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Yıl:2016; Cilt: 53; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2016;53(4):338-343
Şizofreni Hastaları ve Birinci Derece Yakınlarında Zihin Kuramı ve Duygu Tanımanın Değerlendirilmesi
R Ay, Ö Böke, O Pazvantoğlu, AR Şahin, G Sarısoy, AC Arık, H Güz
Ondokuz Mayıs Üniversitesi, Samsun
Amaç: Sosyal biliş, kişinin kendisiyle diğerleri arasındaki ilişkinin tasarımlarını yapılandırabilme, bu tasarımları sosyal davranışları esnek bir şekilde yönlendirebilmek için kullanabilme becerisidir. Sosyal bilişi en iyi açıklayan ve en çok çalışılan modeller zihin kuramı (ZK) ve duygu tanı- madır. Bu çalışmada şizofreni hastaları ve birinci derece akrabalarında ZK ve duygu tanıma bozukluklarının saptanması amaçlanmıştır. Yöntem: Çalışmaya 30 remisyonda şizofreni hastası, şizofreni hastalarının birinci derece akrabaları (s=30) ve yaş ve eğitim süresi açısından hastalar ile eşleştirilmiş 30 sağlıklı gönüllü dâhil edildi. Çalışmaya katılan hasta grubuna sosyodemografik ve klinik verileri içeren bilgi formu, Pozitif ve Negatif Semptom Ölçeği (PANSS), Dokuz Eylül Zihin Teorisi Ölçeği (DEZTÖ),Gözlerden Zihin Okuma Testi, Yüzde Dışa Vuran Duyguları Tanıma Testi (YDTT), Yüzde Dışa Vuran Duyguları Ayırt Etme testi (YDAT) uygulandı. Bulgular: Şizofreni hastalarında ve akrabalarında ZK ve duygu tanımanın bozuk olduğu saptandı. ZK ve duygu tanıma performansları kö- tüden iyiye doğru şizofreni grubu, aile grubu ve kontrol grubu sırasını izledi. DEZTÖ alt ölçekleri değerlendirildiğinde İroni dışındaki bütün alt bileşenlerde şizofreni hastaları kötü performans gösterdi. Aile grubunda Empati alt bileşeni sağlıklı kontrollerle benzer performans gösterirken, İkinci Derece Yanlış İnanç (İDYİ), metafor, faux pas(pot kırma, gaf yapma) alt bileşenleri ise hasta grubuyla benzer performans gösterdi. Birinci Derece Yanlış İnanç (BDYİ) alt ölçeğinde ise DEZTÖ toplamda olduğu gibi her üç grup arasında fark vardı. En kötü performansı hasta grubu, daha sonra aile grubu, en iyi performansı ise kontrol grubu gösterdi. Sonuç: Hem atak döneminden bağımsız olarak remisyon döneminde hem de hastalık belirtisi olmayan birinci derece akrabalarda ZK ve duygu tanıma bozukluklarının saptanması, şizofreni için hastalık döneminden bağımsız sürekli bir değişken olabileceği görüşünü desteklemektedir.
Social Cognition in Schizophrenia Patients and Their First-Degree Relatives
Introduction: Social cognition is a person's ability to configure the designs of relationships between themselves and others and to use these designs to guide social behaviors in a flexible manner. The models that are the most studied and describe social cognition are the theory of mind (ToM) and emotion recognition. This study was aimed to detect ToM and emotion recognition disorders in schizophrenia patients and their first-degree relatives. Methods: Thirty schizophrenia patients in remission, the firstdegree relatives of schizophrenia patients (n=30), and 30 healthy volunteers who were paired with the patients in terms of age and duration of education were included in the study. The Positive and Negative Symptom Scale (PANSS), Dokuz-Eylül Theory of Mind Scale (DEToMS), Reading the Mind in the Eyes test, Facial Emotion Identification Test (FEIT), and Facial Emotion Discrimination Test (FEDT) were performed by the patients participating in this study. Results: ToM and emotion recognition were found to be defective in the schizophrenia patients and their relatives. The performances of ToM and emotion recognition were ranked as the schizophrenia group, family group, and control group, from the worst to the best. The schizophrenia group showed poor performance in all sub-components except irony. In the family group, the empathy subcomponent showed similar performance with the control group, whereas the subcomponents of the second-order false belief, metaphor, and faux pas tests showed similar performance with the patient group. There were differences among the three groups in the first-order false belief subscale as well as the total DEToMS. The patient and family groups showed the poorest performances, whereas the control group showed the best performance. Conclusion: The detection of ToM and emotion recognition disorders in the remission period, regardless of the attack period and asymptomatic first-degree relatives, may support the view that the period of schizophrenia is an independent continuous variable.

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