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Yıl:2005; Cilt: 7; Sayı: 1>> Özet
Türkiye'de Psikiyatri; 2005;7(1):1-6
Alkol Bağımlıları ve Sosyal İçicilerin Sosyal Fobik Özellikler Açısından Karşılaştırılması
F Özdemir, MA Ersoy, B Kayahan
Ege Üniv. Tıp Fak Psikiyatri AD
etiyolojisinde sosyal anksiyete bozukluğunun önemli bir rol oynadığını düşündüren veriler giderek çoğalmaktadır. Bu çalışmanın amacı alkol bağımlıları ve sosyal içicilerin sosyal fobik özellikler açısından karşılaştırılmasıdır.
Yöntem: Bu araştırmada bir üniversite hastanesinin bağımlılık biriminde detoksifikasyon amacıyla yatan 31 alkol bağımlısı hastaya karşılık, alkolü bağımlılık düzeyinde içmeyip kendisini sosyal içici olarak tanımlayan 32 kişi kontrol grubu olarak alındı ve bu iki grup sosyal anksiyete düzeyleri açısından karşılaştırıldı.
Bulgular: Sosyal içicilerle alkol bağımlılarının sosyal anksiyete düzeyleri, Liebowitz Sosyal Fobi Ölçeği (LSFÖ) ile değerlendirildiğinde, iki grup arasında ortalama sosyal kaygı ve ortalama sosyal kaçınma puanlan açısından anlamlı farklılık saptanmadı. Her iki grubu Liebowitz ölçeğindeki her bir madde için tek tek karşılaştırarak, birbirinden ayırabilecek bir sosyal fobik özellik olup olmadığı araştırıldığında, alkol bağımlılarının sosyal içicilere göre 'dikkatleri üzerinde toplamak'tan daha fazla kaygı duymakta oldukları, 'çok iyi tanımadığı bir kişiyle telefonla konuşmak'tan ve 'satış elemanının yoğun baskısına karşı koymak'tan anlamlı olarak kaçındıkları saptandı.
Sonuç: Çalışmamızda sosyal fobi ve subklinik sosyal fobi ile' alkol bağımlılığı arasında bir ilişki saptanmamıştır.
The Comparison of Alcohol Dependents with Soical Drinkers in Terms of Social Phobic Features
Literature Review and Objective: Social anxiety disorder or social phobia is a quite common anxiety disorder which may have severe social or clinical complications. Social phobia is defined as anxiety expressed as feelings of shame or embarrassment and related physical symptoms and avoidance experienced in the presence of others. Alcohol and substance related disorders are found to be common comorbid conditions of anxiety disorders as well as social phobia. Alcohol is consumed in anxiety states as a self medication because it either actually alleviates anxiety or thought by the drinker to do so. Another hypothesis is that anxiety disorders develop as a result of long term and heavy alcohol and/or substance consumption. Social anxiety is recently heavily investigated and specific methods of treatment are developed. Thus studies about the social phobia - alcohol/substance comorbidity will be also very fruitful in managing alcohol/substance related disorders.
Method: Thirty one (93.5% male; 6.5% female) hospitalized patients from the Alcohol/Substance Treatment and Detoxification Unit of Ege University Medical Faculty Hospital (93.5% male; 6.5% female) are recruited for the study. Patients are taken after the acute detoxification is completed (after at least one week). Symptoms of alcohol dependency and social anxiety disorder are questioned using the DSM-IV criteria. Michigan Alcohol Screening Test (MAST) and Liebowitz Social Anxiety Scale (LSAS) are used in order to get the quantitative value for severity of alcohol dependency and social phobia, respectively. Thirty two subjects (81.2% male; 18.7% female) who drink alcohol socially but who are "normal" otherwise are taken as control group. Dependent and control group are compared statistically for socio demographic properties, MAST, and LSAS points.
Results: Mean ages of the patient and control group are found to be 43.45 (min=21, max=56; ss=8.07) and 36.13 [year]s (min=23, max=60, ss=8.972) respectively. Average MATT points of the patient group is 42.26 (min=22, max=97; ss: 15.035). Average MATT points of the control group is expectedly 4.13 (min= 0, max=14; ss=4.904). Three out of 31 (9.7%) alcoholics are diagnosed having social phobia. Thirteen had subclinic social phobic symptoms. LSAS points of alcoholics and social drinkers are 81.97 (min=48, max=146; ss: 23.357) and 77.57 (min= 54, max= 127; ss: 17.669) respectively. The difference is not statistically different. Anxiety and avoidance symptoms are compared separately, but not also found to be statistically different. MATT and LSAS points are investigated for a correlation, yieldirg -z significant result.
Conclusion: Prevalence of social phobia in alcoholics is not more than the prevalence found in epidemiologic studies in general poc Ja: c~ Even though there are minute differences between alcoholics and social drinkers in terms of social phobic symptoms, this study failec :z s~ c.-. any significant differences. Alcohol dependants in our sample are hospitalized, thus dependency level is quite high. This may have played role in the failure of finding meaningful relationship. On the other hand this study may show that social phobia itself plays only a minor role in severe alcohol dependency, and severe alcoholism is only possible in the presence of some other parameters, which were net included in this study.

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