Objective:Obesity is a chronic disease which leads to medical and psychiatric complications. Family climate is a critical factor in the treatment of obesity and comorbid psychiatric disorders. In our study, perceived expressed emotion (EE), psychopathology, self-esteem and emotional and behavioural problems (BP) among obese adolescents were investigated and compared with their non-obese peers.Methods:The subjects were 49 obese adolescents and 47 non-obese adolescents served as the control group. All participants were requested to fill out the Socio-demographic Data Form, Shortened Level of Expressed Emotion Scale, Rosenberg Self-Esteem Scale, Strength and Difficulties Questionnaire-Adolescent Form.Results:In our study, obese adolescents showed a significant difference in perceived EE (p<0.001). Subscales of EE, such as Lack of Emotional Support (p<0.001), intrusiveness (p<0.001), irritability (p<0.001), self-esteem (p<0.001), emotional and BP (p<0.001), attention deficit-hyperactivity disorder (p<0.001), problems in peer relationships (p<0.001) and social skills (p<0.001) were significantly worse when compared with the control group. There was a strong relationship between EE and emotional and BP and self-esteem.Conclusion:The higher rate of perceived EE, psychopathology and low self-esteem among obese adolescents showed that obesity prevention and treatment are also crucial for good mental health in adolescents. The important role of the family in mental health of obese adolescents was emphasized. It was shown that identification of risk factors in childhood that promote obesity should be done so that targeted intervention and prevention programs can be developed.
ÖZETGi rifl: Konsültasyon-liyezon psikiyatrisi genel klinik tıp ve çeşitli uzmanlık alanları ile psişik ve psikososyal durumlar arası bağlantıları araştıran, fiziksel hastalıklara eşlik eden psikiyatrik bozukluk ve psikososyal sorunların tanısı, tedavisi, izlenmesi ile uğraşan psikiyatri alanıdır. Bu çalışmanın amacı bir üniversite hastanesinde son bir yılda istenen çocuk ve ergen ruh sağlığı ve hastalıkları (ÇERSH) konsültasyonlarının nedenleri, olguların sosyodemografik verileri ile bu olgulara dair yürütülen tedavi yaklaşımlarının gözden geçirilmesidir. Gereç ve Yöntem: Uludağ Üniversitesi Tıp Fakültesi (UÜTF) Hastanesinde, Ocak 2012-Ocak 2013 tarihleri arasında acil tıp ve diğer klinikler tarafından, çocuk ve ergen psikiyatrisi ana bilim dalından istenen konsültasyonlara dair hastaların bilgileri geriye dönük taranmıştır Bulgular: UÜTF Hastanesi'nde çocuk acile başvuran olguların %0,48'inden ve 18 yaş altı yatarak tedavi gören olguların %3,25'inden ÇERSH konsültasyonu istenmiştir. Değerlendirilen 275 olgunun %51,5'i kız, %48,5'i erkek olarak bulunurken, olguların yaş ortalaması 13,5±4,23 olarak saptanmıştır. En sık konsültasyon isteyen klinikler; sırasıyla çocuk acil (%27), çocuk hematoloji (%12,5) ve çocuk nefroloji (%12,5) kliniğidir. Olguların %7,6'sı değerlendirilen kesitte psikiyatrik tanı almamıştır. Psikiyatrik tanılar; en sık %26,2 oranla uyum bozukluğu, ikinci sıklıkta %20,7 oranla depresif bozukluk, üçüncü sıklıkta %15,3 oranla anksiyete bozukluğu tanılarıdır. Değerlendirilen olguların %36'sına medikal tedavi uygulanmıştır. Sonuç: Çalışmamız fiziksel hastalığı olan hastalarda uyum bozukluğu ve depresyon başta olmak üzere psikiyatrik bozuklukların sık görüldüğünü ortaya koymaktadır. Yapılan taramalar sonucunda görülmüştür ki; değerlendirilen konsültasyonların sayıları her geçen sene artmaktadır. Çalışmamızın sonuçları konsültasyon istemlerinin değeri ve bölümler arası işbirliğinin önemini vurgulamaktadır.(Gün cel Pe di at ri 2013; 11: 102-6) Anah tar ke li me ler: Çocuk psikiyatrisi, konsültasyon, liyezon SUM MARYIn tro duc ti on: Consultation-liaison psychiatry is a field of psychiatry which investigates associations among clinical medicine in general, different fields of specialties and psychic and psychosocial entities. This psychiatric discipline deals with diagnosis, treatment, follow-up of psychiatric, and psychosocial disorders associated with physical diseases. The objective of this study was to review causes of consultations requested from departments of child and adolescent mental health, and diseases (PAMHD), sociodemographic data of the cases, and treatment approaches related to these cases. Materials and Methods: Patient information related to the consultations requested from the department of child and adolescent psychiatry by the clinics of emergency medicine, and other clinics in the Uludag University, Faculty of Medicine (UUFM) between January 2012 and January 2013 were retrospectively screened. Results: PAMHD consultations were requested from 0.48% of the cases in the UUFM who refer...
Early diagnosis of autism certainly stands as one of the most important determinants to ensure a better prognosis of the disorder, it is common that the screening programs to ensure this, end up not being implemented in health systems of many countries. This may stem from the disadvantages of classically suggested scale‐based screening (SBS) programs. This study presents a nationwide recognition and referral model for early diagnosis of autism spectrum disorders (ASD), in order to meet the obvious need for new methods. The model consists of interactive video‐based training (IVBAT) of health care workers (HCW), a system where family physicians (FPs) record five probable indicators of autism in their family medicine information system; and is therefore, a practical referral system in which the FP may refer a child with any suggestive finding to a child psychiatrist and may well continue to monitor recently diagnosed cases. The autism teams consist of trained child psychiatrists and coordinators, who delivered trainings to 29,612 FPs and 23,511 nurses countrywide. Of 98.8% FPs were trained throughout the country. Total of 1,863,096 children were reported to have a brief examination of autism signs in Family Medicine Units by trained FPs and nurses. A total of 55,314 (2.96%) these children were deemed at risk for ASD and were referred to child psychiatrists. In the evaluation of 55,314 children by child psychiatrists, 10,087 cases were diagnosed with developmental disorders, while 3226 of children at risk were diagnosed with autism. The results of this study, which reached to the largest sample to date, suggest that some other alternative methods, in addition to SBS should also be tested in order to screen ASD. Lay Summary In this study, a nationwide recognition and referral model for early identification of autism spectrum disorders (ASD) is presented. Scale‐based screening (SBS) is the most recommended model for autism, however, it is clear that most countries can not implement this model in their health system. The results of this study, which reached to the largest sample to date, suggest that SBS may not be the only me for screening ASD and that alternative methods should be tried, as there is an obvious need for exploratory approaches.
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