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Yıl:2017; Cilt: 18; Sayı: 1>> Özet
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Anadolu Psikiyatri Dergisi; 2017;18(1):22-28
Şizofrenide anne-baba akraba evliliğinin klinik özelliklere etkisi
T Binbay, DA Binbay, H Ulaş, BB Akdede, K Alptekin
Dokuz Eylül Üniversitesi, İzmir
Amaç: Şizofreni hastalarının anne-babalarında akraba evliliğinin klinik özellikler üzerine etkisini incelemektir. Yöntem: Araştırmanın örneklemini 2009-2011 yılları arasında Sinop Atatürk Devlet Hastanesi’ne başvuran DSMIV tanı sistemine göre şizofreni tanısı konan hastalar oluşturmuştur. Hastaların yaş, cinsiyet, eğitim durumu, sosyoekonomik konum, çalışma durumu, ailede psikiyatrik hastalık öyküsü, hastalık başlangıç yaşı ve hastane yatış sayısı bilgileri ile anne-baba akraba evliliği durumları ve derecesi (birinci derece kuzen evliliği) hasta dosyalarından ve kayıtlardan geriye dönük olarak elde edilmiştir. Bulgular: Yüz seksen iki hasta (%51.1 kadın ve yaş ortalaması 38.8) alınmıştır. Anne-babalarda akraba evliliği ve birinci derece kuzen evliliği oranı sırasıyla %19.9 ve %13.2 olarak saptanmıştır. Hastalık başlangıç yaşı ortalaması anne-baba akraba evliliği olan hastalarda olmayanlara göre daha erken (sırasıyla 22.1 ve 25.5; t(180)=2.1; p<0.05) olarak saptanmıştır. Anne-baba akraba evliliği varlığı, yatış öyküsü olmayan hastalara göre iki veya daha fazla sayıda yatış olasılığını 2.8 kat (%95 GA=1.1-7.1; p<0.02) arttırdığı bulunmuştur. Söz konusu ilişki birinci derece akraba evliliği durumunda biraz daha güçlü olarak (3.0; %95 GA=1.0-8.7; p<0.04) saptanmıştır. Sonuç: Şizofrenide anne-baba akraba evliliği oranı araştırma bölgesindeki genel nüfus oranlarına benzerdir. Diğer yandan şizofreni hastalarının anne-babalarında birinci derece kuzen evliliği bölge oranlarına göre kısmen daha yüksektir. Akraba evliliği ile hastalık başlangıç yaşı ve hastane yatış sayısı arasındaki ilişki daha şiddetli giden bir hastalık sürecine işaret edebilir. Bu ilişki birinci derece evliliğinde daha belirgindir ve bu etki genetik bir kalıtımı ifade edebilir.
Impact of parental consanguinity on clinical features in schizophrenia
Objective: The purpose of this study was to evaluate the impact of parental consanguinity on the clinical features in schizophrenia. Methods: The sample of the study was based on DSM-IV schizophrenia patients admitted to Atatürk State Hospital of Sinop between 2009 and 2001. Sociodemographic (age, gender, marital status, completed years of education, employment status) and clinical features (family history of psychiatric disorders, age of onset, number of hospitalization), and parental consanguinity were retrieved retrospectively from case registries. Results: A total of 182 patients (51.1% female and mean age 38.8) were included. Frequency of any parental consanguinity and first degree cousin marriages were 19.9% and 13.2% respectively. Mean age of onset of schizophrenia was significantly lower among patients with parental consanguinity than patients with no parental consanguinity (22.1 and 25.5 respectively; t180=2.1; p<0.05). Parental consanguinity was significantly associated with higher number of hospitalization (adjusted odds ratio [OR]=2.8; 95% confidence interval [CI]=1.1-7.1; p<0.02). The association between parental consanguinity and number of hospitalization was slightly stronger in patients whose parents were first degree cousins (adjusted OR= 3.0; 95% CI=1.0-8.7; p<0.04). Conclusion: Frequency of parental consanguinity in schizophrenia is similar to rates in general population, however first degree cousin consanguinity may be mildly higher in parents. Parental consanguinity is associated with earlier age of onset and higher number of hospitalization. Both associations may indicate a relative poor prognosis, and are mildly stronger in first degree cousin consanguinity which may represent a unique genetic effect.

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