Compliance process and disease symptoms of children and adolescent with chronic medical disease in the pandemi days
Öz
Aim: In this study, it was aimed to evaluate the changes in psychiatric follow-up process and psychiatric symptoms of children and adolescents with chronic medical diseases by telemedicine.
Materials and Methods: In this study, the cases between 0-18 years old who were followed up at the Consultation liaison outpatient clinic were included. The patients were contacted via Telemedicine on the days and hours of their appointments and their psychiatric interviews were made with their parents and they were evaluated. Questionnaire prepared by the researchers were asked to the patients and their families to investigate the compliance process related to the pandemic and their answers were recorded in the case data form. According to the information in the Clinical Global Impression (CGI) scale scores of the cases before the pandemic, the CGI scores in the pandemic period were also recorded according to the results of the telephone interview.
Results: In our study, 49% (n = 25) of the cases were girls and 51% (n = 26) were boys. The most common chronic medical diseases were identified as neurological (21,6%, n = 11) and metabolic-genetic (21,6%, n = 11) diseases. In the psychiatric diagnoses found in our cases, Attention Deficit/ Hyperactivity Disorder (35,3%) was in the first, Depression Disorders (17,6%) and Mild Intellectual Disability (17,6%) were in the second place. The CGI score of the cases before the pandemic was 2,62 ± 0,59, and the CGI score in the pandemic process was evaluated as 2,90 ± 0,80. The difference is statistically significant (p = 0,003). There was no significant difference between the presence of a health worker at home and the presence of a person affected by the disease and the CGI score (p> 0,05).
Conclusion: Our study is important in terms of showing that mental health is negatively affected during the pandemic process, in patients with chronic medical diseases and psychiatric follow-up, there is an increase in symptoms such as nervousness and anxiety, and new mental symptoms such as immature behaviors and changes in sleep patterns are added.
This study was presented as an oral presentation at the 56th National Psychiatry Online Congress organized on 18-20 December 2020.
Anahtar Kelimeler
Covid-19 pandemic chronic medical disease child and adolescent mental health telemedicine
Kaynakça
- World Health Organization. Who Announced COVID-19 Outbreak A Pandemic. 12.03.2020.
- Yuen KS, Ye ZW, Fung SY, Chan CP, Jin DY. SARS-CoV-2 and COVID-19: The most important research questions. Cell and Bioscience. 2020; 10 (1). doi:10.1186/s13578-020-00404-4.
- World Health Organization. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected, 25.01.2020.
- T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü COVID-19 (SARS-CoV-2 Enfeksiyonu Rehberi) Bilim Kurulu Çalışması. 14.04.2020. Ankara.
- Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID‐19 infection: Different points from adults. Pediatr Pulmonol. 2020; 55 (5): 1169-1174. doi:10.1002/ppul.24718.
- Evliyaoğlu O. Children with chronic disease and COVID-19. Turk Pediatri Ars 2020; 55 (2): 93–4.
- Wallender JL, Varni JW. Effects of pediatric chronic physical disorder on child and family adjustment. J Child Psychol Psychiatry 1998; (39): 29-46.
- Erdoğan A, Karaman MG. Kronik ve ölümcül hastalığı olan çocuk ve ergenlerde ruhsal sorunların tanınması ve yönetilmesi. Anadolu Psikiyatri Derg 2008; (9): 244-252.
- Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality Child Adolesc Psychiatry Ment Health. 2020;14. doi:10.1186/s13034-020-00329-3).
- Özge A, Uludüz D. Pandemi döneminde öne çıkan bir gerçek: Teletıp uygulamaları. Uludüz D, Özge A, editörler. Nörolojik Bilimler ve COVID-19. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.79-85.
- Tanrıverdi Ö. COVID 19 pandemisi ve teletıp. Yalçın Ş, Özet A, editörler. Kanser ve COVID- 19 Pandemisi. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.211-8.
- Li W, Yang Y, Liu Z-H, et al. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J of Biol Sci. 2020; 16 (10): 1732-38. doi:10.7150/ijbs.45120.
- Liu S, Yang L, Zhang C, et al. Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7 (4): 17-8. doi:10.1016/S2215-0366(20)30077-8 ;13.
- Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. The Lancet Psychiatry. 2020;7(4):21. doi:10.1016/S2215-0366(20)30090-0).
- Guy W. Clinical Global Impressions. ECDEU Assessment Manual for Psychopharmacology Revised. 1976 Rockville, MD: U.S. Department of Health, Education, and Welfare; Public Health Service, Alcohol; Drug Abuse, and Mental Health Administration; National Institute of Mental Health. pp. 218-222.
- Hoven CW, Duarte CS, Lucas CP, Wu P, Mandell DJ, Goodwin RD. Psychopathology among New York City public school children 6 months after September 11. Arch Gen Psychiatry 2005; 62: 545-52.
- Laor N, Wolmer L, Mayes LC, Gershon A, Weizman R, Cohen DJ. Israeli preschool children under Scuds: a 30-month follow-up. J Am Acad Child Adolesc Psychiatry 1997; 36: 349-56.
- Imran N., Zeshan M., Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pakistan J of Medic Sci, 36 (COVID19-S4). 2020 https://doi.org/10.12669/ pjms.36.COVID19-S4.2759.
- Olness K., Mandalakas A., Torjesen K. How to Help the Children in Disasters. 2015. 4th ed. Health Frontiers, Kenyon, USA.
- Steiner H, Shaw R. Psychiatric assesment and manegement of medically ill children. A Stoudemire, BS Fogel, DB Greenberg (EDS.) Psychiatric Care of the Medical Patient, second ed., UK, Oxford University Press, 2000, p. 1097-1110.
- Tian F., Li H., Tian S., Yang J., Shao J., Tian C., Psychological Symptoms of Ordinary Chinese Citizens Based on SCL-90 During the Level I Emergency Response to COVID-19, Psychiatry Res, 2020, 288, https://doi.org/10.1016/j.psychres.2020.112992.
- Jiao W., Y Wang L. N., Liu J., Fang S. F., Jiao F. Y., Pettoello-Mantovani M., Somekh E. (2020). Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic. The J al of Pediatrics. doi.org/10.1016/j.jpeds.2020.03.013.
Pandemi günlerinde kronik tıbbi hastalığı olan psikiyatrik takipteki çocuk ve gençlerin uyum süreci ve hastalık belirtileri
Öz
Amaç: Bu çalışmada kronik tıbbi hastalığı olan psikiyatrik takipteki çocuk ve gençlerin pandemi ile ilgili uyum süreci ve psikiyatrik belirtilerindeki değişikliklerin Teletıp uygulaması ile değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya, Konsültasyon Liyezon Polikliniği’nde takipli, 0-18 yaş arasındaki olgular dahil edilmiştir. Olgular randevularının oldukları gün ve saatlerde, Teletıp yolu ile aranarak ebeveyn ve kendileri ile psikiyatrik görüşme yapılıp son durumları değerlendirilmiştir. Pandemi ile ilgili uyum sürecini araştırmak amacıyla araştırmacılar tarafından hazırlanan anket soruları olgu ve ailelerine sorulmuş, cevapları olgu veri formuna kaydedilmiştir. Olguların pandemi öncesi Klinik Global İzlenim (KGİ) ölçeği puanları dosyalarındaki bilgilere göre, pandemi dönemindeki KGİ puanları da telefonla yapılan görüşme sonucuna göre kaydedilmiştir.
Bulgular: Çalışmamıza katılan olguların %49’u (n=25) kız, %51’i (n=26) ise erkektir. En sık görülen kronik tıbbi hastalıklar nörolojik (%21,6, n=11) ve metabolik-genetik (%21,6, n=11) hastalıklar olarak tespit edilmiştir. Olgularımızda pandemi öncesi tespit edilen psikiyatrik tanılarda birinci sırada Dikkat Eksikliği/ Aşırı Hareketlilik Bozukluğu (%35,3), ikinci sırada Depresyon Bozuklukları (%17,6) ve Anlıksal Gelişimsel Bozukluk (Ağır Olmayan) (%17,6) gelmektedir. Olguların pandemi öncesi KGİ puanı 2,62±0,59, pandemi sürecindeki KGİ puanı 2,90±0,80 olarak değerlendirilmiştir. Aradaki fark istatistiksel olarak anlamlıdır (p=0,003). Evde sağlık çalışanı olup olmaması ve yakınlarında hastalıktan etkilenen birey olup olmaması ile KGİ puanı arasında anlamlı bir fark saptanmamıştır (p>0,05).
Sonuç: Çalışmamız kronik tıbbi hastalığı olan ve psikiyatrik takipteki olgularda, pandemi sürecinde ruh sağlığının olumsuz etkilendiğini, sinirlilik ve kaygı gibi belirtilerde artma olduğunu ve immatür davranışlar, uyku düzeninde değişiklik gibi yeni ruhsal belirtilerin eklendiğini göstermesi bakımından önemlidir.
Anahtar Kelimeler
Covid-19 pandemi kronik tıbbi hastalık çocuk ve ergen ruh sağlığı teletıp
Kaynakça
- World Health Organization. Who Announced COVID-19 Outbreak A Pandemic. 12.03.2020.
- Yuen KS, Ye ZW, Fung SY, Chan CP, Jin DY. SARS-CoV-2 and COVID-19: The most important research questions. Cell and Bioscience. 2020; 10 (1). doi:10.1186/s13578-020-00404-4.
- World Health Organization. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected, 25.01.2020.
- T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü COVID-19 (SARS-CoV-2 Enfeksiyonu Rehberi) Bilim Kurulu Çalışması. 14.04.2020. Ankara.
- Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID‐19 infection: Different points from adults. Pediatr Pulmonol. 2020; 55 (5): 1169-1174. doi:10.1002/ppul.24718.
- Evliyaoğlu O. Children with chronic disease and COVID-19. Turk Pediatri Ars 2020; 55 (2): 93–4.
- Wallender JL, Varni JW. Effects of pediatric chronic physical disorder on child and family adjustment. J Child Psychol Psychiatry 1998; (39): 29-46.
- Erdoğan A, Karaman MG. Kronik ve ölümcül hastalığı olan çocuk ve ergenlerde ruhsal sorunların tanınması ve yönetilmesi. Anadolu Psikiyatri Derg 2008; (9): 244-252.
- Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality Child Adolesc Psychiatry Ment Health. 2020;14. doi:10.1186/s13034-020-00329-3).
- Özge A, Uludüz D. Pandemi döneminde öne çıkan bir gerçek: Teletıp uygulamaları. Uludüz D, Özge A, editörler. Nörolojik Bilimler ve COVID-19. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.79-85.
- Tanrıverdi Ö. COVID 19 pandemisi ve teletıp. Yalçın Ş, Özet A, editörler. Kanser ve COVID- 19 Pandemisi. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.211-8.
- Li W, Yang Y, Liu Z-H, et al. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J of Biol Sci. 2020; 16 (10): 1732-38. doi:10.7150/ijbs.45120.
- Liu S, Yang L, Zhang C, et al. Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7 (4): 17-8. doi:10.1016/S2215-0366(20)30077-8 ;13.
- Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. The Lancet Psychiatry. 2020;7(4):21. doi:10.1016/S2215-0366(20)30090-0).
- Guy W. Clinical Global Impressions. ECDEU Assessment Manual for Psychopharmacology Revised. 1976 Rockville, MD: U.S. Department of Health, Education, and Welfare; Public Health Service, Alcohol; Drug Abuse, and Mental Health Administration; National Institute of Mental Health. pp. 218-222.
- Hoven CW, Duarte CS, Lucas CP, Wu P, Mandell DJ, Goodwin RD. Psychopathology among New York City public school children 6 months after September 11. Arch Gen Psychiatry 2005; 62: 545-52.
- Laor N, Wolmer L, Mayes LC, Gershon A, Weizman R, Cohen DJ. Israeli preschool children under Scuds: a 30-month follow-up. J Am Acad Child Adolesc Psychiatry 1997; 36: 349-56.
- Imran N., Zeshan M., Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pakistan J of Medic Sci, 36 (COVID19-S4). 2020 https://doi.org/10.12669/ pjms.36.COVID19-S4.2759.
- Olness K., Mandalakas A., Torjesen K. How to Help the Children in Disasters. 2015. 4th ed. Health Frontiers, Kenyon, USA.
- Steiner H, Shaw R. Psychiatric assesment and manegement of medically ill children. A Stoudemire, BS Fogel, DB Greenberg (EDS.) Psychiatric Care of the Medical Patient, second ed., UK, Oxford University Press, 2000, p. 1097-1110.
- Tian F., Li H., Tian S., Yang J., Shao J., Tian C., Psychological Symptoms of Ordinary Chinese Citizens Based on SCL-90 During the Level I Emergency Response to COVID-19, Psychiatry Res, 2020, 288, https://doi.org/10.1016/j.psychres.2020.112992.
- Jiao W., Y Wang L. N., Liu J., Fang S. F., Jiao F. Y., Pettoello-Mantovani M., Somekh E. (2020). Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic. The J al of Pediatrics. doi.org/10.1016/j.jpeds.2020.03.013.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2021 |
| Gönderilme Tarihi | 11 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2021 |