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Yıl:2017; Cilt: 4; Sayı: 2>> Özet
TAM METİN
The Journal of Neurobehavioral Sciences; 2017;4(2):72-76
Bipolar bozukluk tip 1 tanılı hastalarda kadın ve erkek farklılıkları
TD Berkol, HM Aytaç, S İslam, H Yumrukçal, G Özgen, İ Özyıldırım
Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Cinsiyetin bipolar hastalığın fenomenolojisi ve seyri üzerine önemi son yıllarda artan bir çalışma odağı olmuştur. Bu çalışmanın amacı, cinsiyet farklılıklarının sosyodemografik özellikler, başlangıç yaşı, hastalığın şiddeti, episodların sayısı ve tipi, semptomatoloji ve bipolar bozukluğun tedaviye yanıtı üzerinde etkisinin var olup olmadığını incelemektir.Bipolar bozukluk tip-I’li 300 (193 kadın, 107 erkek) hasta retrospektif olarak incelendi. Bipolar bozukluk tanıları DSM-IV-TR kriterlerine göre iki deneyimli klinisyen tarafından verildi. Hastaların sosyodemografik ve klinik özelliklerini değerlendirmek için geliştirilen yarı yapılandırılmış bir grafik ve sürdürüm tedavisine yanıt biçimlerini değerlendirmek için “ayna dizaynı” yöntemi kullanılmıştır. Bipolar kadınlarda bipolar erkeklere göre herhangi bir duygudurum atak öyküsü (en az bir) olma ihtimali daha yüksekti. Bununla birlikte, manik veya karışık atak sayısında anlamlı bir cinsiyet farklılığı ortaya çıkmamışken kadınlarda daha hazla depresif dönemler mevcuttu. Psikotik atak sıklığı (yaşam boyu en az bir dönem) erkeklerde kadınlardan daha yüksekti. Lityum ve antikonvülsan sürdürüm tedavisine yanıt, ortalama episod şiddeti ve başlangıç yaşı açısından cinsiyetler arasında anlamlı bir farkı yoktu. Bu çalışmanın sonuçları, BD-I’ li hastalarda bazı cinsiyet farklılıklarının görülebileceğini göstermektedir. Bipolar bozukluğu çalışan araştırmacıların değerlendirmede ve tedavi stratejilerinde cinsiyeti için bir değişken olarak kabul etmeleri gerekebilir.
Differences in men and women with bipolar-1 diagnosed patients
The importance of gender on phenomenology and course of bipolar illness has been an increased focus of study over recent years. The purpose of present study was to examine whether gender differences exist in the sociodemographic characterictics, age of onset, severity of disease, number & type of episodes, symptomatology and treatment response of bipolar disorder. The life charts of 300 (193 female; 107 male) patients with BD type-I were evaluated retrospectively. BD diagnosis of patients was given by two experienced clinicians in accordance with DSM-IV-TR criteria. A semi-structured chart which was developed to assess sociodemographic and clinical features of patients and “mirror design” method was utilized for the assessment of patients’ response patterns to maintenance treatment. Bipolar women were significantly more likely to have history of (at least one) any mood episode than bipolar men. However no significant gender differences emerged in number of manic or mix episodes; whereas, women had more depressive episodes. Frequency of psychotic episodes (at least one episode during lifetime) was higher for men than women. There was also no significant gender difference in terms of response to lithium and anticonvulsant maintenance treatment, mean episode severity and age of onset. The results of the present study show that some gender differences may be evident in patients with BD-I. In the highlight of that investigators studying bipolar disorder may need to consider gender as a variable for assessment and treatment strategies.

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