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Yıl:2013; Cilt: 26; Sayı: 4>> Özet
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2013;26(4):333-340
Ana bileşenler analizi ile panik bozukluğu alt tiplerinin değerlendirilmesi
R Konkan, O Senormanci, O Guclu, E Aydin, M Erkiran
Bakırköy Ruh ve Sinir Hastalıkları Hastanesi,İstanbul
Amaç: Panik bozukluğunun (PB) değişik alt tiplerinin olduğu ve farklı alt tiplerin belirlenmesinin tanı, tedavi ve sonlanım açısından önemli olduğu ileri sürülmektedir. PB’nin psikopatolojisinin kantitatif değerlendirilmesi konusundaki çalışmalar azdır. Çalışmamızda, panik atak belirtilerinin faktör analizine dayanan alt tiplerinin belirlenmesi amaçlanmıştır. Yöntem: Çalışmamız, Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi ikinci basamak polikliniklerine başvuran ve çalışmaya dahil edilme ölçütlerini karşılayan 159 hasta üzerinde gerçekleştirildi. Çalışmada, araştırıcılar tarafından hazırlanan sosyodemografik bilgi formu, DSM-IV Eksen I Bozukluklar İçin Yapılandırılmış Klinik Görüşme Formu (SCID-I), Panik Agorafobi Ölçeği (PAÖ), Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Beck Anksiyete Ölçeği (BAÖ) kullanıldı. DSM IV-TR panik atak tanı ölçütlerinde bulunan 13 maddeye, “felç olma korkusu” ile “kaçma isteği, yerinde duramama hali”nin eklenmesiyle toplam 15 maddeden oluşan değişkenlere, katılımcıların son panik ataklarında yaşadıklarını bildirdikleri belirtilere göre Ana Bileşenler Analizi uygulandı. Bulgular: Ana Bileşenler Analizinde toplam varyansın %56’sını açıklayan 6 ayrık faktör kümesi elde edildi. Birinci küme otonomik aktivasyon kümesi, ikinci küme vestibüler belirtiler, üçüncü küme kardiovasküler belirtiler, dördüncü küme psödonörolojik belirtiler, beşinci küme solunum sistemi belirtileri ve altıncı küme ölüm korkusu kümesi olarak adlandırıldı. Sonuç: Çalışmamızda elde edilen belirti profilleri DSM-IV-TR tanı ölçütlerini desteklemektedir. Ana Bileşenler Analizinde, varyansın önemli bir kısmını açıklayan anlamlı alt tipler oluşmuştur. Anahtar kelimeler: Panik atak semptomları, panik bozukluğu, ana bileşenler analizi ile alt tipler
Evaluating the subtypes of panic disorder by using principal component analysis
Objective: Panic disorder is put forward to have a heterogeneous structure and multiple subtypes. Evaluating the different subtypes is important for diagnosis, treatment and prognosis. Studies about the quantitative psychopathology assessment are so rare. We aim to determine the subtypes with principal component analysis of panic attack symptoms. Method: 159 outpatients with panic disorder who had referred to the anxiety disorder outpatient unit in Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery were included in the study. A sociodemographic questionnaire that was prepared by the investigators, The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Panic and Agoraphobia Scale (PAS), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAI) were used in the study. Variables with 15 items were created adding ‘Fear of stroke’ and ‘desire to escape, restlessness’. Principal Component Analysis was applied according to the panic symptoms that the patiens declared. Results: Six loading factors were obtained explaning 56% of total variance in Principal Component Analysis. The first set was named autonomic activation, the second was vestibular symptoms, the third was cardiovascular symptoms, the fourth was pseudoneurologic symptoms, the fifth was respiratory system symptoms and the sixth was fear of death. Conclusion: Symptom profiles in our study were compatible with DSM-IV-TR diagnostic criteria. Significant panic disorder subtypes were found in principal component analysis. Key words: Panic attack symptoms, panic disorder, subtypes by symptoms principal component analysis

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