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Yıl:1998; Cilt: 9; Sayı: 2>> Özet
Türk Psikiyatri Dergisi; 1998;9(2):97-106
Mani Alttipleri: Bir Karşılaştırma Çalışması
Ç YENİLMEZ, C KAPTANOGLU, A EROL, G SEBEP
Bu çalışmada, 20 psikotik özellikleri olmayan manik (PÖOM) hasta, 28 duygudurumla uyumlu psikotik özellikli manik (DUluPÖM) hasta, 23 duygudurumla uyumsuz psikotik özellikli manik (DUsuzPÖM) hastanın seyir, hastalığın şiddeti ve tedaviye yanıt gibi klinik özellikler açılarından farklılıklarının olup olmadığı araştırıldı. Hastalara bölümümüzce hazırlanan anket formu, DSM-III-R Yapılandırılmış Klinik Görüşme Formu (SCID) Türkçe Çevirisi ve Bech-Rafaelson Mani Ölçeği uygulandı. Hastalar ilk karşılaşmada ve atak başlangıcından sonraki yaklaşık 3. ve 6. aylarda değerlendirildi. Klinik seyirde, hastalık başlama yaşı, hastanın ilk başvuru yaşı, önceki yatış sayısı, son atakta hastanede kalış süresi, önceden geçirilmiş depresif atak öyküsü ve intihar girişimi açısından gruplar arasında farklılık bulunmazken, DUsuzPÖM hastalarda, hem DUluPÖM hem de PÖOM gruba göre ataklararası iyilik dönemlerinin ortalama süreleri daha kısa bulundu. Son atakta DUsuzPÖM ile PÖOM hastalar ve DUluPÖM ile PÖOM hastalar arasında daha yüksek dozda nöroleptik kullanımı saptanırken, kontrolde DUsuzPÖM hastalarla PÖOM hastalar arasında fark devam etmekteydi. İlk başvuruda, Bech-Rafaelson Mani ölçeği ile yapılan değerlendirmeler DUsuzPÖM ve DUluPÖM arasında ölçek skorları bakımından anlamlı bir farklılık olmadığını gösterdi. Ancak hem DUluPÖM, hem de DUsuzPÖM PÖOM’den anlamlı ölçüde yüksek puan aldı. İzlemede bu farkın kalktığı gözlendi. İzleme sürecinde yeniden hastaneye yatış, yinelemeler ve iyilik durumu açısından farklılık bulunmadı. Sonuçlar DUsuzPÖM ve DUluPÖM’nin, PÖOM’ye göre daha şiddetli seyreden mani alt tipleri olduklarını düşündürmektedir.
Subtypes of Mania: A Comparison Study
In this study, 20 patients with nonpsychotic mania (NPM), 28 patients with mood congruent psychotic mania (MCPM) and 23 patients with mood incongruent psychotic mania (MICPM) were examined with regard to differences in clinical features such as, course, severity and treatment response. A questionnaire developed by our team, Turkish translation of Structured Clinical Interview (SCID) for DSM-III-R and Bech-Rafaelson mania scale were applied to each patient at initial interview and 3 and 6 [month]s later. There were no significant differences in the age of onset, age at first admission, number of previous hospitalizations, duration of last hospitalization, previous depressive episodes and suicide attemps, between the groups. Mean duration of interepisode remission periods was significantly longer in patients with MCPM and NPM than patients with MICPM and MCPM during index episode. This difference was significant (p<0.05) between patients with MICPM and patients with NPM at the end of the six [month]s follow-up. There was no significant difference on Bech-Rafaelson mania scale scores between patients with MCPM and with MICPM. But nonpsychotic patients’s scores on Bech-Rafaelson mania scale were significantly lower than patients with MICPM and MCPM during index episode, but the difference became nonsignificant at the end of follow-up period. These findings support that both MCPM and MICPM are more severe froms of mania compared to nonpsychotic form.

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