Demographic and Clinical Characteristics of Child and Adolescent Psychiatry Patients in a District State Hospital in Eastern Anatolia
Öz
Aim: This study aims to determine the distribution of diagnoses for patients applying to the only child and adolescent psychiatry policlinic in the Doğubayazıt district of Ağrı province.
Materials and Method: A retrospective analysis was conducted on 1,095 subjects aged 0-18 who applied to the Child and Adolescent Psychiatry Outpatient Clinic of the Ministry of Health Doğubayazıt Dr. Yaşar Eryılmaz State Hospital between January and August 2023. Diagnoses were established based on the DSM-5 criteria classified by gender and age groups (0-6, 7-12, 13-18).
Results: The patients’ mean age was 9.57 years (SD = 4.62), with 60.2% consisting of boys. Attention-deficit hyperactivity disorder (ADHD), specific learning disorders (SLD), and mild intellectual disability were the most common diagnoses among children aged 7-12. Global developmental delay (GDD) and developmental language disorder (DLD) were more prevalent in early childhood (0-6), while anxiety disorders and major depressive disorder (MDD) were more frequent in adolescents (13-18). Boys were diagnosed with ADHD, autism spectrum disorder (ASD), and DLD at higher rates, whereas girls were more frequently diagnosed with anxiety disorders, MDD, and obsessive-compulsive disorder (OCD). About 35% of patients received psychotropic medication, primarily methylphenidate, risperidone, and sertraline.
Conclusion: This study highlights significant gender and age differences in the distribution of mental health diagnoses among children and adolescents in the Doğubayazıt district of the Eastern Anatolia region of Türkiye. The findings contribute to a deeper understanding of childhood mental health issues and may contribute to more effective diagnostic and treatment strategies.
Anahtar Kelimeler
Child psychiatry Mental disorders Attention deficit disorder with hyperactivity Gender differences Age distribution
Etik Beyan
This study did not involve any experimental research on human or animal subjects. It was conducted by ethical principles, with no conflicts of interest or ethical violations. Data were collected anonymously, and participants' confidentiality was safeguarded.
Destekleyen Kurum
Republic of Turkey Ministry of Health, Doğubeyazıt Dr. Yaşar Eryılmaz State Hospital
Teşekkür
The authors would like to thank all parties who directly or indirectly supported and participated in this research, especially the staff of Ministry of Health Doğubeyazıt Dr. Yaşar Eryılmaz State Hospital.
Kaynakça
- Costello EJ, Egger H, Angold A. 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. methods and public health burden. J Am Acad Child Adolesc Psychiatry. 2005;44(10):972–86.
- Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65.
- Barican JL, Yung D, Schwartz C, Zheng Y, Georgiades K, Waddell C. Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking. BMJ Ment Health. 2022;25(1):36–44.
- Copeland WE, Wolke D, Shanahan L, Costello EJ. Adult functional outcomes of common childhood psychiatric problems: A prospective, longitudinal study. JAMA Psychiatry. 2015;72(9):892–9.
- Solmi M, Durbaba S, Ashworth M, Fusar-Poli P. Proportion of young people in the general population consulting general practitioners: Potential for mental health screening and prevention. Early Intervention in Psychiatry. 2020;14(5):631–5.
- Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27(1):281–95.
- Human growth and development. StatPearls. Accessed June 2, 2024. https://www.ncbi.nlm.nih.gov/books/NBK567767/
- Likhar A, Baghel P, Patil M. Early childhood development and social determinants. Cureus. 2022;14(9).
- Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogue Clin Neurosci. 2009;11(1):7–20.
- Costello EJ, Copeland W, Angold A. Trends in psychopathology across the adolescent years: What changes when children become adolescents, and when adolescents become adults? J Child Psychol Psychiatry. 2011;52(10):1015–25.
- Rutter M, Caspi A, Moffitt TE. Using sex differences in psychopathology to study causal mechanisms: unifying issues and research strategies. J Child Psychol Psychiatry. 2003;44(8):1092–115.
- Zahn-Waxler C, Shirtcliff EA, Marceau K. Disorders of childhood and adolescence: Gender and psychopathology. Annu Rev Clin Psychol. 2008;4:275–303.
- Gormez V, Örengül AC, Baljinnyam S, Aliyeva N. Çocuk ve ergen psikiyatrisi polikliniğine başvuran hastalarda tanı dağılımı ve demografik özellikler. JMOOD. 2017;(7)1:41-6.
- Araz Altay M, Bozatlı L, Demirci Şipka B, Görker I. Current pattern of psychiatric comorbidity and psychotropic drug prescription in child and adolescent patients. Medicina. 2019;55(5):159.
- Kılınçel Ş. Çocuk ve ergen psikiyatrisi polikliniğine başvuran hastaların tanı dağılımı ve tedavilerinin değerlendirilmesi. Sakarya Tıp Dergisi. 2020;10(4):661–8.
- Öz B, Kıvrak AC. Sociodemographic and clinical characteristics of children and adolescents applying to the child psychiatry outpatient clinic in Düzce. VHS. 2023;13(2):203–8.
- Sarı BA. Symptoms and diagnosies of patients referring to a child and adolescent psychiatry outpatient clinic in Batman. J Clin Psy. 2013;16:7–17.
- Karacetin G, Arman AR, Fis NP, Demirci E, Ozmen S, Hesapcioglu ST, et al. Prevalence of childhood affective disorders in Turkey: An epidemiological study. J Affect Disord. 2018;238:513–21.
- Ercan ES, Polanczyk G, Ardıc UA, Yuce D, Karacetın G, Tufan AE, et al. The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T). Nord J Psychiatry. 2019;73(2):132-40.
- Sağlık Bakanlığı Yönetim Hizmetleri Genel Müdürlüğü. Accessed June 9, 2024. https://yhgm.saglik.gov.tr/
- Doğubayazıt Kaymakamlığı. Accessed June 8, 2024. http://www.dogubayazit.gov.tr/
- American psychiatric association. diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Association; 2013.
- Krug DA, Arick J, Almond P. Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. J Child Psychol Psychiatry. 1980;21(3):221–9.
- Yilmaz-Irmak T, Tekinsav-Sutcu WS, Aydin A, Sorias O. An investigation of validity and reliability of autism behavior checklist (ABC). Turk J Child Adolesc Ment Health. 2007;14(14):13–23.
- Turgay A. The DSM-IV Based child and adolescent behavior rating scale. Ontario, Integrative therapy institute, Canada. 1995.
- Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE. Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behav Res Ther. 2000;38(8):835–55.
- Gormez V, Kılınçaslan A, Orengul AC, Ebesutani C, Kaya I, Ceri V, et al. Psychometric properties of the Turkish version of the revised child anxiety and depression scale –child version in a clinical sample. Psychiatry Clin Psychopharmacol. 2017;27(1):84–92.
- Gormez V, Kilincaslan A, Ebesutani C, Orengul AC, Kaya I, Ceri V, et al. Psychometric properties of the parent version of the revised child anxiety and depression scale in a clinical sample of turkish children and adolescents. Child Psychiatry Hum Dev. 2017;48(6):922–33.
- Usta MB, Gumus YY, Aral A, Say GN, Karabekiroglu K. Psychotropic medication use in children and adolescents: review of outpatient treatments. Dusunen Adam Journal of Psychiatry and Neurological Sciences. 2018;31(1):72.
- McClure EB. A meta-analytic review of sex differences in facial expression processing and their development in infants, children, and adolescents. Psychol Bull. 2000;126(3):424–53.
- Geary DC. Sexual selection and human life history. Adv Child Dev Behav. 2002;30:41–101.
- Baron-Cohen S. The extreme male brain theory of autism. Trends Cogn Sci. 2002;6(6):248–54.
- Knickmeyer R, Baron-Cohen S, Raggatt P, Taylor K, Hackett G. Fetal testosterone and empathy. Horm Behav. 2006;49(3):282–92.
- Jacquemont S, Coe BP, Hersch M, Duyzend MH, Krumm N, Bergmann S, et al. A higher mutational burden in females supports a “female protective model” in neurodevelopmental disorders. Am J Hum Genet. 2014;94(3):415–25.
- Young EA. Sex differences and the HPA axis: implications for psychiatric disease. J Gend Specif Med. 1998;1(1):21–7.
- Gender Differences at Puberty. Cambridge University Press. Accessed June 3, 2024. https://books.google.com/books?hl=tr&lr=&id=JnO_VCuH7scC&oi=fnd&pg=PR11
- Mental Health Surveillance Among Children — United States, 2013–2019. MMWR Suppl. Accessed June 1, 2024. https://www.cdc.gov/mmwr/volumes/71/su/su7102a1.htm
- Piovani D, Clavenna A, Bonati M. Prescription prevalence of psychotropic drugs in children and adolescents: an analysis of international data. Eur J Clin Pharmacol. 2019;75(10):1333–46.
- Identifying Mental Health Difficulties in Children & Young People: The Role of Schools. ACAMH. Accessed June 8, 2024. https://www.acamh.org/blog/identifying-mental-health-difficulties-in-children-youngpeople-the-role-of-schools/
- Loades ME, Mastroyannopoulou K. Teachers’ recognition of children’s mental health problems. Child Adolesc Ment Health. 2010;15(3):150–6.
Doğu Anadolu'da Bir İlçe Devlet Hastanesindeki Çocuk ve Ergen Psikiyatri Hastalarının Demografik ve Klinik Özellikleri
Öz
Amaç: Bu çalışmanın amacı, Ağrı ilinin Doğubeyazıt ilçesindeki tek çocuk ve ergen psikiyatrisi polikliniğine başvuran hastaların yaş ve cinsiyete göre tanı dağılımını belirlemektir.
Gereç ve Yöntem: Ocak ve Ağustos 2023 tarihleri arasında Doğubayazıt Dr. Yaşar Eryılmaz Devlet Hastanesi Çocuk ve Ergen Psikiyatrisi Polikliniğine başvuran 0-18 yaş arası 1,095 olgu üzerinde retrospektif bir analiz yapılmıştır. Tanılar, DSM-5 kriterlerine göre belirlenmiş olup cinsiyet ve yaş gruplarına (0-6, 7-12, 13-18) göre sınıflandırılmıştır.
Bulgular: Hastaların ortalama yaşı 9.57 yıl (SS = 4.62) olup, %60.2’si erkektir. 7-12 yaş grubunda en sık görülen tanılar dikkat eksikliği ve hiperaktivite bozukluğu (DEHB), özgül öğrenme güçlükleri (ÖÖG) ve hafif zihinsel yetersizliktir. Erken çocukluk döneminde (0-6 yaş) genel gelişimsel gecikme ve gelişimsel dil bozukluğu (GDB) daha yaygınken, ergenlerde (13-18 yaş) anksiyete bozuklukları ve major depresif bozukluk (MDB) daha sık görülmüştür. DEHB, otizm spektrum bozukluğu (OSB) ve gelişimsel dil bozukluğu (GDB) tanıları erkeklerde daha sık saptanmıştır. Buna karşılık, anksiyete bozuklukları, MDB ve obsesif-kompulsif bozukluk (OKB) daha sık kızlarda görülmüştür. Vakaların yaklaşık %35'ine psikotrop ilaçlar reçete edilmiş olup, en sık kullanılan ilaçlar sırasıyla metilfenidat, risperidon ve sertralindir.
Sonuç: Bu çalışma, Türkiye'nin Doğu Anadolu bölgesindeki Doğubeyazıt ilçesinde çocuk ve ergenler arasında ruh sağlığı tanılarının dağılımında belirgin cinsiyet ve yaş farklılıklarını vurgulamaktadır. Bulgular, çocukluk çağı ruh sağlığı sorunlarının daha iyi anlaşılmasına katkıda bulunmakta olup, daha etkili tanı ve tedavi stratejilerinin geliştirilmesine yardımcı olabilir.
Anahtar Kelimeler
Çocuk psikiyatrisi Ruh sağlığı bozuklukları Dikkat eksikliği hiperaktivite bozukluğu Cinsiyet farklılıkları Yaş dağılımı
Kaynakça
- Costello EJ, Egger H, Angold A. 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. methods and public health burden. J Am Acad Child Adolesc Psychiatry. 2005;44(10):972–86.
- Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65.
- Barican JL, Yung D, Schwartz C, Zheng Y, Georgiades K, Waddell C. Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking. BMJ Ment Health. 2022;25(1):36–44.
- Copeland WE, Wolke D, Shanahan L, Costello EJ. Adult functional outcomes of common childhood psychiatric problems: A prospective, longitudinal study. JAMA Psychiatry. 2015;72(9):892–9.
- Solmi M, Durbaba S, Ashworth M, Fusar-Poli P. Proportion of young people in the general population consulting general practitioners: Potential for mental health screening and prevention. Early Intervention in Psychiatry. 2020;14(5):631–5.
- Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27(1):281–95.
- Human growth and development. StatPearls. Accessed June 2, 2024. https://www.ncbi.nlm.nih.gov/books/NBK567767/
- Likhar A, Baghel P, Patil M. Early childhood development and social determinants. Cureus. 2022;14(9).
- Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogue Clin Neurosci. 2009;11(1):7–20.
- Costello EJ, Copeland W, Angold A. Trends in psychopathology across the adolescent years: What changes when children become adolescents, and when adolescents become adults? J Child Psychol Psychiatry. 2011;52(10):1015–25.
- Rutter M, Caspi A, Moffitt TE. Using sex differences in psychopathology to study causal mechanisms: unifying issues and research strategies. J Child Psychol Psychiatry. 2003;44(8):1092–115.
- Zahn-Waxler C, Shirtcliff EA, Marceau K. Disorders of childhood and adolescence: Gender and psychopathology. Annu Rev Clin Psychol. 2008;4:275–303.
- Gormez V, Örengül AC, Baljinnyam S, Aliyeva N. Çocuk ve ergen psikiyatrisi polikliniğine başvuran hastalarda tanı dağılımı ve demografik özellikler. JMOOD. 2017;(7)1:41-6.
- Araz Altay M, Bozatlı L, Demirci Şipka B, Görker I. Current pattern of psychiatric comorbidity and psychotropic drug prescription in child and adolescent patients. Medicina. 2019;55(5):159.
- Kılınçel Ş. Çocuk ve ergen psikiyatrisi polikliniğine başvuran hastaların tanı dağılımı ve tedavilerinin değerlendirilmesi. Sakarya Tıp Dergisi. 2020;10(4):661–8.
- Öz B, Kıvrak AC. Sociodemographic and clinical characteristics of children and adolescents applying to the child psychiatry outpatient clinic in Düzce. VHS. 2023;13(2):203–8.
- Sarı BA. Symptoms and diagnosies of patients referring to a child and adolescent psychiatry outpatient clinic in Batman. J Clin Psy. 2013;16:7–17.
- Karacetin G, Arman AR, Fis NP, Demirci E, Ozmen S, Hesapcioglu ST, et al. Prevalence of childhood affective disorders in Turkey: An epidemiological study. J Affect Disord. 2018;238:513–21.
- Ercan ES, Polanczyk G, Ardıc UA, Yuce D, Karacetın G, Tufan AE, et al. The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T). Nord J Psychiatry. 2019;73(2):132-40.
- Sağlık Bakanlığı Yönetim Hizmetleri Genel Müdürlüğü. Accessed June 9, 2024. https://yhgm.saglik.gov.tr/
- Doğubayazıt Kaymakamlığı. Accessed June 8, 2024. http://www.dogubayazit.gov.tr/
- American psychiatric association. diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Association; 2013.
- Krug DA, Arick J, Almond P. Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. J Child Psychol Psychiatry. 1980;21(3):221–9.
- Yilmaz-Irmak T, Tekinsav-Sutcu WS, Aydin A, Sorias O. An investigation of validity and reliability of autism behavior checklist (ABC). Turk J Child Adolesc Ment Health. 2007;14(14):13–23.
- Turgay A. The DSM-IV Based child and adolescent behavior rating scale. Ontario, Integrative therapy institute, Canada. 1995.
- Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE. Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behav Res Ther. 2000;38(8):835–55.
- Gormez V, Kılınçaslan A, Orengul AC, Ebesutani C, Kaya I, Ceri V, et al. Psychometric properties of the Turkish version of the revised child anxiety and depression scale –child version in a clinical sample. Psychiatry Clin Psychopharmacol. 2017;27(1):84–92.
- Gormez V, Kilincaslan A, Ebesutani C, Orengul AC, Kaya I, Ceri V, et al. Psychometric properties of the parent version of the revised child anxiety and depression scale in a clinical sample of turkish children and adolescents. Child Psychiatry Hum Dev. 2017;48(6):922–33.
- Usta MB, Gumus YY, Aral A, Say GN, Karabekiroglu K. Psychotropic medication use in children and adolescents: review of outpatient treatments. Dusunen Adam Journal of Psychiatry and Neurological Sciences. 2018;31(1):72.
- McClure EB. A meta-analytic review of sex differences in facial expression processing and their development in infants, children, and adolescents. Psychol Bull. 2000;126(3):424–53.
- Geary DC. Sexual selection and human life history. Adv Child Dev Behav. 2002;30:41–101.
- Baron-Cohen S. The extreme male brain theory of autism. Trends Cogn Sci. 2002;6(6):248–54.
- Knickmeyer R, Baron-Cohen S, Raggatt P, Taylor K, Hackett G. Fetal testosterone and empathy. Horm Behav. 2006;49(3):282–92.
- Jacquemont S, Coe BP, Hersch M, Duyzend MH, Krumm N, Bergmann S, et al. A higher mutational burden in females supports a “female protective model” in neurodevelopmental disorders. Am J Hum Genet. 2014;94(3):415–25.
- Young EA. Sex differences and the HPA axis: implications for psychiatric disease. J Gend Specif Med. 1998;1(1):21–7.
- Gender Differences at Puberty. Cambridge University Press. Accessed June 3, 2024. https://books.google.com/books?hl=tr&lr=&id=JnO_VCuH7scC&oi=fnd&pg=PR11
- Mental Health Surveillance Among Children — United States, 2013–2019. MMWR Suppl. Accessed June 1, 2024. https://www.cdc.gov/mmwr/volumes/71/su/su7102a1.htm
- Piovani D, Clavenna A, Bonati M. Prescription prevalence of psychotropic drugs in children and adolescents: an analysis of international data. Eur J Clin Pharmacol. 2019;75(10):1333–46.
- Identifying Mental Health Difficulties in Children & Young People: The Role of Schools. ACAMH. Accessed June 8, 2024. https://www.acamh.org/blog/identifying-mental-health-difficulties-in-children-youngpeople-the-role-of-schools/
- Loades ME, Mastroyannopoulou K. Teachers’ recognition of children’s mental health problems. Child Adolesc Ment Health. 2010;15(3):150–6.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Psikiyatri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 28 Ekim 2024 |
| Kabul Tarihi | 20 Haziran 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 3 Sayı: 2 |
