Nörolojik Hastalıkları Olan Çocuk ve Ergenlerde Konsültasyon-Liyezon Psikiyatrisi
Özet
Bu bölümde sırasıyla Serebral Palsi, Serebrovasküler Olaylar, Baş Ağrısı, Katatoni, Pediatrik Akut Başlangıçlı Nöropsikiyatrik Sendrom, PANDAS, Otoimmün Ensefalitler başlıkları altında farklı nörolojik hastalık ve klinik tablolar için KLP uygulamaları ele alınmaktadır. Etiyoloji ve seyir açısından farklılıklara sahip olan bu durumların tümünde ortak olarak merkezi sinir sistemi etkilenmekte ve günlük işlevselliğin pek çok alanına yansıyan bilişsel, duygusal ve sosyal zorluklar görülebilmektedir. Bu açıdan nörolojik hastalıklarda psikososyal değerlendirme ve müdahaleler çocuk ve ergen psikiyatristleri için önemli bir çalışma alanıdır. Bununla birlikte nörolojik hastalıklarda psikiyarik tanı ve tedavi süreçlerini zorlaştıran iletişimsel kısıtlılıklar söz konusu olabilmektedir. Sıklıkla tedavinin hastanın zihinsel ve sosyal düzeyine göre uyarlanarak sunulması yararlı olmaktadır. İlaç tedavileri açısından vakaların bir kısmında eşlik eden epileptik nöbetler daha incelikli yaklaşım gerektirmektedir. Ancak tüm bunlardan önemlisi hastaların ve ailelerinin yaşadıkları sorunların bütüncül olarak ele alınarak sağlığın duygusal ve sosyal boyutlarının ihmal edilmemesidir.
This chapter discusses the applications of Consultation-Liaison Psychiatry (CLP) for various neurological diseases and clinical conditions under the headings of Cerebral Palsy, Cerebrovascular Events, Headaches, Catatonia, Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS), PANDAS, and Autoimmune Encephalitis. Despite differences in etiology and course, all these conditions share a common impact on the central nervous system, leading to cognitive, emotional, and social challenges that affect multiple areas of daily functioning. In this regard, psychosocial assessment and interventions in neurological diseases constitute a significant field of work for child and adolescent psychiatrists. However, communication limitations can complicate psychiatric diagnosis and treatment processes in neurological disorders. It is often beneficial to adapt treatment approaches according to the patient’s cognitive and social level. In terms of pharmacological treatments, co- occurring epileptic seizures, in some cases, require a more nuanced approach. Most importantly, the problems experienced by patients and their families should be addressed holistically, ensuring that the emotional and social dimensions of health are not overlooked.
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