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Yıl:2012; Cilt: 49; Sayı: 1>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2012;49(1):20-28
Depresif Duygu Durum ile Giden Uyum Bozukluğunun Klinik Açıdan Major Depresif Bozukluk ile Karşılaştırılması
ST Temiz, G Güleç, C Kaptanoğlu
Yunus Emre Devlet Hastanesi, Psikiyatri Bölümü, Eskişehir, Türkiye
Amaç: Bu çalışmada, Depresif Duygudurumla giden Uyum Bozukluğu (DDUB) tanısı konulan hastalar ile stres yaratan yaşam olayı ardından gelişmiş Major Depresyon (MD) tanısı konulan hastaların klinik özellikleri, hastalık öncesindeki stres yaratan yaşam olaylarının doğası ve işlevsellik düzeylerinin karşılaştırılması amaçlanmıştır.
Yön­tem­ler: Psikiyatri polikliniğine başvuran DDUB tanısı konulan 32 hasta, stres yaratan yaşam olayının ardından gelişmiş MD tanısı konulan 22 hasta ve kontrol grubu olarak 30 kişi çalışmaya alınmıştır. Katılımcılara Hamilton Anksiyete Ölçeği (HAÖ), Hamilton Depresyon Ölçeği (HDÖ), Rahe-Holmes Strese Yeniden Uyum Ölçeği (RHÖ), Sarason'unYaşam Değişimleri Anketi (SYDA), İşlevselliğin Genel Değerlendirilmesi Ölçeği (İGD) ve Sosyal İşlevsellik Ölçeği Hasta Formu uygulanmıştır. DDUB ve MD grubundaki hastalar 6 ay süreyle takip edilmiştir. Elde edilen verilere yapılarına uygun olarak ki-kare testi, Mann-Whitney U testi, One Way varyans analizi, Kruskal-Wallis One Way varyans analizi ve Spearman ilişki analizi uygulanmıştır.
Bul­gu­lar: DDUB grubundaki hastaların semptom profilinin, MD grubundaki hastaların semptom profiline benzediği ancak MD grubunun HAÖ ve HDÖ puanlarının DDUB grubuna göre daha yüksek olduğu, işlevsellik düzeylerinin ise daha düşük olduğu saptanmıştır. Her iki hasta grubunun HDÖ, HAÖ puanlarının kontrol grubuna göre anlamlı şekilde daha yüksek olduğu, İGD puanlarının ise daha düşük olduğu belirlenmiştir. Stres yaratan yaşam olayının şiddetinin DDUB grubunda prognozu ve psikopatolojinin şiddetini etkilediği ancak MD grubunda etkilemediği saptanmıştır.
So­nuç: DDUB'u klinik açıdan MD'a oldukça benzemekle birlikte, MD'dan daha az şiddetli, işlevselliğin daha iyi olduğu ve belirtilerin stres yaratan yaşam olayları
ile ilişkili olduğu bir bozukluktur. MD ve DDUB arasındaki ilişkinin daha geniş örneklem grubu ve daha uzun süreli izlem çalışmaları ile araştırılmasına ihtiyaç vardır.
Clinical Comparison Between Adjustment Disorder with Depressive Mood and Major Depressive Disorder
Objective: The aim of this study was to compare patients with major depressive disorder (MDD) following a life event to those suffering from adjustment disorder (AD) with depressed mood in terms of clinical features, nature of precipitating stress factors, and functioning.
Met­hods: In this study, we included 32 individuals diagnosed as AD with depressed mood, 22 individuals diagnosed as MDD following a life event, and a control group of 30 individuals without any psychological or physical illness. The participants completed the Hamilton Anxiety Scale (HAS), Hamilton Depression Scale (HDS), Rahe-Holmes Social Readjustment Rating Scale, Life Experiences Survey (LES), Global Assessment of Functioning (GAF) Scale and the Social Functioning Scale (SFS). Both patient groups have been evaluated prospectively for six [month]s. The data were analyzed using Spearman's rank correlation, one-way analysis of variance (ANOVA), Kruskal-Wallis one-way analysis of variance, chi-square and Mann-Whitney U tests.
Re­sults: The symptom profile of patients diagnosed as having AD with depressed mood was found to be similar to that of subjects with MDD. However, the patients suffering from AD with depressed mood had higher scores on HAS and HDS as compared to the individuals with MDD and, the functioning levels were lower in the MDD group than in the AD group. The severity of life event was related to the severity of psychopathology in the AD group, but this was not the case for the MD group.
Conc­lu­si­on: Clinically, AD is quite similar to MDD. AD, a disorder related to life event, is less severe disorder than MDD in terms of symptom profile. At the same time, AD patients demonstrate higher level of functioning than MDD patients. The relationship between MDD and AD should be investigated with larger sample size and long prospective studies.

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