Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Sivas Cumhuriyet Üniversitesi Tıp Fakültesi Adli Tıp Polikliniğine Başvuran Travma Olgularında Depresyon, Anksiyete ve Stres Düzeylerinin Değerlendirilmesi: Tanımlayıcı Çalışma
The Evaluation of the Depression, Anxiety and Stress Levels in Trauma Cases Admitted to Sivas Cumhuriyet University Medicine Faculty Forensic Medicine Polyclinic: A Descriptive Study
Muhsin Gürkan GÜRSOYa , Ali YILDIRIMb , Fatma YÜCEL BEYAZTAŞb , Yavuz YILMAZc
aAdli Tıp Kurumu, Van Adli Tıp Grup Başkanlığı, Van, Türkiye
bSivas Cumhuriyet Üniversitesi Tıp Fakültesi, Adli Tıp AD, Sivas, Türkiye
cSivas Cumhuriyet Üniversitesi Tıp Fakültesi, Ruh Sağlığı ve Hastalıkları AD, Sivas, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2024;21(3):129-38
doi: 10.5336/forensic.2024-103599
Article Language: TR
Full Text
ÖZET
 Amaç: Adli tıp polikliniğine başvuran travma mağdurlarının adli olaya ilişkin verilerinin araştırılması, bu olguların adli tıbbi değerlendirmelerinde ruhsal etkilenim düzeylerinin tespit edilmesi ve psikiyatrik bulguların belirlenmesinde çalışılan belirti ölçeklerinin adli tıp pratiğinde de kullanılabilirliğinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmada, Sivas Cumhuriyet Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulundan alınan izin ile adli tıp polikliniğine adli makamlar tarafından 01/10/2022-31/01/2023 tarihleri arasında adli rapor temini için yönlendirilen ve çalışmaya katılmayı kabul eden kişilere psikometrik ölçekler (Depresyon-Anksiyete-Stres Ölçeği, Klinisyen Tarafından Uygulanan Travma Sonrası Stres Bozukluğu Ölçeği) uygulanmıştır. Olguların sosyodemografik verileri, adli olayla ilgili özellikleri, Türk Ceza Kanunu'na göre yaralanmalarının ağırlıkları ve adli raporları incelenerek analiz edilmiştir. Bulgular: Çalışmamızda 70'i (%75,3) erkek olmak üzere 93 katılımcı yer almıştır. Kadın cinsiyet ve yaşamsal tehlikeye neden olan düzeyde yaralanmanın olması ile anksiyete arasında (p=0,001, p=0,049), birden fazla anatomik bölgede yaralanmanın olması ile depresyon arasında (p=0,020), birden fazla anatomik bölgede veya yaşamsal tehlikeye neden olan düzeyde yaralanmanın olması ile stres düzeyi arasında (p=0,033, p=0,006), yaşamsal tehlikeye neden olan düzeyde yaralanmaya maruziyet ile travma sonrası stres bozukluğu (TSSB) arasında (p=0,001) istatistiksel olarak anlamlı ilişki bulunmuştur. Kadın katılımcıların anksiyete, depresyon ve TSSB ölçeklerinden aldıkları puan ortancaları, erkek katılımcılara göre istatistiksel olarak anlamlı şekilde daha yüksek tespit edilmiştir (p=0,003, p=0,047, p=0,019). Sonuç: Yaralanmanın bireyler üzerinde fiziksel etkilerinin yanı sıra ruhsal etkilerinin de göz ardı edilmemesi en temel insan haklarının gereğidir. Bu amaçla bireylerde fiziksel ve ruhsal etkilerinin olduğu travma gibi durumlarda adli tıbbi değerlendirme yapılırken ruhsal travma bulgularının tespit edilmesinde kullanılan psikometrik ölçeklerin, adli tıp pratiğinde kullanılabilirlik açısından faydalı olacağı kanaatine varılmıştır.

Anahtar Kelimeler: Adli travmatoloji; ruhsal travma; travma sonrası stres bozukluğu; depresyon; anksiyete
ABSTRACT
 Objective: It was aimed to investigate the data of trauma victims admitted to the forensic medicine outpatient clinic regarding the forensic event, to determine the level of psychological effects in forensic medical evaluations of these cases and to evaluate the usability of the symptom scales used in the determination of psychiatric problems in forensic medicine practice. Material and Methods: In this study, with the permission of Sivas Cumhuriyet University Non-Interventional Clinical Research Ethics Committee, psychometric scales (Depression Anxiety Stress Scale-21, Clinican-Administered PTSD Scale for DSM-5) were applied to the people who were referred to the forensic medicine outpatient clinic by the judicial authorities between 01/10/2022- 31/01/2023 for obtaining forensic reports and who agreed to participate in the study. Sociodemographic data, characteristics related to the forensic incident, severity of injuries according to the Turkish Penal Code and forensic reports of the cases were analyzed. Results: Our study included 93 participants, 70 of whom were male (75.3%). A statistically significant relationship was found between female gender and having a lifethreatening injury and anxiety (p=0.001, p=0.049), between having an injury in more than one anatomical region and depression (p=0.020), between having an injury in more than one anatomical region or life-threatening injury and stress level (p=0.033, p=0.006), and between exposure to life-threatening injury and post-traumatic stress disorder (PTSD) (p=0.001). The median scores of female participants on anxiety, depression and PTSD scales were statistically significantly higher than male participants (p=0.003, p=0.047, p=0.019). Conclusion: In addition to the physical effects of injury on individuals, it is a requirement of the most basic human rights that the mental effects should not be ignored. For this purpose, it has been concluded that psychometric scales used in the detection of psychological trauma findings during forensic medical evaluation in cases such as trauma with physical and psychological effects on individuals will be useful in terms of usability in forensic medicine practice.

Keywords: Forensic traumatology; psychological trauma; post-traumatic stress disorder; depression; anxiety
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