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Yıl:2015; Cilt: 5; Sayı: 4>> Özet
TAM METİN
Journal of Mood Disorders; 2015;5(4):173-178
İki Uçlu Mizaç Bozukluğu’nda dürtüsellik ve hastalığın başlangıç yaşı ile ilişkisi
G Çelikeloğlu, ŞV Buturak, HÖ Rezaki, A Güneş, OM Koçak, ŞB Nazlı
Kırıkkale Üniversitesi, Kırıkkale
Amaç: İki uçlu mizaç bozukluğu (İUMB) işlevsellik kaybına ve yeti yitimine neden olan ciddi bir hastalıktır. Plan yapmadan ve düşünmeden eyleme geçme olarak tanımlanan dürtüsellik duruma bağlı ve yapısal olarak iki bileşene ayrılmaktadır. Yapısal dürtüsellik hastalığın farklı evrelerinde sabit kalan bileşen olmakla birlikte, duruma bağlı (durumsal) dürtüsellik ise hastalığın evresine göre değişen parçadır. Bu çalışmada; dikkat eksikliği ve hiperaktivite bozukluğu etkisi kontrol altına alındığında dürtüselliğin İUMB olan hastalarda ötimik dönemde de normal popülasyona oranla daha sık görüldüğü hipotezini sınamak amaçlanmıştır. Yöntem: Çalışmaya toplam 53 İUMB tanısı alan hasta alınmıştır. Yaş ve cinsiyet eşleştirilerek daha önce ve halen herhangi bir psikiyatrik hastalık öyküsü olmayan 52 kişi kontrol grubu olarak çalışmaya dahil edilmiştir. Tanılar DSM-IV’e göre yapılandırılmış klinik görüşme kullanılarak deneyimli tek bir psikiyatrist tarafından konulmuştur. Hastaların sosyodemografik verileri ve hastalıkla ilişkili bilgilerin toplanması için SKİP-TÜRK formu kullanılmıştır. Hastalara Wender Utah Derecelendirme Ölçeği ve Barratt Dürtüsellik Ölçeği-11 uygulanmıştır. Bulgular: Hasta ve kontrol grubu arasında Wender Utah Derecelendirme Ölçeği kısa ölçeği ortalama puanları ve kesme puanını geçenlerin oranları arasında anlamlı fark saptanmamıştır. İUMB’de görülen dürtüselliğin yapısal olduğunu göstermenin amaçlandığı bu çalışmada, İUMB ötimik dönemde olan hastalarda total Barratt Dürtüsellik Ölçeği-11 puan ortalamasının kontrol grubuna oranla istatistiksel olarak anlamlı derecede daha yüksek olduğu saptanmıştır. Yine bu çalışmada hasta grubunda Barratt Dürtüsellik Ölçeği-11 total, plan yapamama, motor puanlarının hastalığın başlangıç yaşı ile ters yönde ilişkili olduğu saptanmıştır. Tartışma: İUMB’de sıklıkla eşlik eden Dikkat Eksikliği ve Hiperaktivite Bozukluğunda görülen dürtüselliğin etkisinin ortadan kaldırılarak incelendiği çalışmada bu sonuçlar İUMB’de dürtüselliğin ötimik dönemde de kontrol grubundan anlamlı derecede yüksek olduğunu göstermektedir. Hasta grubunda hem ötimik dönemde dürtüselliğin kontrol grubuna göre istatistiksel olarak daha yüksek çıkması hem de dürtüsellik düzeylerinin hastalığın başlangıç yaşı ile ters yönde ilişkili olduğunun saptanması dürtüselliğin İUMB’de durumsal olma durumuna ek olarak yapısal olduğunun bir göstergesi olabilir.
Impulsivity in euthymic bipolar disorder patients and relation with age at onset of the disorder
Objective: Bipolar disorder is a serious disease that causes loss of functionality and disability. Impulsivity, which has been defined as making plans and take action without thinking is divided into two components: state impulsivity and trait impulsivity. Although trait impulsivity is the component of impulsivity that remains constant at different episodes of the disorder, state impulsivity is the changing part due to the state of the disorder. In this study we aimed to test the hypothesis that the impulsivity is statistically higher in patients with bipolar disorders than normal controls when the impact of attention deficit hyperactivity disorder was controlled. Method: Fifty-three patients with bipolar disorder were taken to the study. Age and sex matched 52 individuals who had not any history of psychiatric illness lifetime included in the study as a control group. Diagnoses were confirmed by an experienced psychiatrist with using the Structured Clinical Interview for DSM-IV according to the DSM-IV -TR. SKIP-TURK form was used to collect socio demographic data and information associated with the illness. Wender Utah Rating Scale, Barratt Impulsiveness Scale Version 11 (BIS-11) was applied to the patients and the control group. Results: There was no significantly difference between the patients and control groups in terms of Wender Utah rating scales average scores and the ratio of the individuals who had higher scores from the cut-off point. This study, which aimed to show the impulsivity in bipolar disorder is trait, demonstrated that Barratt Impulsiveness Scale Version 11 score was significantly higher in euthymic bipolar disorder patients than the control group. The negative correlation was also found in this study between age at onset and attention, motor, non-planning subscale scores in Barratt Impulsiveness Scale-11. Discussion: Eliminating the effect of impulsivity seen in Attention Deficit Hyperactivity Disorder that often accompanies bipolar disorders, these results indicate that the impulsivity in euthymic bipolar disorder patients is significantly higher than the control group. Determination of the higher impulsivity in euthymic bipolar disorder patients than the control group and the negative correlation between the age at onset and impulsivity levels shows that the impulsivity in bipolar disorder has a trait component in addition to state.

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