Abstract
Amac: Konversiyon bozuklugu; psikolojik catismaya eslik eden, fiziksel bir bozuklugu dusundurecek bicimde bedensel islevsellikte kayiplarla giden, bir ya da daha fazla norolojik semptomla belirli bozukluk olarak tanimlanmaktadir. Bu calismanin amaci konversiyon bozuklugu tanisinin acil serviste ne kadar yer buldugu; hastalarin sosyodemografik ve klinik ozellikleri ve hekim tutum ve tedavi yaklasimlarini incelemekti. Gerec ve Yontem: Bu retrospektif, kesitsel calisma, 2. Basamak bir devlet hastanesinde gerceklestirilmistir. Etik kurul onayi sonrasinda, 1 Temmuz- 31 Aralik 2017 tarihleri arasinda, cesitli semptomlarla acil servise basvuran ve konversiyon bozuklugu tanisi alan 18 yas ustu hastalar, calismaya dahil edilmistir. Dislama kriterleri; 18 yas alti olmak, konversiyon bozuklugu disinda ek patoloji tespit edilmek, psikiyatri konsultasyonu olmamak ve sistemden verilerine ulasilamamak olarak belirlenmistir. p<0.05 degeri istatistiksel anlamli kabul edilmistir. Bulgular: Toplam 124 hasta calismaya dahil edildi. Hastalarin %71’I kadin ve %54.8’i bekar; %17.7’sinin komorbid hastaligi mevcuttu. Tum hastalarda hastane basvurusu oncesi bir stres maruziyeti mevcuttu. Hastalarin %50’si 23 yas altiydi. En sik basvuru sikayeti senkoptu. 93 hasta ambulans ile basvurmultu. %66.1 hastada daha onceden konversiyon oykusu mevcuttu. Hastalarin %61.3’unde herhangi bir tetkik gerekmemisti. Ortalama taburculuk suresi 135 dakikaydi. Hastaneye ambulansla basvuranlar ile ayaktan basvuranlar arasinda, ortalama taburculuk suresi acisindan istatistiksel anlamli bir fark mevcuttu. Sonuc: Konversiyon bozuklugunun; kadin cinsiyet ve genc yas grubunda daha sik goruldugu; en sik basvuru sikayetinin senkop oldugu; hastalarin buyuk kisminin daha once de benzer sikayetleri oldugu; hastalarin siklikla ambulans ile hastaneye basvuruyu tercih ettikleri; triaj koduna gore kirmizi kod alan hastalar ile hemen hemen ayni sureler icinde muayene edildikleri ve uzun saatler acil serviste kaldiklari sonuclarina ulasilmistir.
Highlights
It was detected that the conversion disorder was more commonly seen in female gender and young age group, the most common complaint of conversion disorder was syncope, most of the patients with conversion disorder had similar complaints before, patients with conversion disorder often preferred to transport to the hospital with ambulance, the patients who received the red code according to the triage code and patients with conversion disorder were examined in almost the same time period and the patients with conversion disorder stayed in emergency department for long hours
Conversion disorder is defined as a specific disorder that accompanies the psychological conflict, has one or more neurological symptoms and in which there is a loss of bodily functioning that would seem to a physical disturbance
Four types of conversion disorder are specified as type with motor symptoms, type with sensory symptoms, type with contractions and type with mixed presentation.Patients often admit to the emergency service due to the syncope and mutism complaints developing following a stressful situation
Summary
Conversion disorder is defined as a specific disorder that accompanies the psychological conflict, has one or more neurological symptoms and in which there is a loss of bodily functioning that would seem to a physical disturbance. If there is no organic cause, the patients should be consulted to psychiatrist by combining the stressor story and the disease.If it is considered that there is no organic disease and the diagnosis is thought to be psychiatric, the treatment is not urgent Psychiatric treatment of these patients is not performed in emergency departments.psychiatric emergency services performed with effective measures in a limited period of time, can provide minimize loss from the physical and psychological burden of the disease for the both patient and patient relatives as a result of fast and correct orientation of patients.A successful first aid will facilitate the patient's compliance with the subsequent treatments in addition to preventing the second emergency situation [2]
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