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Yıl:2011; Cilt: 1; Sayı: 2>> Özet
Psikiyatride Güncel; 2011;1(2):140-155
Şizofrenide Psikiyatrik Ektanılar
BB Akdede
Dokuz Eylül Üniv. Tıp Fak., İzmir
Psikiyatrik ektanılar şizofrenide oldukça sık görülmektedir. Depresyon, anksiyete bozuklukları ve madde kullanım bozuklukları en sık görülen
ektanılardır. Şizofrenide görülen anksiyete bozukluğu ektanıları içinde obsesif kompulsif bozukluk (OKB) sıklığı %12.1, sosyal fobi
sıklığı %14.9, yaygın anksiyete bozukluğu sıklığı %10.9, panik bozukluk sıklığı %9.8 ve travma sonrası stres bozukluğu sıklığı %12.4'tür.
Şizofrenide depresyon görülme sıklığı %25 ile %50 arasında değişen oranlarda bildirilirken, hastaların %47'si nde yaşam boyu madde kullanım
bozukluğu ektanısı saptandığı bildirilmektedir.
Ülkemizde şizofrenide ektanıların saptanmasına yönelik çalışma sayısı sınırlı olmakla birlikte, madde kullanım bozukluğu dışındaki sıklık
oranları benzerdir. Şizofrenide OKB ve depresyon ilişkisine dair daha fazla bilgi varken, panik bozukluğu ve diğer anksiyete bozuklukları
daha çok son yıllarda araştırılan ektanılardır. Şizofrenide ortaya çıkan ektanılar tanı ve tedavide zorluklara yol açmaktadır. Şizofreni
ve ektanıya ait belirtilerin ayrı bir hastalık mı yoksa şizofreniye ait belirtiler mi olduğu tartışılmaktadır. Bu tartışmalara açıklık getirebilecek
çalışmalar ise metodolojik sınırlılıkları nedeniyle anlamlı kanıtlar sunamamaktadır. Bu yazıda şizofrenide görülen ektanıların sıklığı,
klinikte yol açtığı zorluklar, etiyoloji ve tedaviye yönelik mevcut bilgiler tartışılacaktır.
Comorbidity in schizophrenia

Psychiatric comorbidities are common in patients with schizophrenia. Depression, anxiety disorders and substance use disorders are the
most common. Among anxiety disorders comorbidity, the prevelance rates are %12.1 for obsessive-compulsive disorder, %14.9 for social
phobia, %10.9 for generalized anxiety disorder, %9.8 for panic disorder and %12.4 for posttraumatic disorder. While comorbid depression
has been reported in %25-50 of the patients with schizophrenia, % 47of the patients have also a life time substance use disorder diagnosis.
Although the number of studies investigating the prevelance rate of psychiatric comorbidity in patients with schizophrenia in our
country is limited, the prevelance rates are comparable except for substance use disorders. While the association between depression and
obsessive compulsive disorder with schizophrenia is better known, panic disorder and other anxiety disorder comorbidity has been more
investigated in recent [year]s. Psychiatric comorbidity leads to difficulties in diagnosis and treatment of patients with schizophrenia. It has
been an ongoing debate whether the symptoms occuring in patients with comorbid psychiatric disorder belong to a distinct disorder or
schizophrenia itself. The studies which might answer the question above is lack of sufficent evidence because of methodological limitations.
In this paper, the prevelance rates, clinical difficulties and current information regarding etiology and treatment for psychiatric
comorbidity in schizophrenia will be discussed.

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