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Yıl:2019; Cilt: 32; Sayı: 2>> Özet
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Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2019;32(2):141-151
Madde kullanım bozukluğu, maddeye bağlı psikoz ve çocukluk çağı DEHB’si olan bireylerde çocukluk çağı Yavaş Bilişsel Tempo (YBT)’nun değerlendirilmesi
A Gul, H Gul
Ufuk Universitesi, Ankara
Amaç: Madde Kullanım Bozuklukları (MKB), kullanılan maddenin etkileri ile ilgili patolojik davranış paternlerini içerir ve madde kaynaklı psikoz (MKP) ile ilişkilidir. Özellikle öz kontrol seviyesi düşük kişiler, MKB ve MKP geliştirmeye yatkındır. Bu çalışmanın amacı DEHB’den farklı ancak yakından ilişkili bir problem olan çocukluk çağı Yavaş Bilişsel Tempo (YBT)’nun MKB ve MKP ile ilişkili olup olmadığını değerlendirmektir. Yöntem: Çocukluk çağı DEHB belirtileri ve en az bir MKP atağı olan 57 MKB hastası çalışmaya dahil edildi. Hastalar Kısa Psikiyatrik Değerlendirme Ölçeği (BPRS), Wender-Utah Derecelendirme Ölçeği (WURS) ve YBT Ölçeği ile değerlendirildi. Bulgular: Çocukluk dönemi YBT komorbidite oranı % 63.8 olarak bulundu. Çocukluk YBT grubunda total BPRS, düşünce çözülmesi, motor yavaşlama, olağandışı düşünceler, duygusal küntlük, taşkınlık ve dezoryantasyon skorları daha yüksekti. YBT ve WURS puanları, BPRS puanları ile pozitif olarak koreleydi, ancak WURS, daha fazla psikotik semptomla koreleydi ve korelasyonlardan düşünce çözülmesi, motor yavaşlama ve duygusal küntlük dışındakiler YBT’ye göre daha güçlüydü. Lineer regresyon analizi ile hem çocukluk çağı YBT hem de WURS puanlarının BPRS toplam, motor yavaşlama, olağandışı düşünceler, duygusal küntlük ve taşkınlık puanlarını anlamlı şekilde yordadığını bulduk. Son olarak, çok değişkenli regresyon analizlerinin sonuçları, gerginlik ve suçluluk duygularının WURS’u, duygusal küntlük ve düşünce çözülmesi puanlarının ise YBT puanlarını öngördüğünü göstermiştir. Sonuç: Sonuç olarak, bu gruptaki her 10 hastanın yaklaşık 7’sinde çocukluk çağı YBT’si saptanmıştır. YBT hastaları, diğerleriyle karşılaştırıldığında psikotik semptomlara daha yatkın bulunmuştur. Ayrıca, duygusal küntlük, düşünce çözülmesi ve YBT arasında bir ilişki olduğu gözlenmiştir.
Evaluation of childhood Sluggish Cognitive Tempo among patients with substance use disorder, substance-induced psychosis and childhood ADHD
Objective: Substance use disorders (SUDs) include a pathological pattern of behaviors related with the effects of the drug used and are associated with substance-induced psychosis (SIP). Individuals with lower levels of self-control are particularly predisposed to develop SUDs and SIP. The purpose of this study was to evaluate whether childhood sluggish cognitive tempo (SCT), which is a problem distinct from but related with ADHD, is associated with SUDs and SIP. Method: Fifty-seven SUD patients who had childhood ADHD symptoms and at least one SIP attack were enrolled the study. Patients were evaluated by Brief Psychiatric Rating Scale (BPRS), Wender-Utah Rating Scale (WURS), and SCT Scale. Results: The rate of childhood SCT comorbidity was 63.8%. The total BPRS and conceptual disorganization, motor retardation, unusual thought content, blunted affect, excitement, and disorientation scores were higher in the childhood SCT group. SCT and WURS scores were positively correlated with BPRS scores but WURS scores were correlated with more psychotic symptoms and the correlations were stronger in WURS than SCT except “conceptual disorganization,” “motor retardation.” and “blunted affect.” Using linear regression analysis, we found that both childhood SCT and WURS scores significantly predicted the BPRS total, motor retardation, unusual thought content, blunted affect and excitement scores. Finally, the results of multivariate stepwise regression analyses indicated that tension and guilt significantly predicted WURS while blunted affect and conceptual disorganization predicted SCT scores. Conclusion: Approximately, 7 in 10 patients in this group seem to have had childhood SCT. SCT patients showed more proneness to psychotic symptoms when compared with others. In addition, there was a relationship between blunted affect, conceptual disorganization, and SCT.

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