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Yıl:2012; Cilt: 1; Sayı: 1>> Özet
TAM METİN
NPAkademi; 2012;1(1):16-22
Türkiye'de bir dermatoloji kliniğinde obsesif kompulsif bozukluk ve diğer I. eksen bozukluklarının fenomenolojisi ve yaygınlığı
BÖ Ünsalver, M Özmen, Ö Tecer, E Aydemir
Üsküdar Üniv., İstanbul
Amaç: Geçmiş çalışmalarda birçok obsesif kompulsif bozukluk (OKB) hastasının dermatoloji kliniklerine başvurduğu bildirilmiştir. Çalışmamızdaki amaçlarımız, bir dermatoloji ayaktan tedavi birimine başvuran hastalar arasında OKB ve diğer DSM-IV I. eksen bozukluklarının yaygınlığını ölçmek, dermatolojik hastalıklar ve OKB arasındaki olası ilişkiyi belirlemek ve bu popülasyondaki OKB alt grubunun klinik ve fenomenolojik özelliklerini belirlemekti. Yöntem: Çalışma, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Dermatoloji Polikliniği’nde yürütülmüştür. Rastgele dağılımı sağlamak amacıyla, çalışmanın yapıldığı dönem boyunca dermatoloji polikliniğine ilk defa başvuran beş hastadan biri çalışmaya alındı. Psikiyatrik değerlendirmede, DSM-IV I. Eksen Bozuklukları için Yapılandırılmış Klinik Görüşme (SCID-I), Yale-Brown Obsesif Kompulsif Belirtiler Ölçeği (Y-BOKÖ) ve Olgu Bildirim Formu kullanıldı. İstatistiksel analizler Sosyal Bilimler için İstatistik Paket (Windows için SPSS, 11.5. sürüm, Chicago, IL, ABD) ile yapıldı. Karşılaştırmalarda, tanımlayıcı istatistik, ki-kare testi ve Kruskal-Wallis testiyle ANOVA uygulandı. Bulgular %95 güvenilirlik aralığında yorumlandı ve p<0.05 olarak belirlendi. Bulgular: Doksan dokuz hastadan 21’ine (%21.2) OKB tanısı, 34’üne (%34.3) diğer psikiyatrik bozukluk tanıları kondu. Kırk dört hastada (%44.4) hiçbir psikopatoloji saptanmadı. Dermatolojik hastalık süresi bir yıldan uzun olanlarda OKB tanısı anlamlı olarak daha yüksekti. En sık görülen obsesyonlar sırasıyla bulaşma (%63.6), düzenleme (%22.7) ve simetriydi (%18.1). En sık görülen kompulsiyonlar ise, sırasıyla temizlik/yıkama (%63.6), kontrol etme (%40.9) ve saymaydı (%31.8). Psiko-kütanöz hastalıklar ve egzemanın OKB ile ilişkili olduğu bulundu. Sonuç: OKB ve diğer I. eksen bozukluklarının prevalansının, özellikle psiko-kütanöz hastalıklar ve egzema hastalarında daha belirgin olmak üzere, dermatoloji hastaları arasında yüksek olduğunu bulduk. Türkiye’de dermatoloji ve psikiyatri arasında yakın işbirliği kurulmasını öneririz.
Phenomenology and prevalence of obsessive compulsive and other axis I disorders in a Turkish dermatology clinic
Background: Previous studies report that many obsessive compulsive disorder (OCD) patients seek help especially from dermatology clinics. The aims of the present study were: to determine the prevalence of OCD and other DSM-IV Axis I disorders among patients attending an outpatient clinic of dermatology, to identify any possible relationship between dermatological diseases and OCD, to determine the clinical and phenomenological features of the OCD subgroup in this population. Methods: The study was conducted in the Dermatology Outpatient Clinic of Istanbul University, Cerrahpasa Medical Faculty. To achieve randomization, every fifth patient applying for the first time within the denoted period was included. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Yale-Brown Obsessive Compulsive Symptoms Scale (Y-BOCS), and a Case Report (CRF) were used for psychiatric evaluation. The Statistical Package for Social Sciences (SPSS for Windows, Version 11.5, Chicago, IL., USA) was used for statistical analyses. Descriptive statistics, chi-square test and One-way Analysis of Variance (ANOVA, via Kruskal-Wallis test) were used for comparisons. The results were interpreted within a confidence interval (CI) of 95 % and p was set at 0.05. Results: Among 99 patients 21 (21.2%) were diagnosed as having OCD and 34 were (34.3%) found to have other mental disorders whereas 44 (44.4%) had no psychopathology. OCD was found to be significantly commoner among those who had disease more than a year. The most common obsession was found to be contamination (63.6%), ordering (22.7%) and symmetry (18.1%). Most frequent compulsions were found to be Washing/ Cleaning (63.6%), checking (40.9%) and counting (31.8%). Psycho-cutenous disorders and eczema were found to be related with OCD. Conclusion: We have found increased prevalences of both OCD and other axis I disorders among dermatology patients, especially those with psycho-cutenous reactions and eczema and we argue that a closer cooperation among dermatology and psychiatry is needed also in Turkey.

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