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Yıl:1999; Cilt: 7; Sayı: 3>> Özet
Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi; 1999;7(3):206-214
Sosyal fobiye eşlik eden çekingen kişilik bozukluğu tedavisinde sertralinin etkinliği
L Sevinçok, H Kaynak, Ç Dereboy, F Dereboy
Adnan Menderes Üniversitesi, Aydın
Amaç: Bu çalışmadaki birincil amacımız Sosyal Fobi (SF) hastalarında eşlik eden çekingen kişilik bozukluğunun (ÇKB) sertralin tedavisine nasıl yanıt verdiğini araştırmaktır. Çalışmada demografik değişkenlerle, SF, ÇKB ve depresyon şiddeti yönünden tedaviye yanıt veren ve vermeyen hastalar arasındaki farklılıklar da incelenmiştir. SF ile ÇKB arasındaki tanısal ilişkinin bu bulgular ışığında tartışılması amaçlanmıştır. Yöntem: 29 SF'li hasta ÇKB'nun varlığı yönünden değerlendirilmiştir. ÇKB'nun eşlik ettiği 27 SF'li hastaya 8 haftalık sertralin tedavisi başlanmıştır. Flastalarm tedavi öncesi, 4. ve 8.hafta değerlendirmeleri Kısa Sosyal Fobi Ölçeği (KSFÖ) ve Hamilton Depresyon Değerlendirme Ölçeği (HDDÖ) ile yapılmıştır. DSM-III-R, SCID-II ile tedavi öncesi ve sonu ÇKB özellikleri değerlendirilmiştir. Bulgular: 29 SF hastasının 27'sinde (% 93.1) ÇKB eşlik etmektedir. Çalışmayı tamamlayan 21 hastanın % 47.6'sı (n=10) sertralin tedavisine olumlu yanıt vermiştir. Yanıt veren ve vermeyen grupların her ikisinde de tedavi sonunda KSFÖ toplam ve alt ölçek skorları ve HDDÖ skorlarında anlamlı bir azalma olmuştur. Yanıt veren grupta KSFÖ toplam, korku ve kaçınma alt ölçeği ve HDDÖ 8.hafta skorları yanıt vermeyen gruba göre anlamlı olarak düşüktür. Yanıt vermeyen grupta tedavi öncesi ÇKB ortalama tanı ölçütü sayısı yanıt veren gruba göre anlamlı ölçüdefazladır. Sonuç: Bulgularımız SF ve ÇKB'nun sıklıkla birarada bulunduğunu, ÇKB'nun da SF gibi farmakolojik tedaviye yanıt verebilen bir bozukluk olduğunu göstermektedir. Tedaviden önce ÇKB'nun şiddetli olduğu hastalarda tedaviye yanıtın daha az olduğu bulunmuştur.
The effîcacy of sertraline in the treatment of avoidant personality disorder comorbid with socialphobia
Objective: Our primary goal in this study was to inversitgate the efficacy of sertraline in avoidant personality disorder (APD) comorbid with social phobia (SP). It was also examined the differences between responders and non-responders in terms of several demographic variables, the severity of SP, APD and depression. We aimed to discuss the diagnostic relationship between SP and APD in the light of these findings. Method: 29 SP atients were assessed for the existence of APD. An eight weeks of sertalin treatment was administrated to 27 SP patients with APD. The pre-treatment, fourth and eighth week assessments of the patients were made by Brief Social Phobia Scale (BSPS) and Hamilton Depression Rating Scale (HDRS). The pre- and end-treatment APD assessments were performed through DSM-III-R, SCID-II. Results: APD coexists in 27 ofthe patients (93.1 "/<>). The 47.6 % of 21 patients who completed the study responded to sertralin treatment. There was a significant improvement in both responders and non-responders in BSPS total and subscale scores, and HDRS scores at the end of the treatment. Eighth week BPSP total, fear, avoidance subscale scores and HDRS scores were significantly less than non-responders. The average number of pretreatment APD criteria in non-responders was more likely than responder. Conclusion: Our findings demonstrate that SP and APD frequently coexist, and APD also responds to pharmacologic treatment as well SP does. The response to treatment is less favorable in patients with more severe pre-treatment APD.

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