Endokrinolojik Hastalıkları Olan Çocuk ve Ergenlerde Konsültasyon-Liyezon Psikiyatrisi-2
Özet
Tip 1 Diyabet çocuklarda ömür boyu takip gerektirmesi sebebi ile tanı sonrasında zorluklar yaşanması beklenen bir durumdur. Bu dönemde yaşanan uyum problemleri, ilerleyen süreçte tedaviye uyumda güçlük yaşanma riskini artırabilir. Çocuklara ve ebeveynlere sağlanacak psikososyal desteğin, hem hastalığın yönetiminde hem de gelecekte ortaya çıkabilecek psikiyatrik sorunların önlenmesinde önemli bir rol oynayabileceği düşünülmektedir.Tip 2 Diyabet tanısı almış çocuk ve ergenlerde psikolojik iyi oluşun sağlanamaması, fizyolojik mekanizmalar üzerinden glisemik kontrolü olumsuz etkileyebilir. Bu nedenle, çocuk ve ergen psikiyatristlerine erişimin kolay olması gerekmektedir. Tanı sonrası, pediatristlerin yönlendirmesi veya bireyin kendi talebi doğrultusunda psikiyatrik değerlendirmeye alınması, psikiyatrik bozuklukların erken tespit edilmesine ve gerekli müdahalelerin zamanında yapılmasına yardımcı olacaktır. Özellikle çocuk ve ergenlerde yaygın olarak kullanılan ikinci kuşak antipsikotik ilaçların metabolik etkileri göz önünde bulundurulmalı ve bu ilaçları kullanan bireylerin metabolik parametreleri düzenli olarak izlenmelidir. Obezitesi olan çocuklarda, depresyon, anksiyete ve davranışsal problemler gibi psikiyatrik bozuklukların eşlik edebileceği bilinmektedir. Sinirlilik, kaygı, huzursuzluk, beden imgesiyle ilgili memnuniyetsizlik, depresif belirtiler, sağlıksız beslenme alışkanlıkları, aile içi çatışmalar gibi faktörler uyarıcı işaretler obezitesi olan çocuklarda kırmızı bayraklar olarak kabul edilmeli ve gerekli vakaların çocuk ve ergen psikiyatristleri tarafından detaylı değerlendirilmesi sağlanmalıdır.
Type 1 Diabetes requires lifelong monitoring in children, making it expected for difficulties to arise following diagnosis. Adaptation problems during this period may increase the risk of future non- adherence to treatment. Providing psychosocial support to both children and parents is considered essential for effective disease management and the prevention of future psychiatric issues. In children and adolescents diagnosed with Type 2 Diabetes, failure to achieve psychological well-being can negatively affect glycemic control through physiological mechanisms. Therefore, ensuring easy access to child and adolescent psychiatrists is crucial. After diagnosis, referrals from pediatricians or voluntary psychiatric evaluations can facilitate early detection of psychiatric disorders and timely interventions. Particular attention should be given to the metabolic effects of second-generation antipsychotic medications, which are commonly used in children and adolescents. The metabolic parameters of individuals taking these medications should be regularly monitored. It is well known that obesity in children is often accompanied by psychiatric disorders such as depression, anxiety, and behavioral problems. Symptoms such as irritability, anxiety, restlessness, dissatisfaction with body image, depressive symptoms, unhealthy eating habits, family conflicts should be recognized as red flags in children with obesity. These cases should be referred to child and adolescent psychiatrists for a comprehensive evaluation and appropriate intervention.
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