Dergi Ara >>
Yıl:2009; Cilt: ; Sayı: 1>> Özet
Psike Dergi; 2009;(1):37-0
Obsesif kompulsif bozukluk ve nöropsikoloji
F Karadağ
Pamukkale Üniv. Tıp Fak. Psikiyatri ABD, Denizli
Obsesif kompulsif bozukluğun (OKB) temel klinik belirtileri olan ısrarlı, tekrarlayıcı düşünce ve davranışların bilgi işleme sürecindeki bozukluk veya yanlılık ile ilişkili olabileceği düşünülmektedir. Bu konudaki çalışmalar sözel ve görsel bellek, dikkat süreçleri ve yürütücü işlevler üzerinde yoğunlaşmıştır. Bazı çalışmalar OKB'daki bellek bozukluğunun, üstbellek (metamemory) sistemindeki işlev bozukluğunu düşündürecek biçimde belleğe duyulan güvenin azalması ile ilişkili olduğunu bildirmektedir. Sözel bellek konusundaki çelişkili sonuçlara karşın özellikle bireyin kendi eylemleri ve karmaşık görsel bilgiye yönelik sözel olmayan bellek bozukluğuna ilişkin daha tutarlı kanıtlar vardır. OKB hastaları kendileri için tehdit oluşturan bilgileri işleme yönünde bir dikkat yanlılığının yanı sıra istenmeyen, karıştıcı bilgilerin işlenmesini baskılama yetisinde bozulma gösterebilirler. Nöropsikolojik çalışmalar OKB hastalarının temelde yürütücü işlev bozukluğu gösterdiklerini, bellek ve dikkat süreçlerinin bunlara ikincil olarak etkilendiğini düşündürmektedir. Bellek bozukluğunun daha çok frontostriatal işlev bozukluğu ile bağlantılı olarak belleğin organizasyon stratejisindeki bozulma ile ilişkili olduğu, dikkat bozukluklarının da olasılıkla bir yürütücü işlev olan bilişsel inbihisyon sürecindeki bozulmayı işaret ettiği düşünülmektedir. Bu alandaki çalışmalar ayrıca, OKB hastalarının, sağlıklı bireylere göre, bilişsel veya motor yanıtı baskılama becerilerinin yanı sıra karar verme, planlama, kurulumu değiştirme gibi yürütücü işlevlerde bozukluk gösterdikleri bildirilmektedir. Son çalışmalar yanıtı ketlemedeki yetersizliğin OKB için nörobilişsel bir endofenotipi yansıtabileceği düşünülmektedir.
Obsessive compulsive disorder and neuropsychology
ersistent repetitive thouhgts and behaviours which are the core clinical symptoms of obsessive compulsive disorder (OCD) are thought to be associated with the impairment or bias in the information processing. The studies on these issues have focused on verbal and non-verbal memory, attention and executive functions. A number of studies have indicated that memory deficits in OCD are associated with a low confidence about memory suggesting dysfunctional metamemory systems. Although there are divergent results for verbal memory, there is more consistent evidence suggesting impairment for non-verbal memory, particularly for complex visual information and the individual's own actions. OCD patients may also show an attentional bias favoring threatening information, as well as the failure of cognitive inhibition for aversive and interfering information. Neuropsychological studies have suggested that OCD patients showed primarily executive dysfunction and memory and attentional process are effected secondarily. It has been considered that memory deficits are associated with impairment of organizational strategies of memory suggesting a frontostriatal dysfunction, and attentional disturbances are also likely to refer to failure of cognitive inbitory proces which is an executive function. The studies investigating these issues have also reported that OCD patients show executive dysfunctions such as decision making, set shifting, planning as well as impairment of cognitive behavioral inhibition compared to healthy individuals. Recent studies have suggested that the failure of response inhibition may reflect a neurocognitive endophenotype for OCD.

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