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Amaç: Ergen yaş grubunda, ilaçların fazla doz alımı ile özkıyım girişiminde bulunma çocuk acilde çalışan hekimlerin sıklıkla karşılaştığı bir durumdur. Gelecekte bir özkıyım girişimine neden olabilecek risk faktörlerini belirlemek önemlidir. Çalışmamızda, fazla doz ilaç alımıyla özkıyım girişiminde bulunan ergen yaş grubu olguların, klinik ve demografik verileri ile risk faktörlerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Bir yıllık süre içinde (01.10.2015 ile 01.10.2016), çocuk acil servisimize fazla doz ilaç alımıyla özkıyım girişimi ile başvuran 135 olgu (10-18 yaş) geriye dönük değerlendirildi. Bulgular: Toplam 135 hastanın 111’i (%82.2) kız, yaş ortalaması 15.65±1.37’di. Hastaların çoğunluğu orta adölesan (14-16 yaş) grubunda yer almaktaydı (%69.6). Olguların 17’sinin (%12.6) daha önce benzer girişim öyküsü vardı. İlaç içimi ile acile başvuru saati arası fark ortalama 4.2 (min. 1 saat-max. 96 saat) saatti. Olguların %72.6’sı ilk 4 saatte başvurdu. 60 olgu (%44.5) çoklu ilaç almıştı. Özkıyımda içilen tekli ve çoklu ilaç grupları sıklık sırasına göre analjezikler %48.9, antidepresanlar %28.9, antibiyotikler %20.7, gastrointestinal sistem ilaçları %14, antihipertansifler %8.8, antipsikotikler %7.4, antiepileptikler %7.4 ve diğer (antidiyabetik, vitamin- mineral, dekonjestan, kas gevşetici, antihistaminik, psikostimulan, antitrombotik, antigut) %14.8’di. En sık nedenler sırasıyla ailevi sorunlar, erkek-kız arkadaş ayrılma, sınav kaygısı, anksiyete ve diğerleri (yalnızlık, cinsiyet hoşnutsuzluğu) şeklindeydi. Öncesinde tanı almış olan ruhsal bozukluklar sırasıyla majör depresif bozukluk, davranım bozukluğu ve dikkat eksikliği hiperaktivite bozukluğuydu. Psikiyatrik tanı dışında 3 olgunun epilepsi tanısı vardı. Bu tanılara yönelik öncesinde başlanan ilaç ile özkıyım girişimi (n=22, %16.3) istatistiksel olarak anlamlıydı (p<0.05). Hastaların hepsi yatırılarak tedavi edildi. Olguların hiçbirinde özkıyım girişimi sırasında ya da sonrasında ölüm gelişmedi. Sonuç: Gençlerle çalışan klinisyenler özkıyım düşüncesi, davranışı ve diğer risk faktörlerin varlığını gençlerde değerlendirip, gencin risk düzeyini belirlemelidir. Anahtar Sözcükler: Adölesan, İlaç aşırı
Purpose: In the adolescent age group, overdose of medications is a situation that is often encountered by emergency doctors in the child. It is important to identify the risk factors that may lead to a self-determination initiative in the future. Our study is aimed at identifying the adolescent age group facts, clinical and demographic data and risk factors that are in the attempt to self-dose with overdose medication. In the course of a year (01.10.2015 to 01.10.2016), 135 cases (10-18 years of age) with an overdose of medication from our child emergency service were recurrently assessed. Results: 111 of the total 135 patients (82.2%) were girls with an average age of 15.65±1.37. The majority of patients were in the middle-age group (14-16 years of age) (69.6 percent). 17 of the cases (12.6%) had a similar initiative history before. The difference between the time of emergency application and drug intake is 4.2 (min. 1 hour max. 96 hours of time. 72.6% of the cases appealed in the first 4 hours. 60 cases (44.5 percent) had taken multiple medications. The single and multiple medication groups in my self-drying were in frequency order; analgesics 48.9%, antidepressants 28.9%, antibiotics 20.7%, gastrointestinal system drugs 14%, antihypertensive drugs 8.8%, antipsychotics 7.4%, antiepileptics 7.4%, and others (antidiabetic, vitamin-mineral, deconestane, muscle relaxant, antihistaminic, psychostimulant, antithrombotic, antigut) 14.8%. The most common causes were, respectively, in the form of family problems, male-girl friendship separation, exam anxiety, anxiety and others (solitude, gender dissatisfaction). The mental disorders that were previously diagnosed were, respectively; major depressive disorder, behavioral disorder and lack of attention, hyperactivity disorder. In addition to the psychiatric diagnosis, there were three epilepsy symptoms. The initiative of the drug and self-determination (n=22, 16.3%), which began before these diagnoses, was statistically meaningful (p<0.05). All of the patients were treated. In any of the cases, death has not evolved during or after the attempt of self-sufficiency. Result: Clinics working with young people should evaluate the presence of self-thought, behavior and other risk factors in young people, and determine the risk level of young people. Keywords: medication, drugs
Objective: In the adolescence period, suicide attempts by drug overdose is the problem that emergency doctors are often faced with. It is very important to identify risk factors that can be predictive of future suicide attempts. In our study, we evaluated the adolescents who presented to our pediatric department with suicidal drug overdose to assess the risk factors clinically and demographically. Material and Methods: The records of 135 patients (10-18 years of age) who presented to our pediatric emergency department with suicidal drug overdose were evaluated during a one-year period (1.10.2015 and 1.10.2016). Results: We included 135 patients (82.2% female) with an average age of 15.65±1.37 years in the study. Most of the patients were in the middle adolescence (14-16 years) period (69.6%). 17 patients (12.6%) had a prior suicide attempt history. The time between drug overdose and arrival at the pediatric emergency department was 4.2 hours (min. 1 hour-max. 96 hours) on average. 72.6% of the them applied in the first 4 hours. 60 patients had taken multiple drugs. The usage frequency of the drugs (single/multiple) that the patients had taken to commit suicide was analgesics 48.9%, antidepressants 28.9%, antibiotics 20.7%, gastrointestinal drugs 14%, antihypertensive 8.8%, antipsychotics 7.4%, antiepileptics 7.4% and others (antidiabetics, vitamins-minerals, decongestants, muscle relaxants, antihistamines, psychostimulants, antithrombotics, antigut drugs) 14.8%. The reasons for suicide attempts included family related reasons, boy-girl friend separation, exam anxiety, school anxiety and others (loneliness, gender dysphoria). The most frequent psychiatric disorders that had been previously diagnosed were major depressive disorder, conduct disorder and attention deficit hyperactivity disorder. Epilepsy had been diagnosed in 3 patients other than psychiatric disorder. The number of suicide attempts with the drugs started for these diagnoses (n=22, %16.3) was statistically significant (p<0.05). All the patients were hospitalized and observed for at least 24 hours. There was no mortality during or after the suicide attempt. Conclusion: Clinicians working with young people are required to assess the presence of suicidal ideation, suicidal behavior, and other risk factors, and to determine the level of risk.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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