder, 2 schizophreniform disorder) with a rate of 26,5% (n=18) and depression disorders with a rate of 26.5% (n=18). The average hospitalization duration of cases was 25.02±1.87 days. The disorder causing the longest hospitalization duration was Bipolar Affective Disorder. It was determined that while 60.3% (n=41) of patients received pharmacotherapy and psychotherapy, 36.8% (n=25) received only pharmacotherapy as treatment. Multiple drugs were used in 64.7% (n=44) of cases. The most frequently used drug group was antipsychotic drugs.. REFERENCES Meagher SM, Rajan A, Wyshak G et al (2013) Changing trends in inpatient care for psychiatrically hospitalized youth: 1991-2008. Psychiatr Q, 84:159–168 Coşkun M, Bozkurt H, Ayaydın H et al (2012). Clinical and sociodemographic features of adolescent s hospitalized in the psychiatric inpatient unit of a university hospital. (in Turkish) Çocuk ve Gençlik Ruh Sağlığı Dergisi,19(1): 17-24. Varol Taş F, Güvenir T, Miral S (2007). Psychotropic drug use in a child and adolescent inpatient psychiatry clinic. Çocuk ve Gençlik Ruh Saglığı Dergisi,14: 139-150. Najjar F, Welch C, Grapentine WL et al. (2004). Trends in psychotropic drug use in a child psychiatric hospital from 1991-1998. J Child Adolesc Psychopharmacol,14: 87-93. Thomas CP, Conrad P, Casler R et al. (2006).Trends in the use of psychotropic medications among adolescents, 1994 to 2001. Psychiatric Services, 57: 63-69. Güvenir T, Varol Taş F, Özbek A.(2009).Child and adolescent mental health inpatient services in Turkey: Is there a need and are they effective? Archives of Neuropsychiatry,2009; 46: 143-148. Green J, Jacobs B, Beecham J et al (2007). Inpatient treatment in child and adolescent psychiatry-a prospective study of health gain and costs. Journal of Child Psychology and Psychiatry 48: 1259-1267. Van Kessel K, Myers E, Stanley S et al (2012).Trends in child and adolescent discharges at a New Zealand psychiatric inpatient unit between 1998 and 2007. N Z Med J 125: 55-61. Table 1: Sociodemographic characteristics of cases ID MVSD Age15.152.53 n% Sex Girl4261.8 Boy2638.2 Educational Status Illiterate22.9 Attends only special education45.9 Drop off from primary school45.9 Primary school student1116.2 Primary school graduate45.9 Drop off from high school45.9 High school student3957.3 Living with Parents4972,1 Mother1319,1 Father22,9 Relatives22,9 In an institution22,9 Psychiatric Disorders Caused Hospitalizationn% Hospitalization Duration (MV±SD) Depressive disorders1826.5 21.67±1.41 Schizophrenia spectrum and other psychotic disorders 1826.5 27.39±2.01 Disruptive, impulse-control, and conduct disorders1014.7 18.4±1.35 Trauma- and stressor-related disorders710.3 31.42±2.07 Bipolar and related disorders45.9 46.25±3.23 Anxiety disorders34.4 18.00±7.55 Feeding and eating disorders34.4 32.33±2.31 Somatic symptom and related disorders34.4 19.33±7.64 Neurodevelopmental disorders22.9 5.00±2.83 Total68100.025.02±1.87 Table 2: Psychiatric disorders and hospitalization duration of cases
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