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Yıl:2016; Cilt: 27; Sayı: 3>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2016;27(3):151-160
Sinop İlinde Tanımlı Bir Alanda Şizofreni, Şizoafektif Bozukluk ve Bipolar I Bozukluğun Başvuru Temelli Yaygınlığı
T Binbay, D Arık Binbay, H Ulaş, Kl Alptekin
Dokuz Eylül Üniversitesi, İzmir
Amaç: Tanımlı bir alanda sağlık kayıtlarına dayalı olarak şizofreni, şizoafektif ve bipolar I (BPI) bozukluk yaygınlıklarını saptamak amaçlanmıştır. Yöntem: 2009-2011 arasında Sinop ilinde tanımlı bir alandaki birinci ve ikinci basamak sağlık kuruluşları kayıtlarına ICD-10 sistemine göre F06.1, F06.2, F10.5, F12.5, F19.5, F20-29, F30-31, F32.3, F33.3, F39 tanılarıyla geçen hastalar olası psikotik bozukluk olgusu olarak dâhil edilmiştir. Son tanıları DSM-IV tanı sistemine göre yapılandırılmış görüşme, telefon görüşmesi ya da en olası tanı yöntemiyle elde edilmiştir. Bulgular: Kayıtlarda tanımlı alanda yaşayan 15-64 yaş arası 1410 olası psikotik bozukluk olgusu saptanmıştır. Olası olguların %66,8’ine (s: 955) tanısal görüşme, diğerlerine ise telefon görüşmesi ya da en olası tanı yöntemi uygulanmıştır. Tanımlı alanda (15-64 yaş nüfusu 73.503) 727 kişiye psikotik belirtili bozukluk tanısı konmuştur. Buna göre psikotik belirtili herhangi bir DSM-IV bozukluk yaygınlığı 1000 kişide 9,8 (%95 güven aralığı [GA]: 8,2-11,5), şizofreni yaygınlığı 3,6 (%95 GA: 3,0-4,2), şizoafektif bozukluk yaygınlığı 1,1 (%95 GA: 0,8-1,4) ve BPI bozukluk yaygınlığı 2,7 (%95 GA: 2,0-3,3) ve psikotik bulgulu depresyon yaygınlığı 1000 kişide 1,0 (%95 GA: 0,6-1,3) olarak saptanmıştır. Sonuç: Her 1000 erişkinden 10’u birinci ve ikinci basamak sağlık hizmetlerine psikotik belirtili bir bozukluk için başvurmaktadır. Kayıtlara dayalı yaygınlıklar yaşamboyu yaygınlıklara göre daha düşük olmakla birlikte geniş kapsamlı kayıtlar hizmetlerin bu yaygınlıklara göre planlanmasını sağlayabilir.
Admission-Based Prevalence of Schizophrenia, Schizoaffective Disorder and Bipolar I Disorder in a Catchment Area in Sinop, Turkey
Objective: To provide registry-based prevalence estimates of schizophrenia, schizoaffective, and bipolar I (BPI) disorders in a defined area of Sinop, Turkey. Material and Methods: All patients that presented to primary and secondary health services over three year time (2009-2011) with diagnosis of psychotic disorder (F06.1, F06.2, F10.5, F12.5, F19.5, F20-29, F30-31, F32.3, F33.3, F39 in ICD-10) covering a population of 73,503 aged 15-64 were included via case registry systems. All accessed case records were pooled. Case ascertainment and diagnostic assessment were achieved through structured clinical interview for DSM-IV, phone interview, or farming a best-estimated diagnosis via records on registers. Results: Registries provided 1,410 probable cases. The successful clinical reappraisal rate was 66.8% (n: 955) while, the final diagnoses were determined via phone interview or best-estimate diagnosis in the rest of the cases. Seven hundred twenty seven individuals were diagnosed with DSM-IV yielding a prevalence of 9.8 per 1,000 (95% confidence interval [CI]: 8.2-11.5). Registry-based prevalence of schizophrenia, schizoaffective disorder, BPI disorder, and depression with psychotic features were 3.6 (95% CI: 3.0-4.2), 1.1 (95% CI: 0.8-1.4), 2.7 (95% CI: 2.0-3.3), and 1.0 (95% CI: 0.6-1.3) per 1,000, respectively. Conclusion: Ten individuals per 1,000 adult persons admit for any disorder with psychotic symptoms. Registry-based prevalence estimates are lower than the lifetime prevalence estimates. However, analyses of administrative data appear to provide information needed for effectively plan and implement psychiatric services.

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