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Yıl:2015; Cilt: 5; Sayı: 1>> Özet
TAM METİN
Journal of Mood Disorders; 2015;5(1):31-35
Amotivasyonel sendrom: Az bilinen ve tanı konulan bir klinik
M Arı, M Şahpolat, MH Kokaçya, ÜS Çöpoğlu
Mustafa Kemal Üniversitesi, Hatay
Amotivasyonel sendrom (AS) süreğen esrar kullananlarda tanımlanmış geniş anlamıyla ilgisizlik, vurdumduymazlık ve asosyal davranışı içermektedir. Bu etkilerin bir kısmı genel olarak diğer santral sinir sistemi baskılayıcılarında da görülmektedir, bundan dolayı bu sendromu esrar kullanımına özgülemenin ne kadar doğru olduğu hala tartışılmaktadır. AS genellikle ergenlik çağında ve erkeklerde görülmektedir. Farklı çalışmalarda AS görülme sıklığı olarak düzenli esrar kullananlarda %16 ve %21 gibi oranlar bildirilmiştir. Patofizyolojisinde rol oynayan nedenler hala tartışmalı olmakla birlikte etiyolojide en sık suçlanan etmen esrardır. Nörobiyolojisinde noradrenerjik ve dopaminerjik sistemleri içeren limbik yolakta meydana gelen değişiklikler suçlanmaktadır. Tanısı öznel yakınmalara dayanır, tanı klinik belirtiler ve Apati Değerlendirme Ölçeği (ADÖ) kullanılarak konmaktadır. AS tedavisi konusunda günümüzde çok az deneysel veriler mevcuttur ve klinik deneyim de oldukça azdır. Aralık 2013’te seçilen ‘amotivational syndrome, cannabis and amotivational syndrome, cannabis and motivation’ anahtar sözcükleriyle yapılan PUBMED taraması sonucunda 1960’dan beri yayınlanan, esrar ve AS ilişkisini inceleyen çalışmalar gözden geçirilmiştir. Bu yöntem sonunda 76 tanesi direkt AS ile ilişki olmak üzere 536 makaleye ulaşılmıştır. İngilizce olmayan makaleler değerlendirme dışı bırakılmıştır.
Amotivational syndrome: less known and diagnosed as a clinical 
Amotivational syndrome (AS) is a disorder that includes apathy, callousness and antisocial behavior in chronic cannabis users. Some of these effects may generally be seen in other central nervous system depressants as well. Therefore, to make these effects specific for this syndrome is still debated. AS is usually seen among men during puberty. In different studies, the incidence of AS in regular cannabis users has been reported as between 16 to 21%. Although the causes accused in pathophysiology is still controversial, cannabis is the most commonly accused factor in the etiology. In neurobiology of the disease, noradrenergic and dopaminergic systems containing changes in limbic road have been blamed. The diagnosis is based on subjective complaints, and scored by clinical signs and Apathy Evaluation Scale (AES). There are very few experimental data available in treatment of AS, and clinical experience is very limited. By PubMed searching the keywords of ‘amotivational syndrome, cannabis and amotivational syndrome, cannabis and motivation’ from 1960 to December 2013, the published studies examining the relationship between marijuana and AS have been reviewed. We have reached 536 articles, of which 76 include direct relationship with AS, by the end of this search. Non-English articles were excluded from the study.

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