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Yıl:2014; Cilt: 27; Sayı: 3>> Özet
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Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2014;27(3):233-241
Alkol bağımlılığında obsesif kompulsif bozukluk ve dürtü kontrol bozukluğu ek tanısı ile dürtüsellik, kompülsivitenin değerlendirilmesi
BB Güngör, R Aşkın, İ Taymur, S Sarı
Şevket Yılmaz Eğitim ve Araştırma Hastanesi, Bursa
Amaç: Bu çalışmada alkol bağımlısı bireylerde dürtü kontrol bozuklukları ve obsesif kompulsif bozukluk ek tanıları araştırılmış; aynı zamanda dürtüsellik ve kompülsivitenin alkol bağımlılığı şiddeti ile ilişkisi değerlendirilmiştir. Yöntem: Çalışmamızda alkol bağımlılığı tanısı alan 81 erkek hastada SCID-I ile dürtü kontrol bozukluğu (DKB) ve obsesif kompulsif bozukluk (OKB) tanıları araştırıldı. Barratt İmpulsivite Ölçeği (BIS-11) ile dürtüsellik, Maudsley Obsesif Kompulsif Soru Listesi (MOKSL) ile kompülsivite, Michigan Alkolizm Tarama Testi (MATT) ile alkolizm şiddeti değerlendirildi. Bulgular: Alkol bağımlısı bireylerin %24.6’sında en az bir DKB ek tanısı saptandı. En sık rastladığımız alttipi %16.0’lık oranla patolojik kumar oynama olurken, ikinci sıklıkta %6.1 oranıyla aralıklı patlayıcı bozukluk, üçüncü sırada %3.7 sıklıkta bulunan kompulsif alışveriş idi. Hastaların %13.5’i OKB tanısı alırken, %19.8’inde subklinik düzeyde OKB saptandı. Hastaların %46.9’undü ‘obsesif kompulsif özellik’ ya da DKB’den herhangi biri ya da her ikisi birden bulunmaktaydı. Sonuç: Alkol bağımlılarında dürtüsellik ve kompülsivitenin ölçeklerle değerlendirilmesinin yanında OKB ve DKB ek tanıları da araştırıldı. BTA dürtü kontrol bozuklukları da eklendiğinde alkol bağımlılarının %24.6’sında en az bir DKB ve %13.5’inde OKB ek tanısı eşlik etmekteydi
Obsessive compulsive disorder and impulse control disorder comorbidity and evaluation of impulsivity and compulsivity in alcohol dependent patients
Objective: The aim of this study was to investigate the comorbidity of obsessive compulsive disorder and impulse control disorders in patients with alcoholism and evaluate the effects of impulsivity and compulsivity on the severity of alcohol dependence. Methods: Using SCID-I, we investigated impulse control disorder (ICD) and obsessive compulsive disorder (OCD) in 81 male patients diagnosed with alcohol dependence. Impulsivity was evaluated using the Barratt Impulsiveness Scale (BIS-11). The Maudsley Obsessive Compulsive Inventory (MOCI) and the Michigan Alcoholism Screening Test (MAST) were used to evaluate compulsivity and severity of alcohol dependence, respectively. Results: There was at least one ICD in 24.6% of the alcohol dependent patients. The most commonly encountered subtype was pathological gambling (16.0%) which was followed by intermittent explosive disorder (6.1%) and compulsive shopping (3.7%). 13.5% of the patients were diagnosed with OCD while OCD at a subclinical level was found in 19.8% of them. 46.9% of the patients presented either with “obsessive compulsive traits” or ICD or both. Conclusion: In addition to the evaluation of impulsivity and compulsivity with using scales, OCD and ICD comorbidity was investigated in alcohol dependent patients. Together with the not otherwise specified impulse control disorders, at least one ICD was found in 24.6% of the addicts while 13.5% presented with OCD comorbidity.

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