Dergi Ara >>
Yıl:2023; Cilt: 12; Sayı: 2>> Özet
TAM METİN
Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi; 2023;12(2):167-178
Obsesif-Kompulsif Bozuklukta Aşırı Değerlendirilmiş Düşünceler, Üstbilişler, Büyüsel Düşünceler ve Yaşam Kalitesi
MG Teksin, S Aslan, G Teksin
Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, İstanbul
Obsesif Kompulsif Bozukluk (OKB) kişilerin yaşam kalitesini olumsuz etkileyerek yeti yitimine yol açan heterojen doğaya sahip bir bozukluktur. Hastaların obsesif düşüncelerinin ve kompulsiyonlarının sürdürülmesinde üst bilişsel süreçlerin önemi yadsınamaz. Klinik pratikte obsesyonlar zaman zaman Aşırı Değerlendirilmiş Düşünceler (ADD) olarak görülebilir. Bu hastalarda obsesyonlar sanrısal düzeyde olmasa da içgörüden yoksundur. Bununla birlikte literatürde hatalı nedensellik ilişkisi olarak tanımlanan, herhangi bir psikiyatrik rahatsızlığı bulunmayan kişilerde stres durumunda ortaya çıkabilen büyüsel düşünceler OKB hastalarında da görülebilmektedir. Obsesif kompulsif bozukluk hastalarında büyüsel düşüncelerin varlığı obsesif semptomların niteliğini veya niceliğini etkileyebilir. Tüm bu bilgiler ışığında bu çalışmadaki amacımız OKB hastalarında ADD’lerin varlığının, klinik özellikler, üstbilişsel süreçler, büyüsel inançlar ile ilişkisini değerlendirmek, bu parametreleri sağlıklı kontrol grubuyla kıyaslamak ve bu klinik özelliklerin hastalık şiddeti ve yaşam kalitesine olan etkisini incelemektir. Bu amaçla, ek ruhsal hastalığı olmayan 54 OKB ve 55 kontrol grubu çalışmaya dâhil edilmiştir. Klinik görüşmeye ve Y-BOCS semptom listesine göre hastalar otojen (n: 23) ve reaktif (n: 31) olarak iki ayrı gruba ayrılmışlardır. Obsesif kompulsif bozukluk tanılı hastalara tek bir klinisyen tarafından OVIS uygulanmış olup sonrasında MCQ-30, MIS, WHOQOL-Bref-TR ve MOCI ölçeklerinin hastalar ve kontrol grubu tarafından doldurulması sağlanmıştır. Çalışmanın sonuçları incelendiğinde OKB tanısı almış hasta grubunda WHOQOL-Bref-TR, MCQ-30 ve MOCI total puanlarının kontrol grubuna göre anlamlı olarak yüksek, MIS toplam puanlarının ise her iki grup arasında benzer olduğu tespit edildi. Ek olarak OKB hastalarında MCQ-30 puanları ve büyüsel inançların şiddeti arttıkça yaşam kalitelerinin azaldığı saptandı. Ayrıca otojen ve reaktif obsesyonları olan OKB hastaları MCQ-30, WHOQOL-Bref, MOCI, Y-BOCS, MIS ve OVIS toplam ve alt ölçek puanlarına göre karşılaştırıldı. Bu iki grup arasında toplam MCQ-30 puanında istatistiksel olarak anlamlı bir fark yoktu. Otojen obsesyonları olan hastaların OVIS puanları otojen obsesyonları olan hastalardan daha yüksek iken, otojen obsesyonları olan hastaların MCQ-30 ölçeğinin “Kontrol edilemezlik ve tehlike” alt ölçeğinin puanı reaktif obsesyonları olan hastalardan daha yüksekti. Yüksek üst bilişsel puanlar ve büyülü düşüncelerin şiddeti, OKB hastalarında düşük yaşam kalitesine işaret eder. Ayrıca OKB alt tip gruplarında benzer üstbilişsel patolojilerin olması, alt tip dikkate alınmadan üstbilişsel terapinin bir tedavi seçeneği olarak kullanılması düşüncesini desteklemektedir
Overvalued Ideas, Metacognitions, Magical Ideations and Quality of Life in Obsessive-Compulsive Disorder
The importance of metacognitive processes is very important in the reinforcement of obsessive thoughts and compulsions in Obsessive Compulsive Disorder (OCD). In clinical practice, obsessions can sometimes be seen as Overvalued Ideas (OVI). In these patients, the obsessions are not delusional but lack insight. Magical thinking (MT), which are defined as a faulty causality relationship in the literature can also be seen in OCD. Presence of MT in OCD may affect the quality or quantity of obsessive symptoms. In this study, we aimed to assessment the association of OVI with metacognition and MT in OCD by comparing with controls and examining the impact of these clinical features on the severity of the OCD and the quality of life (QoL). For this purpose, 54 OCD and 55 control groups were included in the study. According to clinical interview and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) symptom list, patients were divided into two groups as autogenous (n: 23) and reactive (n: 31). Then Overvalued Ideas Scale (OVIS) was applied one-to-one by a same clinician to patients. All participants completed the Metacognitions Questionnaire-30 (MCQ-30), Magical Ideation Scale (MIS), World Health Organization Quality of Life Assessment-Bref-TR (WHOQOL-Bref-TR), Maudsley Obsessional Compulsive Inventory (MOCI). In the results of the study, the WHOQOL-Bref-TR, MCQ-30 and MOCI total scores were significantly higher in the patient group compared to the control group; MIS total scores were found to be similar between the two groups. In addition; the QoL decreased as the MCQ-30 scores and the severity of MT increased in patients. Obsessivecompulsive disorder patients with autogenous and reactive obsessions were compared according to MCQ-30, WHOQOL-BREF, MOCI, Y-BOCS, MIS, and OVIS total and subscale scores. There was no statistically significant difference in the total MCQ-30 score between these two groups. While the OVIS scores of the patients with reactive obsessions were higher than the patients with autogenous obsessions, the “Uncontrollability and danger” subscale score of the MCQ-30 scale with autogenous obsessions was higher than the patients with reactive obsessions. High metacognition scores and severity of magical ideations indicate poor quality of life among OCD patients. Also, similar metacognitive pathologies in the OCD subtype groups support the thought of using Metacognitive Therapy as a treatment option with no consideration of the subtype.

http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-red.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-white-grey.html http://www.simplehandbaga.com/hermes-kelly-32cm-ostrich-vein-6108-black-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-dark-red.html http://www.simplehandbaga.com/hermes-herbag-31cm-green-canvas-bag.html http://www.simplehandbaga.com/hermes-epsom-leather-wallet-camel-silver.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-green-silver.html http://www.simplehandbaga.com/hermes-kelly-32cm-togo-leather-6108-electric-blue-silver.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-blue-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-pink-bag.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-croco-leather-black.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-pink-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-elephant-grey.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-dark-blue-golden.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-brown.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-electric-blue.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-pink.html http://www.simplehandbaga.com/hermes-h-wallet-royal-blue-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-electric-blue.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-blue-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-burgundy.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-grey.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-grey-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-elephant-grey.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-red.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-camel-gold.html http://www.simplehandbaga.com/hermes-kelly-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-pink.html http://www.simplehandbaga.com/hermes-herbag-31cm-burgundy-canvas-bag.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-blue-silver.html http://www.simplehandbaga.com/hermes-30cm-birkin-bag-togo-leather-with-strap-light-pink-gold.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-rose-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-brown.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-green.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-black.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-red-silver.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-pink-silver.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-pink.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-in-orange.html http://www.simplehandbaga.com/hermes-picotin-lock-togo-leather-red.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-green-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbag-yellow-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-camel-gold.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-gold-light-coffee.html http://www.simplehandbaga.com/hermes-kelly-28cm-bag-togo-leather-blue-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-pink.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-red.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-burgundy-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-dark-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-light-coffee-silver.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-hot-pink-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-white.html http://www.simplehandbaga.com/hermes-garden-party-36cm-leather-handbag-black-hot-pink.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-brown-gold.html http://www.simplehandbaga.com/hermes-constance-wallet-togo-leather-rose.html http://www.simplehandbaga.com/hermes-bi-fold-wallet-h006-black.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-black-silver.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-blue.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-orange-bag.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-h-red.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-birkin-35cm-crocodile-leather-handbag-grey-white-gold.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-dark-khaki-silver.html http://www.simplehandbaga.com/hermes-garden-party-36cm-canvas-handbag-yellow.html http://www.simplehandbaga.com/hermes-calf-leather-8616-handbag-cherry-pink.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-orange-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-camel.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-green.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-green.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-togo-leather-orange-silver.html