Öz
Aim: In this study, it was aimed to evaluate the changes in the adaptation process and psychiatric symptoms system of children in the preschool age group who are under psychiatric follow-up, related to the COVID-19 pandemic with the Telemedicine system.
Materials and Methods: Preschool children who are under psychiatric follow-up were included in this study. On the appointment days, the questionnaire prepared by the researchers in order to evaluate the adaptation process to the pandemic were asked and recorded through the Telemedicine system. Clinical Global Impression-Severity of Illness (CGI-Severity) scale was used to evaluate the severity of illness for the pandemic and pre-pandemic period.
Results: In our study, 27.5% of 51 patients were girls and 72.5% were boys. The average age is 4.42±1.15. Most frequently observed psychiatric diagnoses are Autism Spectrum Disorder (52.9%), Attention Deficit and Hyperactivity Disorder (21.6%), and Mild Intellectual Disability (13.7%). As the primary change observed during the pandemic period, 25.5% of the cases reported increased irritability and 19.6% increased anxiety, 54.9% change in sleep pattern and 39.2% change in nutritional routine. CGI-Severity score before the pandemic was evaluated as 3.37 ± 0.87, and as 3.74 ± 0.89 during the pandemic period.
Conclusion: The most common complaints in the preschool age group were irritability, anxiety and sleep/ nutritional changes. Our study has been a guide in determining the levels of being affected by the pandemic period and emphasized the necessity of providing children an appropriate information for their age and continuing their treatment and follow-up through telemedicine.
Anahtar Kelimeler
Pandemic Covid-19 child and adolescent mental health preschool child 0-6 years Telemedicine
Kaynakça
- Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020; 92 (6): 568-76.
- WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. [a.yer 22 Kasım 2020]. Erişim adresi: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
- Caykus E, Mutlu T. Ways to Promote Children’ Resiliency to the COVID-19 Pandemic Suggestions For Families, Teachers and Mental Health Specialists / COVID-19 Pandemi Sürecinde Çocukların Psikolojik Dayanıklılığını Güçlendirme Yolları: Ailelere, Öğretmenlere ve Ruh Sağlığı Uzmanlarına Öneriler. 31 Mayıs 2020; 7: 95-113.
- Cluver L, Lachman JM, Sherr L, Wessels I, Krug E, Rakotomalala S, vd. Parenting in a time of COVID-19. Lancet Lond Engl. 11 2020; 395 (10231): e64.
- Black MM, Jukes MCH, Willoughby MT. Behavioural and emotional problems in preschool children. The Lancet Psychiatry, 4 (2), 89–90. doi:10.1016/s2215-0366(17)30005-6 5. Black MM, Jukes MCH, Willoughby MT. Behavioural and emotional problems in preschool children. Lancet Psychiatry. 2017; 4 (2): 89-90.
- Bornstein MH, Hahn C-S, Suwalsky JTD. Developmental Pathways among Adaptive Functioning and Externalizing and Internalizing Behavioral Problems: Cascades from Childhood into Adolescence. Appl Dev Sci. 2013; 17 (2): 76-87.
- Noble KG, Houston SM, Brito NH, Bartsch H, Kan E, Kuperman JM, vd. Family income, parental education and brain structure in children and adolescents. Nat Neurosci. Mayıs 2015; 18 (5): 773-8.
- Luby JL, Belden A, Harms MP, Tillman R, Barch DM. Preschool is a sensitive period for the influence of maternal support on the trajectory of hippocampal development. Proc Natl Acad Sci U S A. 17 Mayıs 2016; 113 (20): 5742-7.
- Imran N, Zeshan M, Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pak J Med Sci. Mayıs 2020; 36 (COVID19-S4): S67-72.
- Sevgen FH, Altun H. Presenting complaints and psychiatric diagnoses in childrenchildren aged 0–5 years presented to a child psychiatry and adolescent clinic -. Psychiatry Behav Sci. 2017; 7 (4): 205-11.
- Guy W, Clinical Global Impressions. ECDEU Assesment Manual for Psychopharmacology Revised. 1976 Rockville, MD: US Department of Health, Education, and Welfare; Public Health Service, Alcohol; Drug Abuse, and Mental Health Administration; National Institute of Mental Health. pp. 218-22.
- Amerikan Psikiyatri Birliği Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı (DSM V). Beşinci Baskı. Ankara: Hekimler Yayın Birliği; 2014.
- 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 [İnternet]. 12 Mayıs 2020 [a.yer 28 Haziran 2020]; 14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216870/
- Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, vd. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet Lond Engl. 14 2020; 395 (10227): 912-20.
- Sahbudak B, Emiroğlu N. COVID-19 Pandemic and Mood Disorders in Children and Adolescents. Turk J Child Adolesc Ment Health. 01 Temmuz 2020; 27: 59-63.
- Mental health and psychological resilience during the COVID-19 pandemic [Internet]. [a.yer 16 Eylül 2020]. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/mental-health-and-psychological-resilience-during-the-covid-19-pandemic
- 2420201236-cocuklarCOVID.pdf [İnternet]. [a.yer 22 Kasım 2020]. Erişim adresi: https://www.psikiyatri.org.tr/uploadFiles/2420201236-cocuklarCOVID.pdf
- Froechlich-Santino W, Steiner H, Shaw RJ. Psychiatric Assesment of the Physically III Child [Internet]. Psychiatric Care of the Medical Patient. Oxford University Press; [a.yer 22 Kasım 2020]. Available from: www.oxfordmedicine.com/view/10.1093/med/9780199731855.001.0001/med-9780199731855-chapter-79
- Hinkley T, Brown H, Carson V, Teychenne M. Cross sectional associations of screen time and outdoor play with social skills in preschool children. PloS One. 2018; 13 (4): e0193700.
- Moreno C, Wykes T, Galderisi S, Nordentoft M, Crossley N, Jones N, vd. How mental health care should change as a consequence of the COVID-19 pandemic. Lancet Psychiatry. Eylül 2020; 7 (9): 813-24.
Öz
Amaç: Bu çalışmada okul öncesi yaş grubunda olup psikiyatrik takibi devam eden çocukların COVID-19 pandemisi ile ilgili uyum süreci ve psikiyatrik belirtilerindeki değişikliklerin Teletıp sistemi ile değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Bu çalışmaya psikiyatrik takibi devam eden okul öncesi yaş grubundaki hastalar alınmıştır. Randevu günlerinde Teletıp sistemi aracılığıyla görüşülerek covıd-19 pandemisi ile ilgili uyum sürecini değerlendirmek amacıyla araştırmacılar tarafından hazırlanan anket soruları sorulmuş ve kaydedilmiştir. Pandemi ve pandemi öncesi dönemdeki hastalık şiddetlerini değerlendirmek için Klinik Global İzlenim-Hastalık Şiddeti (KGİ-Şiddet) ölçeği kullanılmıştır
Bulgular: Çalışmamıza dahil edilen 51 hastanın %27,5’i kız, %72,5’i erkektir. Yaş ortalaması 4,42±1,15’tir. Psikiyatrik tanılarda birinci sırada Otizm Spektrum Bozukluğu (%52,9), ikinci sırada Dikkat Eksikliği / Hiperaktivite Bozukluğu (%21,6), üçüncü sırada ise Hafif Düzeyde Mental Retardasyon (%13,7) yer almaktadır. Pandemi döneminde gözlenen birincil değişiklik olarak olguların %25,5’i sinirlilikte artış, %19,6’sı kaygıda artış bildirmiştir. Hastaların uyku ve beslenme rutinleri sorgulandığında %54,9’u uyku, %39,2’si beslenme ile ilgili değişiklik bildirmiştir. Hastaların pandemi öncesindeki KGİ-Şiddet puanı 3,37±0,87, pandemi dönemindeki ise 3,74±0,89 olarak değerlendirilmiştir.
Sonuç: Okul öncesi yaş grubunda en sık saptanan yakınmalar sinirlilik, kaygı artışı ile uyku ve beslenme düzeni değişiklikleri olmuştur. Çalışmamız pandemi sürecinden etkilenme düzeylerini tespit etmek açısından yol gösterici olmuş ve çocuklara yaş gruplarına uygun bilgilendirmeler yapılmasının, Teletıp yolu ile tedavi ve takiplerinin devam etmesinin gerekliliği vurgulamıştır.
Anahtar Kelimeler
Pandemi Covid-19 çocuk ve ergen ruh sağlığı okul öncesi çocuk 0-6 yaş Teletıp
Kaynakça
- Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020; 92 (6): 568-76.
- WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. [a.yer 22 Kasım 2020]. Erişim adresi: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
- Caykus E, Mutlu T. Ways to Promote Children’ Resiliency to the COVID-19 Pandemic Suggestions For Families, Teachers and Mental Health Specialists / COVID-19 Pandemi Sürecinde Çocukların Psikolojik Dayanıklılığını Güçlendirme Yolları: Ailelere, Öğretmenlere ve Ruh Sağlığı Uzmanlarına Öneriler. 31 Mayıs 2020; 7: 95-113.
- Cluver L, Lachman JM, Sherr L, Wessels I, Krug E, Rakotomalala S, vd. Parenting in a time of COVID-19. Lancet Lond Engl. 11 2020; 395 (10231): e64.
- Black MM, Jukes MCH, Willoughby MT. Behavioural and emotional problems in preschool children. The Lancet Psychiatry, 4 (2), 89–90. doi:10.1016/s2215-0366(17)30005-6 5. Black MM, Jukes MCH, Willoughby MT. Behavioural and emotional problems in preschool children. Lancet Psychiatry. 2017; 4 (2): 89-90.
- Bornstein MH, Hahn C-S, Suwalsky JTD. Developmental Pathways among Adaptive Functioning and Externalizing and Internalizing Behavioral Problems: Cascades from Childhood into Adolescence. Appl Dev Sci. 2013; 17 (2): 76-87.
- Noble KG, Houston SM, Brito NH, Bartsch H, Kan E, Kuperman JM, vd. Family income, parental education and brain structure in children and adolescents. Nat Neurosci. Mayıs 2015; 18 (5): 773-8.
- Luby JL, Belden A, Harms MP, Tillman R, Barch DM. Preschool is a sensitive period for the influence of maternal support on the trajectory of hippocampal development. Proc Natl Acad Sci U S A. 17 Mayıs 2016; 113 (20): 5742-7.
- Imran N, Zeshan M, Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pak J Med Sci. Mayıs 2020; 36 (COVID19-S4): S67-72.
- Sevgen FH, Altun H. Presenting complaints and psychiatric diagnoses in childrenchildren aged 0–5 years presented to a child psychiatry and adolescent clinic -. Psychiatry Behav Sci. 2017; 7 (4): 205-11.
- Guy W, Clinical Global Impressions. ECDEU Assesment Manual for Psychopharmacology Revised. 1976 Rockville, MD: US Department of Health, Education, and Welfare; Public Health Service, Alcohol; Drug Abuse, and Mental Health Administration; National Institute of Mental Health. pp. 218-22.
- Amerikan Psikiyatri Birliği Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı (DSM V). Beşinci Baskı. Ankara: Hekimler Yayın Birliği; 2014.
- 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 [İnternet]. 12 Mayıs 2020 [a.yer 28 Haziran 2020]; 14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216870/
- Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, vd. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet Lond Engl. 14 2020; 395 (10227): 912-20.
- Sahbudak B, Emiroğlu N. COVID-19 Pandemic and Mood Disorders in Children and Adolescents. Turk J Child Adolesc Ment Health. 01 Temmuz 2020; 27: 59-63.
- Mental health and psychological resilience during the COVID-19 pandemic [Internet]. [a.yer 16 Eylül 2020]. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/mental-health-and-psychological-resilience-during-the-covid-19-pandemic
- 2420201236-cocuklarCOVID.pdf [İnternet]. [a.yer 22 Kasım 2020]. Erişim adresi: https://www.psikiyatri.org.tr/uploadFiles/2420201236-cocuklarCOVID.pdf
- Froechlich-Santino W, Steiner H, Shaw RJ. Psychiatric Assesment of the Physically III Child [Internet]. Psychiatric Care of the Medical Patient. Oxford University Press; [a.yer 22 Kasım 2020]. Available from: www.oxfordmedicine.com/view/10.1093/med/9780199731855.001.0001/med-9780199731855-chapter-79
- Hinkley T, Brown H, Carson V, Teychenne M. Cross sectional associations of screen time and outdoor play with social skills in preschool children. PloS One. 2018; 13 (4): e0193700.
- Moreno C, Wykes T, Galderisi S, Nordentoft M, Crossley N, Jones N, vd. How mental health care should change as a consequence of the COVID-19 pandemic. Lancet Psychiatry. Eylül 2020; 7 (9): 813-24.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2021 |
| Gönderilme Tarihi | 24 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 60 Sayı: 2 |
