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Yıl:2019; Cilt: 56; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2019;56(2):139-143
Şizofrenide Ruhsal Toplumsal Beceri Eğitimi ve Üstbiliş Eğitiminin Toplumsal ve Bilişsel İşlevsellik Üzerine Etkisi
M Yıldız, Z Özaslan, A İncedere , A Kırcalı, F Kiras, K İpçi
Kocaeli Üniversitesi, Kocaeli
Amaç: Bu çalışma ile Ruhsal Toplumsal Beceri Eğitimi (RUTBE) ve Üstbiliş Eğitiminin (ÜBE) ayaktan tedavisi devam eden şizofreni hastalarında genel psikopatoloji, bilişsel işlevsellik ve toplumsal işlevsellik üzerine etkisini incelemek amaçlandı. Yöntem: Araştırmaya Ocak-Haziran 2016 tarihleri arasında Kocaeli Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Polikliniğinde ayaktan tedavi gören şizofreni hastalarından araştırmaya katılmayı kabul eden ve dahil olma ölçütlerini karşılayan 20 hasta alındı. Hastalar 10’ar kişilik iki gruba rastgele yerleştirildi. Her grubun yönetimi bir eğitici ve bir de yardımcısı ile gerçekleştirildi. Eğitime katılan hastalara eğitim öncesi ve sonrasındaki iki hafta içerisinde gruplara kör klinisyenler tarafından psikopatolojiyi değerlendirmek için Pozitif ve Negatif Belirti Ölçeği (PNBÖ) ve Klinik Genel İzlenim-Şiddet (KGİ-Ş), toplumsal işlevselliği değerlendirmek için İşlevselliğin Genel Değerlendirmesi (İGD) ve Şizofreni Hastalarında Yaşam Nitelikleri Ölçeği (ŞYNÖ), bilişsel işlevselliği değerlendirmek için Bilişsel Değerlendirme Görüşmesi (BDG) uygulandı. Eğitim sonrasında ilk ve son test ölçek puanları karşılaştırıldı. Bulgular: Çalışmaya katılan 20 hasta çalışmayı tamamladı (erkek=13; kadın=7). Grupların bireysel ve klinik özelliklerinin karşılaştırılmasında yaş, cinsiyet, medeni durum, eğitim yılı, hastalık süresi, hastalık başlangıç yaşı ve toplam yatış sayısı açısından anlamlı fark yoktu (p>0.05). Grupların eğitim öncesi ve sonrası ölçeklerden aldıkları puanlar karşılaştırıldığında; her iki grupta da psikopatoloji, bilişsel ve toplumsal işlevsellik açısından anlamlı değişiklikler saptandı (p<0.05). Etki düzeyi açısından gruplar arasında fark yoktu. Sonuç: Bu araştırma şizofrenide iyileşmeyi hedef alan iki farklı eğitim programının da psikopatoloji ve işlevsellik üzerinde olumlu etkisi olduğunu gösterdi. Bilişsel işlevsellikteki değişme kontrol grubunun da olduğu geniş ölçekli çalışmalarda sinirbilişsel testlerle de sınanmalıdır
The Effect of Psychosocial Skills Training and Metacognitive Training on Social and Cognitive Functioning in Schizophrenia
Introduction: The aim of this study is to investigate the effects of Psychosocial Skills Training (PSST) and Metacognitive Training (MCT) programs on general psychopathology, cognitive functioning, and social functioning in patients with schizophrenia. Methods: Twenty patients with schizophrenia who were treated at the Kocaeli University Psychiatry Department outpatient clinic between January and June 2016, accepted to participate in the study and met inclusion criteria were included in this study. Patients were randomized as two groups of 10 people. The management of each group was carried out by a trainer and a co-trainer. The Positive and Negative Symptom Scale (PANSS) and Clinical Global Impression Scale-Severity (CGI-S) to assess psychopathology, the General Assessment of Functioning (GAF) and the Quality of Life Scale in Schizophrenia (QoLS) to assess social functioning, the Cognitive Assessment Interview (CAI) to assess cognitive functioning were used by the clinicians blinding to groups in the first two weeks before and after the intervention. After the training, first and last test scale scores were compared. Results: All patients who participated in the study completed the study (male=13, female=7). There was no significant difference in age, gender, marital status, years of education, duration of illness, the age of onset, and the number of hospitalizations in comparison of individual and clinical characteristics of the groups (p>0.05). When the scores were compared of the groups before and after the intervention, there was a significant difference concerning psychopathology, social and cognitive functioning in both groups (p <0.05). There were no significant differences between the groups in terms of effect size. Conclusion: The study showed that both programs aiming to improve psychopathology and functioning in the treatment of schizophrenia have positive results. Improvement in cognitive functioning should also be tested by neurocognitive tests in the large-scale studies with control groups. .

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