COMPARISON OF REFERRALS TO A UNIVERSITY CHILD AND ADOLESCENT PSYCHIATRY OUT-PATIENT UNIT BEFORE AND DURING THE COVID-19 PANDEMIC

Year 2022, Volume: 23 Issue: 4, 406 - 413, 17.10.2022

Mert Besenek , Doğancan Sönmez , Burak Okumuş

https://doi.org/10.18229/kocatepetip.986672

Abstract

OBJECTIVE: It’s essential to carefully assess and define the effects of illness conception and precautions related to COVID-19 pandemic, in addition to it’s physical effects, on children followed-up in psychiatry clinics. We aimed to define the effects of pandemic on patient profile and clinical practice by comparing child psychiatry out-patient unit referrals before and during the pandemic.
MATERIAL AND METHODS: All child psychiatry out-patient referrals during 14-months periods before (before pandemic [BP]) and after (during pandemic [DP]) the official announce of first COVID-19 case in Turkey on 11 March 2020 were retrospectively examined. First (PFP) and second (PSP) 7-months periods of DP were additionally explored. Age, gender and psychiatric problems of all referrals were recorded and compared.
RESULTS: Total referrals decreased by 45.9% in DP compared to BP and increased by 82.5% in PSP compared to PFP. For the diagnoses, rates of attention deficit-hyperactivity disorder and depressive disorders significantly decreased; whereas obsessive-compulsive disorder, anxiety disorders, learning disorders and personality disorders significantly increased in DP compared to BP (p<0.001 for each). Rates of personality disorders significantly increased; whereas conduct disorders, obsessive-compulsive disorders and anxiety disorders significantly decreased in PSP compared to PFP (p<0.001 for each).
CONCLUSIONS: Despite the psychological stressors came along with COVID-19 pandemic, dropping rates of referrals in DP shows these individuals cannot access psychiatric support even if they need it. Sharp increase in referral rates in PSP might implicate growing demand for psychiatric support in the long run. Further studies with larger samples and longitudinal design are needed in order to fully define how and to what extend psychiatric problems are effected by COVID-19 pandemic.

Keywords

COVID-19, Psychopathology, Child and adolescent

BİR ÜNİVERSİTE ÇOCUK VE ERGEN RUH SAĞLIĞI VE HASTALIKLARI POLİKLİNİĞİNE COVID-19 PANDEMİSİ ÖNCESİ VE SIRASINDAKİ BAŞVURULARIN KARŞILAŞTIRILMASI

Abstract

AMAÇ: COVID-19 salgınının fiziksel etkilerinin yanında; hem hastalık kavramının hem de alınan tedbirlerin ruh sağlığı kliniklerinde takip edilen çocuklar üzerindeki etkilerinin dikkatle izlenmesi ve ortaya konması çok önemlidir. Çalışmamızda, pandemi öncesi ve pandemi sırası dönemlerdeki çocuk psikiyatrisi poliklinik başvurularının karşılaştırılarak pandeminin hasta profili ve poliklinik pratiğine etkilerinin ortaya konması amaçlanmıştır.
GEREÇ VE YÖNTEM: Türkiye’de ilk COVID-19 vakasının bildirildiği 11 Mart 2020 tarihinden önceki (pandemi öncesi [PÖ]) ve sonraki 14 aylık dönem (pandemi sırası [P]) boyunca üniversitemizin çocuk psikiyatrisi polikliniğine yapılan girişlerin tamamı geriye dönük olarak incelenmiştir. P’nin ilk 7 ayı “pandeminin ilk dönemi (PİD)”, son 7 ayı ise “pandeminin son dönemi (PSD)” olarak ayrıca araştırılmıştır. Tüm hastaların yaşları, cinsiyetleri ve psikiyatrik sorunları ayrıntılı olarak kaydedilmiş ve karşılaştırılmıştır.
BULGULAR: Toplam poliklinik başvuru sayısı PÖ’ne göre P’de %45,9 azalmış; PİD’ne göre PSD’nde %82,5 artmıştır. Tanılar özelinde başvuru sayıları PÖ’ne göre P’de; dikkat eksikliği ve hiperkativite bozukluğu ve depresif bozukluklar için belirgin azalma, obsesif-kompulsif bozukluk, anksiyete bozuklukları, özgül öğrenme bozukluğu ve kişilik bozuklukları için belirgin artış göstermiştir (her biri için p<0,001). PİD’ne göre PSD’nde ise başvuru sayıları; kişilik bozuklukları için artış, davranım bozukluğu, obsesif-kompulsif bozukluk ve anksiyete bozuklukları için azalma göstermiştir (her biri için p<0,001).
SONUÇ: COVID-19 pandemisinin getirdiği psikolojik stresörlere rağmen P’de poliklinik başvurularının azalmış olması bu kişilerin ihtiyaçları olmasına rağmen psikiyatrik desteğe yeterince ulaşamadıklarını göstermektedir. PSD’nde poliklinik başvurularında oldukça keskin bir artış izlenmesi de, uzun dönemde ruh sağlığı desteğine olan talebin artabileceğini vurgulamaktadır. Psikiyatrik sorunların COVID-19 pandemisinden nasıl ve ne ölçüde etkilendiğini tam olarak ortaya koyabilecek geniş kapsamlı uzunlamasına izlem çalışmalarına ihtiyaç vardır.

Keywords

COVID-19, Psikopatoloji, Çocuk ve ergen

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