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Yıl:2022; Cilt: 59; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2022;59(4):309-314
Bipolar Bozukluk ve Şizofreni Tanılı Bireylerde Yaşam Kalitesi
ŞG Şişmanlar, Y Dursun, G Ünverdi, NN Olgun, A Coşkun
Maltepe Üniversitesi,Mersin
Amaç: Yaşam kalitesi, kişinin öznel olarak, yaşamdaki konumuna ilişkin algısı olarak değerlendirilen ve bipolar bozukluk (BPB) ve şizofreni gibi birçok psikiyatrik hastalıkta olumsuz etkilenen bir kavramdır. Yaşam kalitesini temel alan tedavi yaklaşımlarının hastanın tedaviye uyumunu arttıracağı, kişinin doyumu yüksek bir hayat yaşamasına katkı sağlayacağı düşünülmektedir. Bu çalışmada BPB ve şizofreni tanılı bireylerin yaşam kalitesinin sağlıklı kontrollerle karşılaştırılması, hastalık ve iyilik dönemlerinin yaşam kalitesi üzerindeki etkisinin araştırılması amaçlanmıştır. Yöntem: Yaşam kalitesinin değerlendirilmesi amacıyla BPB (n=124), şizofreni (n=74) tanılı bireylere ve sağlıklı kontrollere (SK, n=81) Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği-Kısa Formu (WHOQOL-Bref) verilmiştir. Yaş ve eğitim düzeyi eş değişken olarak alınarak gruplar arasında WHOQOLBref alt ölçek ve toplam puanları MANCOVA ile karşılaştırılmıştır. Ardından hasta grupları atak ve remisyon döneminde olmalarına göre yaş, eğitim düzeyi ve Global Değerlendirme Ölçeği puanları eş değişken olarak alınarak MANCOVA ile karşılaştırılmıştır. Klinik özellikler ile yaşam kalitesi puanları arasındaki ilişki korelasyon analiziyle değerlendirilmiş, anlamlılık saptanan değişkenler için lineer regresyon analizi uygulanmıştır. Bulgular: Şizofreni veya BPB tanılı bireylerin SK’lere göre WHOQOL-Bref psikolojik, sosyal ve toplam puanlarının düşük olduğu, şizofreni tanılı bireylerin ek olarak fiziksel ve çevre alt ölçek puanlarının da SK’lere göre düştüğü saptanmıştır. Ek olarak şizofreni tanılı bireylerin WHOQOLBref fiziksel, psikolojik, sosyal ve toplam puanları, BPB tanılı bireylere göre düşüktür. Remisyon döneminde BPB ve şizofreni tanılı bireyler arasında yaşam kalitesi açısından anlamlı farklılık saptanmamıştır. Atak dönemindeki BPB tanılı bireylerin remisyondakilere göre WHOQOLBref fiziksel, psikolojik alt ölçek ve toplam puanları anlamlı olarak düşük saptanmıştır. Atak dönemindeki BPB tanılı bireylerin, atak dönemindeki şizofreni tanılı bireylere göre WHOQOL-Bref psikolojik, çevre ve toplam ölçek puanları anlamlı olarak düşük bulunmuştur. Sonuç: BPB tanılı bireylerin yaşam kalitesinin sağlıklı bireyler ile şizofreni tanılı bireyler arasında olduğu, öte yandan BPB atak dönemlerinin yaşam kalitesini, şizofreni atak dönemlerine göre daha çok düşürdüğü, remisyonda ise her iki hasta grubunun birbirine benzer özellikler gösterdiği söylenebilir. Her iki hastalık grubunda yaşam kalitesi açısından benzerlik ve farklılıkların ortaya konması, hastaların ihtiyaç duydukları tedavi türünün belirlenmesi açısından büyük öneme sahiptir.
Quality of Life of Individuals with Bipolar Disorder and Schizophrenia
Introduction: Quality of life (QoL) is a concept defined as a subjective perception of one’s position in life and is negatively affected in many psychiatric illnesses such as bipolar disorder (BD) and schizophrenia (SCZ). It is hypothesized that therapeutic approaches based on QoL can increase the patient’s adherence to treatment and contribute to a satisfactory life. This study aimed to compare the QoL of individuals having BD and schizophrenia with that of healthy controls (HCs) and to investigate the impact of the state of remission on QoL. Method: The World Health Organization QoL Scale-Short Form (WHOQOL-Bref) was administered to individuals with BD (n=124) and SCZ (n=74) and to HCs (n=81) to evaluate QoL. The WHOQOL-Bref subscale and total scores were compared between the groups using multifactor analysis of covariance (MANCOVA) by considering age and education level as the covariates. Then, the patient groups were compared using MANCOVA based on the state of remission by taking age, level of education, and Global Assessment of Functioning scores as the covariates. The relationship between clinical features and QoL scores was evaluated using correlation analysis, and linear regression analysis was applied for the variables that were found to be significant. Results: It was found that individuals with SCZ or BD had lower WHOQOL-Bref psychological, social, and total scores than HCs. Those with SCZ additionally had lower physical and environmental subscale scores than HCs. Furthermore, those with SCZ had lower WHOQOL-Bref physical, psychological, social, and total scores than individuals with BD. There was no significant difference in WHOQOL-Bref scores between individuals with BD and SCZ in the remission period. WHOQOL-Bref physical, psychological, and total scores were found to be significantly lower in unremitted BD patients when compared with remitted BD patients. Unremitted BD patients were found to have significantly lower WHOQOL-Bref psychological, environmental, and total scale scores than unremitted SCZ patients. Conclusion: It can be concluded that the QoL of individuals with BD is between that of healthy individuals and those with SCZ. However, unremitted BD patients have lower QoL than unremitted SCZ patients. Both patient groups display similar features during remission. Identifying the similarities and differences in terms of QoL in both patient groups is of great importance to develop the best type of treatment for the patients.

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