Yıl: 2015 Cilt: 52 Sayı: 4 Sayfa Aralığı: 393 - 399 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The Psychiatric Consequences of Child and Adolescent Sexual Abuse

Öz:
Amaç: Bu çalışmanın amacı, adli birimlerden hastanemiz çocuk ve ergen psikiyatrisi polikliniğine sevk edilen cinsel istismar mağduru çocuk ve ergenlerde istismarın psikiyatrik sonuçlarını ve bunlara etki eden faktörleri araştırmaktır Yöntem: İki yıllık bir sürede adli birimlerce Ondokuz Mayıs Üniversitesi Çocuk ve Ergen Psikiyatrisi Kliniği'ne yönlendirilen cinsel istismara maruz kalmış 1-18 yaş arası (ortalama 13,56±3,38) tüm olgular [n=590, erkek: 83 (%14,1); kız: 507 (%85,9)] çalışmaya dahil edildi.Tüm olgular adli tıp ve çocuk ve ergen psikiyatrisi uzmanları tarafından değerlendirildi. Ol-gulara, Wechsler Çocuklar İçin Zeka Ölçeği Yeniden Gözden Geçirilmiş Formu (WÇZÖ-R) ve Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli-Türkçe (K-SA-DS-PL-T) uygulandı.Bulgular: Olguların %75,2'sinde istismar ile ilişkili psikiyatrik bozukluk (%45,9 olguda major depresif bozukluk ve %31,7 olguda travma sonrası stres bozukluğu) tespit edildi. Olguların %80,3'ü failleri tanıyordu [ensest, n=91 (%15,1)] ve %48,8'inde cinsel ilişki gerçekleşmişti. Herhangi bir psi-kiyatrik bozuklukla cinsiyet ve yaş grupları arasında belirgin bir ilişki saptan-mazken istismarın şiddeti (örneğin tamamlanmış cinsel ilişki) (p=0,006), ek fiziksel saldırı (p<0,001) ve ensest (p<0,001) ile belirgin bir korelasyon saptandı. Cinsel saldırı ile ilişkili psikiyatrik bozukluk gelişmesine etki eden faktörlerin belirleyicilik değerini araştırmak için yaş, cinsiyet, istismar şid-deti, ensest, diğer mağdurların olması, ek fiziksel saldırı ve ilk istismar ile ilk psikiyatrik değerlendirme arasındaki süre lojistik regresyon modeli ile araş-tırıldı. Bu değişkenlerin kombinasyonunun (ensest varlığı, ek fiziksel saldırı ve ilk istismar ve ilk psikiyatrik değerlendirme arasındaki süre) herhangi bir psikiyatrik bozukluk ortaya çıkmasının anlamlı bir şekilde önceden haber vericisi olduğu bulunmuştur (?2=55,42, df=7, n=522, p<0,001). Sonuç: Bulgularımız, ensest mevcudiyetinde, ek fiziksel saldırı olmasında ve ilk istismar ile ilk psikiyatrik değerlendirme arasındaki sürenin uzun ol-masında cinsel istismar ile ilgili psikiyatrik bozukluk gelişme olasılığının daha yüksek oranda olduğunu ortaya koymaktadır.
Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri

Çocuk ve Ergenlerde Cinsel İstismarın Psikiyatrik Sonuçları

Öz:
Introduction: The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico-legal units. Methods: All victims of sexual abuse (n=590) aged 1-18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied.Results: Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (?2=55.42; df=7; n=522; p<.001).Conclusion: Our findings reveal that the occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluationpredicthigherratesofsexualabuse-relatedpsychiatricdisorders.
Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA YÜCE M, KARABEKİROĞLU K, YILDIRIM Z, Sahin S, SAPMAZ D, BABADAĞI Z, TURLA A, AYDIN B (2015). The Psychiatric Consequences of Child and Adolescent Sexual Abuse. , 393 - 399.
Chicago YÜCE Murat,KARABEKİROĞLU KORAY MEHMET ZEYNEL,YILDIRIM Zeynep,Sahin Serkan,SAPMAZ Dicle,BABADAĞI Zehra,TURLA Ahmet,AYDIN Berna The Psychiatric Consequences of Child and Adolescent Sexual Abuse. (2015): 393 - 399.
MLA YÜCE Murat,KARABEKİROĞLU KORAY MEHMET ZEYNEL,YILDIRIM Zeynep,Sahin Serkan,SAPMAZ Dicle,BABADAĞI Zehra,TURLA Ahmet,AYDIN Berna The Psychiatric Consequences of Child and Adolescent Sexual Abuse. , 2015, ss.393 - 399.
AMA YÜCE M,KARABEKİROĞLU K,YILDIRIM Z,Sahin S,SAPMAZ D,BABADAĞI Z,TURLA A,AYDIN B The Psychiatric Consequences of Child and Adolescent Sexual Abuse. . 2015; 393 - 399.
Vancouver YÜCE M,KARABEKİROĞLU K,YILDIRIM Z,Sahin S,SAPMAZ D,BABADAĞI Z,TURLA A,AYDIN B The Psychiatric Consequences of Child and Adolescent Sexual Abuse. . 2015; 393 - 399.
IEEE YÜCE M,KARABEKİROĞLU K,YILDIRIM Z,Sahin S,SAPMAZ D,BABADAĞI Z,TURLA A,AYDIN B "The Psychiatric Consequences of Child and Adolescent Sexual Abuse." , ss.393 - 399, 2015.
ISNAD YÜCE, Murat vd. "The Psychiatric Consequences of Child and Adolescent Sexual Abuse". (2015), 393-399.
APA YÜCE M, KARABEKİROĞLU K, YILDIRIM Z, Sahin S, SAPMAZ D, BABADAĞI Z, TURLA A, AYDIN B (2015). The Psychiatric Consequences of Child and Adolescent Sexual Abuse. Nöropsikiyatri Arşivi, 52(4), 393 - 399.
Chicago YÜCE Murat,KARABEKİROĞLU KORAY MEHMET ZEYNEL,YILDIRIM Zeynep,Sahin Serkan,SAPMAZ Dicle,BABADAĞI Zehra,TURLA Ahmet,AYDIN Berna The Psychiatric Consequences of Child and Adolescent Sexual Abuse. Nöropsikiyatri Arşivi 52, no.4 (2015): 393 - 399.
MLA YÜCE Murat,KARABEKİROĞLU KORAY MEHMET ZEYNEL,YILDIRIM Zeynep,Sahin Serkan,SAPMAZ Dicle,BABADAĞI Zehra,TURLA Ahmet,AYDIN Berna The Psychiatric Consequences of Child and Adolescent Sexual Abuse. Nöropsikiyatri Arşivi, vol.52, no.4, 2015, ss.393 - 399.
AMA YÜCE M,KARABEKİROĞLU K,YILDIRIM Z,Sahin S,SAPMAZ D,BABADAĞI Z,TURLA A,AYDIN B The Psychiatric Consequences of Child and Adolescent Sexual Abuse. Nöropsikiyatri Arşivi. 2015; 52(4): 393 - 399.
Vancouver YÜCE M,KARABEKİROĞLU K,YILDIRIM Z,Sahin S,SAPMAZ D,BABADAĞI Z,TURLA A,AYDIN B The Psychiatric Consequences of Child and Adolescent Sexual Abuse. Nöropsikiyatri Arşivi. 2015; 52(4): 393 - 399.
IEEE YÜCE M,KARABEKİROĞLU K,YILDIRIM Z,Sahin S,SAPMAZ D,BABADAĞI Z,TURLA A,AYDIN B "The Psychiatric Consequences of Child and Adolescent Sexual Abuse." Nöropsikiyatri Arşivi, 52, ss.393 - 399, 2015.
ISNAD YÜCE, Murat vd. "The Psychiatric Consequences of Child and Adolescent Sexual Abuse". Nöropsikiyatri Arşivi 52/4 (2015), 393-399.