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Yıl:2012; Cilt: 2; Sayı: 1>> Özet
Güncel Psikiyatri ve Psikonörofarmakoloji; 2012;2(1):5-14
Ötimik Bipolar Hastalarda Bilişsel İşlevlerin Tek ve Çoklu İlaç kullanımlarına Göre Değerlendirilmesi
BE Cumurcu, R Karlıdağ, Ş Kartalcı, IG Gül, S Demir, B Yeşil
İnönü Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, Malatya
Amaç: Bipolar bozukluklu hastalarla ilgili yapılan çalışmalarda hastalığın aktif ve remisyon dönemlerinde
bilişsel işlevlerinde yetersizlikler olduğu bildirilmektedir. Bipolar bozukluktaki bilişsel hasarların neden kaynaklandığı
ise hala net olarak bilinmemektedir. Çoklu ilaç kullanımının tek ilaç kullanımına göre bilişsel fonksiyonlarda
bozucu etkisinin daha fazla olabileceği hipotezini öngörerek, hastalığın tedavisinde kullanılan
ilaçların bilişsel fonksiyonlara etkisini incelemeyi amaçladık.
Yöntem: Çalışmaya DSM-IV-TR tanı kriterlerine göre bipolar bozukluk (bipolar I ve bipolar II) tanısı almış 80
hasta ile yaş, cinsiyet ve eğitim seviyeleri açısından birbiriyle eşleştirilmiş 80 sağlıklı kontrol grubu alındı. Çalışmaya
alınma ölçütlerini karşılayan ve çalışmaya katılmayı kabul eden hasta ve kontrol gruplarından gerekli
onam formları alındıktan sonra çalışma başlatıldı. Hastalarda klinik durum psikiyatrik muayene, Young Mani
ve Hamilton Depresyon Derecelendirme Ölçeği kullanılarak değerlendirilmiştir. Bilişsel işlevler birçok testi
içeren kapsamlı bir nörokognitif batarya ile değerlendirilmiştir (Wechsler Bellek Ölçeği Geliştirilmiş Formu,
Stroop, Sözel Bellek Süreçleri Testi).
Bulgular: Birçok bilişsel testte her iki hasta grubu da kontrollerden daha kötü performans göstermekteydi.
Tek ilaç kullanan hastalar çoklu ilaç kullanan hastalardan sadece sözel bellek süreçleri testinde, en yüksek
öğrenme ve uzun süreli hatırlama alt puanları açısından daha iyi performansa sahipti. Diğer testler açısından
herhangi anlamlı bir fark bulunamadı.
Sonuçlar: Bizim çalışmamız bildirilen çalışmalarla uyumlu olarak, bipolar bozukluğun sadece aktif dönemlerinde
değil, ötimik dönemlerinde de bilişsel işlevlerde yetersizlikler olduğunu işaret etmektedir. Hipotezimize
göre sadece sözel bellek süreçleri testinde en yüksek öğrenme ve uzun süreli hatırlama puan
ortalamaları açısından tek ilaç kullananlar çoklu ilaç kullananlara göre daha iyi performans gösterirken, diğer
testler açısından anlamlı bir farklılık yoktu.
Evaluation of Cognitive Functions in Bipolar Patients According to Monotherapy and Polytherapy
Aim: Studies which are releated with patients suffering from bipolar disorders show that in active and remission periods of the disorder there
is cognitive insufficiensies. Causes of cognitive insuffuciensies in bipolar disorder is not yet well understood. We anticipate that polytherapy has
more adverse effects on cognitive fonctions than monotherapy and our aim in this study is to investigate the cognitive effects of drugs used
in treatment of bipolar disorder.
Methods: 80 patients due to DSM-IV criteria (bipolar I and bipolar II) and 80 healthy controls are included to the study and two groups
matched with other age,sex and education aspects. Patient and control groups who accepted to take part in study were included, necessary
aproval and ethic committe determinations were taken before the study. Patiens were evaluated with psychiatric interview, Young Mania Scale
and Hamilton Depression Rating Scale. A large neurocognitive battery (Wechsler Memory Scale-Revised, Stroop, Verbal Memory Processes
Scale) was used for neurocognitive assessment.
Results: In most cognitive tests, patient group's results were worse than the control group. Monotherapy group patients showed better results
only in Verbal Memory Processes Scale highest in learning scores and long term memory scores. Other tests showed no significant differences.
Conclusion: Our study shows that, like other studies, cognitive function of bipolar patients show deficiencies not only in active periods of
bipolar disorder but also during remission periods.
Our hypothesis showed that Verbal Memory Processes Scale-highest learning scores and long term memory scores showed better results in
patients using monotherapy than polytherapy patients. Other tests did not show any significant differences.

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