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Yıl:2013; Cilt: 50; Sayı: 2>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2013;50(2):141-146
Panik Bozukluğu Olan Hastalarda Obsesif İnançlar
R Konkan, E Aydın, O Güçlü, Ö Şenormancı, MZ Sungur
Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim Araştırma Hastanesi, İstanbul
Amaç: Bilişsel modeller obsesif kompulsif bozukluk (OKB) gelişimi ve sürdürümünde obsesif inançların rolünü vurgulamaktadır. Ancak bazı çalışmalarda obsesif inançların OKB’ye özgül olmadıkları; genel olarak anksiyete bozuklukları ve depresyonun ortak bir özelliği olabileceği tartışılmaktadır. Bu çalışmalarda genellikle anksiyete bozuklukları ayrı ayrı çalışılmamış karışık örneklem olarak kullanılmıştır. Bu çalışmada sadece panik bozukluğundan oluşan örneklemde obsesif inançların araştırılması amaçlanmıştır. Yöntem: Panik bozukluğu olan 101 hasta ve 155 sağlıklı gönüllü çalışmaya alındı. Panik agorafobi ölçeği (PAÖ) kesme puanına göre ?11 ve ?12 puan alanlar olarak iki grup oluşturuldu. Her iki grup da kontrol grubu ile Obsesif İnanışlar Ölçeği–44 (OİÖ-44) ile obsesif inançlar açısından ve bunun yanı sıra depresyon, durumluk ve sürekli kaygı karıştırıcı etkileri kontrol edilerek karşılaştırıldı. Bulgular: OİÖ-44 toplam ile tüm alt ölçek puanları PAÖ puanı ?12 grupta; hem PAÖ puanı ?11 olan grup hem de kontrol grubundan yüksek bulundu agorafobi varlığı sadece ‘abartılmış sorumluluk/abartılmış tehdit’ alt ölçeği açısından anlamlı fark oluşturdu. Durumluk kaygı düzeyinin karıştırıcı etkisi kontrol edildiğinde OİÖ–44 tüm alt ölçeklerinde anlamlı fark korunurken sürekli kaygı ve depresyon karıştırıcı etkisi kontrol edildiğinde yalnızca ‘düşüncelere önem verme/düşünceleri kontrol etme alt ölçeği anlamlı olmayı sürdürdü. Sonuç: Sürekli kaygı ve depresyon OİÖ–44 ‘düşüncelere önem verme/düşünceleri kontrol etme’ alt ölçeği dışındaki tüm obsesif inançları etkilemektedir. Obsesif inançların OKB’ye özgü olmadığı, sürekli anksiyete ile depresyon gelişiminde ortak bir etken olabileceği düşünüldü. Diğer anksiyete bozuklukları ve depresyonda obsesif inançların araştırılmasının aydınlatıcı olabileceği düşünüldü.
Obsessive Beliefs in Panic Disorder Patients
Background: Cognitive models highlight the role of obsessive beliefs in the development of obsessive-compulsive disorder (OCD) and the prognosis. But some studies suggested that these beliefs are not specific to OCD; generally may be a common feature of anxiety disorders and depression. In these studies, anxiety disorders were not studied separately, but were used as mixed samples. This study aims to investigate obsessive beliefs only in patients with panic disorder. Method: In this study, we enrolled 101 patients who were diagnosed with panic disorder and 155 healthy volunteers. The patients were divided into two subgroups according to the cut-off point of the panic and agoraphobia scale (PAS) scores:, group 1 - with scores ?11 and group 2 - with scores ?12. Both subgroups and control group were compared for obsessive beliefs assessed with the Obsessive Beliefs Questionnaire-44 (OBQ-44) and also compared while evaluating the mixed effects of state-trait anxiety and depression. Results: Group 2 had higher total and subscale scores on OBQ-44 than group 1 and controls. Presence of agoraphobia made a statistically significant difference only for the “responsibility/threat estimation” subscale scores. When trait anxiety level was under control, significant difference was maintained for OBQ-44 subscales, while when state anxiety level and depression were under control, only “importance of thought/controlling thoughts” was statistically significant. Conclusion: Trait anxiety and depression affect all obsessive beliefs except for ‘importance of thought/controlling thoughts’ subscale of OBQ-44. We think that obsessive beliefs are not specific to OCD. Obsessive beliefs may have a common role in the development of trait anxiety and depression. We assume that further studies investigating obsessive beliefs in other anxiety disorders and depression might be enlightening.

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