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Yıl:2020; Cilt: 33; Sayı: 1>> Özet
TAM METİN
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2020;33(1):29-39
Multipl sklerozda uyku kalitesi, dissosiyasyon, patolojik kaygı ve fonksiyonel bozukluk arasındaki ilişkiler: Bir vaka-kontrol çalışması
A Yıldırım, M Boysan, V Cilingir
Kahramanmaraş Sütçü İmam Üniversitesi, Kahramanmaraş
Amaç: Mevcut çalışma, uyku kalitesi, kaygı ve dissosiyatif yaşantılar açısından multipl skleroz (MS) tanıları olan hastalar ile sağlıklı kontrol grubu arasında bulunan farkları araştırmak şeklinde tasarlandı. Yöntem: Seksen sekiz MS tanısı olan hasta ve 139 sağlıklı yetişkin çalışmaya katıldı. Yaş ortalaması 30.96 yıldı (standart sapma=8.88 yıl). Klinik ve sağlıklı katılımcılara Genişletilmiş Özürlülük Durumu Ölçeği, Dissosiyatif Yaşantılar Ölçeği (DYÖ), Penn State Endişe Ölçeği (PSEÖ) ve Pittsburgh Uyku Kalite İndeksi (PUKİ) uygulandı. İkili lojistik ve çoklu regresyon analizleri yapıldı. Bulgular: MS tanılı hastaların %55.7’si kötü uyuyanlar olarak tespit edildi. Ancak klinik ve sağlıklı bireyler arasında PSEÖ toplam puanlarında anlamlı bir fark bulunmadı. Yapılan lojistik regresyon analizine göre MS tanılı hastalar, sağlıklı kontrol grubu ile karşılaştırıldığında anlamlı derecede daha düşük alışılmış uyku etkinliği gösterdi. Sağlıklı erişkinlerin MS tanılı hastalara göre daha yüksek patolojik kaygı puanlarına sahip olması dikkat çekti. MS tanılı hastaların ve sağlıklı erişkinlerin aldıkları DYÖ puanları arasında bir fark bulunmadı. Hastalık süresi ve kaygılandıran düşünceler hastalığın gidişatı boyunca gerçekleşen fonksiyonel bozukluk için anlamlı tahmin unsuru olarak bulundu. Sonuç: MS tanısı olan hastalarda bozukluk yönetimi ve iyileşmesi için anlamlı bir risk faktörü düşünülen düşük alışılmış uyku etkinliği bulundu. Patolojik kaygı ve engellilik hali arasında bir ilişki var gibi görünmektedir. Olumlu sonuçları artırmak için uyku odaklı bilişsel davranışçı müdahalelerin bu grubun tedavi kapsamına alınması tavsiye edilebilir.
Associations between sleep quality, severity of dissociation, pathological worry, and functional impairment in multiple sclerosis: a case-control study
Objective: The current study was designed to investigate differences between patients with multiple sclerosis (MS) and healthy controls regarding sleep quality, worry, and dissociative experiences. We also explored the potential correlates of functional impairment in this group. Method: Eighty-eight patients with MS and 139 healthy adults participated in the study. The mean age was 30.96 (standard deviation=8.88) years. The Expanded Disability Status Scale, Dissociative Experiences Scale (DES), Penn State Worry Questionnaire (PSWQ), and Pittsburgh Sleep Quality Index (PSQI) were completed by clinical and nonclinical subjects. Binary logistic and multiple regression analyses were performed. Results: Of the MS patients, 55.7% were identified as poor sleepers. However, total scores on the PSQI did not differ significantly between clinical and nonclinical subjects. Logistic regression analysis showed that patients with MS reported significantly lower levels of habitual sleep efficiency than healthy controls. Interestingly, healthy adults reported higher scores on pathological worry than patients with MS. Patients with MS and healthy adults did not differ in the DES scores. Duration of illness and worrisome thoughts were significant predictors of the functional impairment occurring during the course of the illness. Conclusion: Patients with MS had poor habitual sleep efficiency, which may be a significant risk factor for management and improvement of the illness. Pathological worry seems to be associated with disability status. Cognitive behavioral interventions including sleep-informed instructions should be integrated into clinical practices to enhance positive outcomes during the course of the treatment in this group.

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