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Yıl:2014; Cilt: 4; Sayı: 1>> Özet
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Güncel Psikiyatri ve Psikonörofarmakoloji; 2014;4(1):5-11
Bir Eğitim Hastanesi Psikiyatri Polikliniğine Başvuran Şizofrenili Hastalarda Eştanılı Ruhsal Bozukluklar
FH Çelik, H Güveli, B Bahçeci, G Kandemir, A Köroğlu, Ç Hocaoğlu
Recep Tayyip Erdoğan Üniversitesi, Rize
Amaç: Bu çalışmanın amacı şizofrenili hastalarda eşlik eden psikiyatrik bozuklukları saptayarak literatür bilgileri eşliğinde tartışmaktır. Yöntem: 101 ayaktan takip edilen şizofrenili hasta çalışmaya alındı. Hastalara araştırmacılar tarafından hazırlanan, hastanın sosyodemografik özelliklerinin ve hastalığı ile ilgili bilgilerin yer aldığı sosyodemografik veri formu, DSM-IV Eksen 1 tanı ölçütlerine göre hazırlanmış yapılandırılmış bir klinik görüşme formu olan SCID-1( Structured Clinical Interview for DSM –IV Axis I Disorders) ve Pozitif ve Negatif Belirtileri Değerlendirme Ölçeği (PBDÖ, NBDÖ) uygulandı. Bulgular: Çalışmaya dahil edilen olguların %37.6 kadın, %62.4 erkek ortalama yaş 39+10.2 idi. Hasta grubunun 19-62 arasında yaş dağılımı gösterdiği, medeni durum dağılımı açısından değerlendirildiğinde; bekar olanların sayısının (% 61.4) ile çoğunlukta olduğu, eğitim yılı açısından değerlendirildiğinde, ilköğrenim mezunu ya da ilköğrenimi tamamlayamamış hasta sayısının % 53.5 ile çoğunlukta olduğu görülmüştür. Olguların %72.2 (n=73)’sinde herhangi bir eş tanılı ruhsal bozukluk saptanmaz iken, %15.8(n=16)’ inde depresif bozukluk, %0.1 (n=1) ’inde panik bozukluğu, %12.8 (n=13)’ inde obsesif kompulsif bozukluk, %0.1 (n=1)’inde agorafobi, %0.1 (n=1)’ inde özgül fobi ve %0.1(n=1)’inde distimik bozukluk saptanmıştır. Eştanı olarak depresif bozukluk saptanan olguların NBDÖ puanı ortalaması 47.76 ± 25.09 iken, PBDÖ puan ortalaması 35.71 ± 23.06 olarak belirlenmiştir. Sonuç: Çalışmamızda şizofrenili hastalarda saptanan eştanı oranı mevcut literatür sonuçlarına göre daha düşüktür. Ancak, literatürle uyumlu olarak depresif bozukluk eş tanısı alan şizofrenili hastaların NBDÖ puan ortalaması daha yüksek olarak saptanmıştır. Bu konuda yapılacak geniş örneklemli çalışmalar ve oluşturulacak tedavi protokolleri şizofrenili hastaların daha iyi hastalık seyri ve belirtilerin kontrolü ile ilaç uyumu ve yaşam kalitesinin artmasına da katkı sağlayabilir.
The Comorbidity of Psychiatric Disorders in Patients with Schizophrenia who Applicate a Teaching Hospital Psychiatric Outpatient Clinics
Objective: The aim of this study is discussing with literature by determining comorbid psychiatric disorders in in patients with schizophrenia. Method: A hundred one patients with schizophrenia were included in this study. A sociodemographic data form with information about the patients' sociodemographic characterstics and the information about the disease which was prepared by the reserchers, a structured clinical interview form SCID-1( Structured Clinical Interview for DSM –IV Axis I Disorders) which was prepared according to the diagnostic of DSM-IV Axis 1 and scale for the assessment of the negative symptoms (SANS) and of the positive symptoms (SAPS) were applied. Results: 37.6% of the patients included in the study were female, 62.4% male, mean age was 39 + 2.10. The patient group was showed 19-62 age distribution. In terms of the distribution of marital status, single was majority with 61.4 %; in terms of education, the primary school graduates or unable to complete primary education were majortiy with 53.5% were seen. 72.2 % (n=73) of the cases were observed any comorbid mental disorder, whereas 15.8% (n=16) with comorbid depressive disorder, 0.1% (n=1) with comorbid panic disorder, 12.8% (n=13) with comorbid obsessive compulsive disorder, 0.1% (n=1) with comorbid agarophobia, 0.1% (n=1) with comorbid spesific phobia and 0.1% (n=1) with comorbid dysthymic disorder were determined. In the patients with depressive disorder comorbidity, the mean of the SANS score was 47.76 ± 25.09,whereas the mean of the SAPS score was 35.71 ± 23.06. Conclusions: In our study the Axis 1 comorbidity in patients with schizophrenia is lower than the existing literature. However, in accordance with the literature in the patients with schizophrenia who had comorbid depressive disorder, the SANS mean score was higher. Large sample studies on this subject and created treatment protocols with better control of the disease course and symptoms in schizophrenic patients may also contribute to an increase in medication adherence and quality of life.

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