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Yıl:2016; Cilt: 27; Sayı: 4>> Özet
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Türk Psikiyatri Dergisi; 2016;27(4):235-243
Tedaviye Gönderilmiş Tutuklu ve Hükümlü Erkek Olgularda Hekimi Yanıltıcı Davranışın Klinik Özellikleri
MC Ger, ND Ljohiy, F Öncü, A Keyvan, G Özgen, A Türkcan
Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Çalışma tutuklu/hükümlü olgularda hekimi yanıltıcı davranışı öngördürücü etmenleri ve klinik özellikleri araştırma amacıyla yapılmıştır. Yöntem: Araştırmaya tedavi için yatırılmış 70 tutuklu/hükümlü erkek olgu alınmıştır. Klinik ve sosyodemografik veri toplama formu, DSM-IV Eksen-I Bozuklukları için Yapılandırılmış Klinik Görüşme (SCID I), DSM-III-R için Yapılandırılmış Klinik Görüşme (SCID II), Belirti Tarama Listesi (SCL-90-R) ve Rey Bellek Testi (RBT) kullanılmıştır. Tanıyı çalışmadan bağımsız iki psikiyatri uzmanı koymuştur. Bulgular: Tutukluların en sık psikotik, hükümlülerin en sık depresif belirtileri taklit ettikleri saptanmıştır. RBT hekimi yanıltıcı davranışta yardımcıdır ve SCL-90-R psikotik belirti ve paranoid belirti alt ölçek puanları RBT skorlarıyla ters yönde korelasyon göstermiştir. Eksen-I ya da Eksen-II tanılarının hekimi yanıltıcı davranışı yordayıcılığı diğer klinik etmenlerden daha güçlü bulunmuştur. Sonuç: Bu çalışmayla, klinisyenlerin tedavi amacıyla başvuran tutuklu-hükümlü olgularda hekimi yanıltıcı davranışı özellikle göz önünde bulundurmaları ve ayırıcı tanıyı dikkatli yapmaları gerektiği belirlenmiştir. Tutuklu ve hükümlü olgularla yürütülecek daha geniş örneklemli araştırmalar ve olguların bilirkişilik ve sağaltım hizmetlerine göre gruplandırıldığı çalışmalar hekimi yanıltıcı davranışla ilgili ek veriler sağlayabilir.
Clinical Characteristics of Malingering Among Arrested and Convicted Male Cases That are Sent for Treatment
Objective: The study is done to investigate the predictive variables of malingering among arrested/convicted cases and the clinical characteristics of malingerers. Method: The study includes 70 arrested/convicted male cases internalized for their treatment. Aform to collect clinical or sociodemografic data, Structured Clinical Interview for DSM-IV Disorders (SCID I), Structured Clinical Interview for DSM-III–R (SCID II), Symptom Check-list (SCL-90-R) and Rey Memory Test (RMT) are applied. Two independent psychiatrists, without being part of the study diagnosed malingering. Results: Arrested cases reported mostly psychotic like and convicted cases mostly depression like symptoms. RMT is helpful by malingering and SCL-90-R psychotic symptom and paranoid symptom subscale scores were both correlated negatively when compared to the RMT scores by malingerers. Axis-I or Axis-II diagnosis were found out to be more predictive than other clinical variables to determine malingering. Conclusion: This study indicate that clinicians have to take malingering into account especially by arrested and convicted cases applied for treatment and they have to be careful by doing the differential diagnosis. Large sample studies conducted with arrested and convicted cases and surveys by grouping cases according to the expertise and treatment services may provide additional data related to malingering.

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