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Yıl:2008; Cilt: 18; Sayı: 3>> Özet
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Klinik Psikofarmakoloji Bülteni; 2008;18(3):183-188
Duygudurum bozukluğu tanısı ile yatan hastaların sosyodemografik ve klinik özellikleri: Bir ön bildirim
BK Gültekin, A Günderci, MV Balcı, F Kökcü, C Gedikbaş, ME Özcan
Adnan Menderes Üniversitesi Tıp Fakültesi Psikiyatri AD, Aydın-Türkiye
Amaç: Ülkemizde psikiyatrik yatan hastaların klinik özellik ve değişkenleri hakkındaki az miktarda veri bulunmaktadır. Bu ön çalışmanın amacı iki yıllık bir dönemde duygudurum bozuklukları biriminde yatırılarak izlenen hastaların sosyodemografik ve klinik özelliklerini araştırmaktır. Bu çalışmada aynı zamanda depresif bozukluk ve bipolar bozukluk bulunan hastaların bu özellikler yönünden karşılaştırılması amaçlandı. Yöntem: Bu çalışmada Adnan Menderes Üniversitesi Tıp Fakültesi Hastanesinin Psikiyatri Kliniği Duygudurum Birimi’nde 16.09.2004-01.09.2006 tarihleri arasında yatan 36 hasta değerlendirmeye alınmıştır. Tanılar DSM-IV-TR sınışandırmasına göre konulmuştur. Majör depresif bozukluk ve yineleyici depresif bozukluk depresif bozukluklar; bipolar I ve II bozukluk, şizoaffektif bozukluk-bipolar tip, siklotimik bozukluk ve antidepresan ile çıkan mani ise bipolar bozukluklar olarak iki grup halinde değerlendirilmişlerdir. Bulgular: Bipolar bozukluk tanılı 26 ve depresif bozukluk tanılı 10 hasta olmak üzere toplam 36 hasta iki yıllık dönemde klinikteki ilk yatışları göz önüne alınarak çalışmaya alınmışlardır. İlk atağın başlangıç yaşı bipolar bozukluk grubunda 27.7±1.7 yıl, depresif bozukluk grubunda 35.3±4.4 yıl olarak bulunmuştur. Depresif bozukluk grubundaki hastaların %90’ında ilk atakta stres etkeni bulunmuşken bu oran bipolar bozukluk grubundaki hastalarda %64 olarak bulunmuştur. Depresif bozukluğu olan hastaların %66.7’sinde, bipolar bozukluğu olan hastaların ise %57.7’sinde aile öyküsünde psikiyatrik bozukluk varlığı saptanmıştır. Geçmişte intihar girişimi her iki grupta da sık olarak, depresif bozukluk grubunda %66.7, bipolar bozukluk grubunda %70 oranlarında bulunmuştur. Depresif bozukluk grubunda %40; bipolar bozukluk grubunda %52 oranında eksen III tanısı saptanmıştır. Ortalama yatış süresi depresif bozukluk grubun da 36.6±5.9 gün, bipolar bozukluk grubunda 40.8±5.0 gün olarak saptanmıştır. Depresif bozukluk grubunda trisiklik antidepresanlar en fazla tercih edilen psikotrop iken, bipolar bozukluk grubunda duygudurum düzenleyici ve antipsikotikler daha fazla tercih edilmiştir. Tartışma: Epidemiyolojik araştırmaların tüm dünyada olduğu gibi ülkemizde de önemi artmaktadır. Türkiye’ye ait bipolar bozukluk ve diğer psikiyatrik hastalıklara ait sağlıklı ve güvenilir bilgilere gereksinim duyulmaktadır. Ülkemizin değişik bölgelerinde yapılan çalışma sonuçlarının değerlendirilerek psikiyatrik hastalıkların Türkiye profilinin oluşturulması, topluma özgü özelliklerinin tanınmasına, risk etmenlerinin saptanmasına, toplumsal ve demografik ilişkilerin ortaya çıkarılmasına katkıda bulunacaktır. Bu çalışmada ilk atak başlangıç yaşı bipolar bozukluklu hasta grubunda daha erken bulunurken, ilk atakta stres etkeninin varlığı depresif bozukluk grubunda daha fazladır.
Demographic and clinical variables among mood disorders inpatients: a preliminary report
Objective: There is limited data to demonstrate the clinical characteristics and variables of psychiatric inpatients in our country.The aim of this preliminary study is to investigate sociodemographic and clinical variables of inpatients, who were followed up at a mood disorders unit during a two [year] period. In addition, patients with depressive disorders and bipolar disorders were compared in terms of these characteristics. Method: A total of 36 inpatients were evaluated in the Mood disorder unit of Psychiatry Department of Adnan Menderes University between 16.09.2004 and 01.09.2006. Diagnoses were made according to DSM-IV-TR. Depressive disorders group included patients with either major depressive or recurrent depressive disorders, while bipolar disorders group consisted of patients with bipolar I, and II disorders, schizoaffective disorder-bipolar type, cyclothymic disorder and antidepressant induced mania. Results: There were 36 inpatients in total, 26 in bipolar disorders group and 10 in depressive disorders group. Age at onset was 27.7 ± 1.7 [year]s in bipolar disorders group and 35.3 ±4.4 [year]s in depressive disorders group. Psychosocial stress prior to the first episode was a factor in 90% of patients with depressive disorders and in 64% of patients with bipolar disorders. Family history was positive for 66.7% of patients with depressive disorders and for 57.7% of patients with bipolar disorders. History of suicide attempts was frequent in both groups; 66.7% in depressive disorders group and 70% in bipolar disorders group. Any comorbid disorder listed at axis III was present in 40% of patients in depressive disorders group and in 52% of patients in bipolar disorders group. The mean hospitalization period was 36.6±5.9 days in depressive disorders group and 40.8±5.0 days in bipolar disorders group. The use of tricyclic antidepressants were more prevalent in the depressive group, whereas the mood stabilizers and antipsychotics were dominantly preferred in the bipolar group. Discussion: The importance of epidemiologic research is increasing in our country as well as other countries recently. Valid and reliable data for bipolar disorders and other psychiatric disorders are required in Turkey. Evaluating the results of studies performed in different regions of our country will contribute to obtain the specific characteristics of psychiatric disorders in Turkey. In the study, the age of onset was earlier in the bipolar group, whereas the existance of a stressor in the first episode was more frequent in the depressive group

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