Bir üniversite hastanesine yönlendirilen adli olguların psikososyal, psikiyatrik ve adli özelliklerinin retrospektif olarak değerlendirilmesi
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Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızın amacı adli polikliniğimize adli makamlar tarafından rapor düzenlenmesi için yönlendirilen olguların psikososyal, psikiyatrik ve adli özelliklerinin değerlendirilerek çocuk ve ergenlerin suça maruz kalma ya da suç işleme açısından risk altında olduğu durumların saptanmasıdır. Yöntem: Ege Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalı Adli Polikliniği'ne adli makamlar tarafından rapor düzenlenmesi için yönlendirilen ve 01.06.2012-29.02.2016 tarihleri arasında adli kurul tarafından değerlendirilip rapor düzenlenen 4-18 yaş arasındaki 750 olgudan randomize olarak seçilen 150 olgunun tarafımızca düzenlenen dosyaları taranmıştır. Olguların yaş, cinsiyet, eğitim düzeyleri, aile özellikleri ve yaşam koşulları başta olmak üzere sosyodemografik özellikleri, karşılaştıkları adli süreçler, adli makamların istekleri ve yaşadıkları adli olayların sonrasında ortaya çıkan psikiyatrik sorunlar dökümente edilmiştir. Olgular cinsel istismar, suça sürüklenen çocuk ve diğer grup olmak üzere 3 ana grupta toplanmış, yukarıda bahsedilen sosyodemografik, psikiyatrik ve adli durumları için gruplar arasında değerlendirme yapılmıştır. Bulgular: Cİ grubunda kız cinsiyet daha fazla iken, SSÇ grubunda erkek cinsiyetin daha fazla olduğu belirlenmiş ve gruplar arasında cinsiyet dağılımı açısından anlamlı fark saptanmıştır (p<0,001). Cİ grubunda kızların 5-18 yaş aralığında ve yaş ortalamasının 13,12±3,54, erkeklerin 6-18 yaş aralığında ve yaş ortalamasının 11,42±3,63 olduğu; SSÇ grubunda ise kızların 14-16 yaş aralığında ve yaş ortalamasının 14,83±0,75, erkeklerin 13-18 yaş aralığında ve yaş ortalamasının 15,13±1,31 olduğu görülmüştür. SSÇ grubunda yaş ortalamasının Cİ grubunun yaş ortalamasından daha yüksek, olay öncesinde psikiyatrik hastalık varlığının daha fazla, anne eğitim düzeyinin ise daha düşük olduğu görülmüş; istatistiksel olarak anlamlı fark saptanmıştır (p<0,001). Cİ grubunda %45,4 sıklıkta psikiyatrik hastalık saptanmış; bunlardan en sık görüleni %21,6 MDB, ikincisi ise %17,5 TSSB olmuştur. Cİ olgularının %66'sında ruh sağlığında kalıcı bir bozulma saptanmamıştır. SSÇ grubunda WISC-R testi sözel, performans ve total IQ puanlarının üçünde de diğer gruplara kıyasla daha düşük olduğu, mental retardasyonun da aynı şekilde daha fazla olduğu saptanmıştır. Sonuç: Çalışmamızda Cİ ve SSÇ grubu arasında; cinsiyet, yaş, zeka kapasitesi, birlikte yaşadığı kişi sayısı, olay öncesinde psikiyatrik hastalık varlığı ve anne eğitim düzeyi açısından anlamlı fark saptanmış; diğer özelliklerde ise anlamlı bir fark saptanmamıştır.
Objective: The objective of our study is to determine the situations in which children and adolescents are at risk of committing or exposure to crime by evaluating the psychosocial, psychiatric and forensic characteristics of cases who were directed to our forensic clinic by legal authority fort he purpose of forensic reporting. Method: The clinical files that were browsed in our study belong to 150 cases that randomly selected amongst 750 cases who were between the ages of 4 to 18 and were directed to Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Forensic Outpatient Clinic by legal authority for the purpose of forensic reporting which were prepared in between 01.06.2012 and 29.02.2016 after clinical evaluation of forensic council. The sociodemographic characteristics predominantly age, gender, educational level, family features, life circumstances, the legal processes, orders of legal authorities, psychiatric problems that occured after forensic events of the cases were decumented. The cases were categorised in 3 main groups as sexual abused (SA), children driven to crime (CDC), others and intergroup comparisons were performed according to the sociodemographic, psychiatric and legal features that were noted above. Results: While female gender is predominant in SA group; it was determined that male gender is predominant in SSÇ group and gender distribution were found significantly different (p<0,001) between groups. It was found that girls in SA group were in between the ages of 5 to 18 and the mean age of that girls was 13,12 +_3,54 and boys in SA group were in between the ages of 13 to 18 and the mean age of that boys was 15,13 +_1,31. On the other hand It was stated that girls in CDC group were in between the ages of 14 to 16 and the mean age of that girls was 14,83 +_0,75 and boys in CDC group were in between the ages of 13 to 18 and the mean age of that boys was 15,13 +_1,31. Relative to SA group it was seen that the mean ages of CDC group is higher, the presence of psychiatric illness before the legal situation is more common in CDC and maternal educational level of that group was lower. Also these parameters were found statistically different in two groups (p<0.001). The frequency of psychiatric disease in SA group was 45,4 % and the most common psychiatric diagnose was major depressive disorder (21,6%) whereas the second most common psychiatric diagnose was post traumatic stress disorder (17,5%). In SA group, it was found that 66% of the cases have no permenant psychiatric disorder. All WISC-R scores (i.e. verbal, performance and total scores) were lower in CDC group comparing to other two groups and mental retardation was more frequent in CDC group. Conclusion: In our study gender, age, mental capacity, the number of individuals that live together, psychiatric disease presence before the legal event and maternal educational level were found significantly different in between SA and CDC group, however other parameters were not found significantly different between the groups.
Objective: The objective of our study is to determine the situations in which children and adolescents are at risk of committing or exposure to crime by evaluating the psychosocial, psychiatric and forensic characteristics of cases who were directed to our forensic clinic by legal authority fort he purpose of forensic reporting. Method: The clinical files that were browsed in our study belong to 150 cases that randomly selected amongst 750 cases who were between the ages of 4 to 18 and were directed to Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Forensic Outpatient Clinic by legal authority for the purpose of forensic reporting which were prepared in between 01.06.2012 and 29.02.2016 after clinical evaluation of forensic council. The sociodemographic characteristics predominantly age, gender, educational level, family features, life circumstances, the legal processes, orders of legal authorities, psychiatric problems that occured after forensic events of the cases were decumented. The cases were categorised in 3 main groups as sexual abused (SA), children driven to crime (CDC), others and intergroup comparisons were performed according to the sociodemographic, psychiatric and legal features that were noted above. Results: While female gender is predominant in SA group; it was determined that male gender is predominant in SSÇ group and gender distribution were found significantly different (p<0,001) between groups. It was found that girls in SA group were in between the ages of 5 to 18 and the mean age of that girls was 13,12 +_3,54 and boys in SA group were in between the ages of 13 to 18 and the mean age of that boys was 15,13 +_1,31. On the other hand It was stated that girls in CDC group were in between the ages of 14 to 16 and the mean age of that girls was 14,83 +_0,75 and boys in CDC group were in between the ages of 13 to 18 and the mean age of that boys was 15,13 +_1,31. Relative to SA group it was seen that the mean ages of CDC group is higher, the presence of psychiatric illness before the legal situation is more common in CDC and maternal educational level of that group was lower. Also these parameters were found statistically different in two groups (p<0.001). The frequency of psychiatric disease in SA group was 45,4 % and the most common psychiatric diagnose was major depressive disorder (21,6%) whereas the second most common psychiatric diagnose was post traumatic stress disorder (17,5%). In SA group, it was found that 66% of the cases have no permenant psychiatric disorder. All WISC-R scores (i.e. verbal, performance and total scores) were lower in CDC group comparing to other two groups and mental retardation was more frequent in CDC group. Conclusion: In our study gender, age, mental capacity, the number of individuals that live together, psychiatric disease presence before the legal event and maternal educational level were found significantly different in between SA and CDC group, however other parameters were not found significantly different between the groups.
