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Yıl:2003; Cilt: 13; Sayı: 1>> Özet
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Klinik Psikofarmakoloji Bülteni; 2003;13(1):13-18
Epileptik olgularda panik bozukluğu görülme sıklığı
T Alkın, A Yıldız, E Onur, B Baklan
Dokuz Eylül Ü. Tıp Fak. Psikiyatri ABD, İzmir
Amaç: Panik bozukluğu ve epilepsi tıp pratiğinde sık karşılaşılan durumlardır. Benzer semptomatolojiye sahip olmaları, yüksek ektanı oranları ve altta yatan benzer fizyopatolojik düzeneklerin bulunma olasılığı nedeniyle bu iki bozukluk arasında bir ilişki olduğu düşünülebilir. Yöntem: Yüz yirmi epilepsi hastası, panik bozukluğu ektanısı açısından, DSM-III-R için Yapılandırılmış Klinik Görüşmesi (SCID-P) ile incelenmiştir. Daha sonra belirlenen epilepsi- panik bozukluğu hastaları, hem epilepsi hastaları, hem de panik bozukluğu hastalarıyla (bir diğer panik çalışmasına katılan ve epilepsisi olmayan panik bozukluğu hastaları arasından rastgele seçilen 12 hastadan oluşan bir kontrol grubu) karşılaştırılmıştır. Bulgular: Epilepsi hastalarının 6’sında (%5.0) aynı zamanda panik bozukluğu saptandı. Bu hastaların panik ataklarının, yalnızca panik bozukluğu olan hastaların (n=12) panik ataklarından ayırdedilemez özellikte olduğu bulundu. İncelenen sosyodemografik, klinik ve elektrofizyolojik değişkenlerden hiçbiri, epilepsi hastalarıyla (n=114), epilepsi-panik bozukluğu hastalarını (n=6) ayırdedici nitelikte değildi. Ayrıca temporal lob anormallikleri ile epilepsipanik bozukluğu ektanısı arasında bir bağlantı saptanmadı. Sonuç: Epilepsi hastalarında saptanan panik bozukluğu prevalansı toplumsal çalışmalarda saptanan oranlardan yüksektir. Ancak bu çalışmada, epilepsi ve panik bozukluğu arasında özgül bir etiyolojik bağlantı olduğuna dair bir kanıt saptanmamıştır. Epilepsipanik bozukluğu ilişkisi daha çok, örtüşen klinik semptomatolojiden kaynaklanan ayırıcı tanı güçlükleri nedeniyle önemlidir.
The prevalence of panic disorder in epilepsy patients
Objective: Panic disorder and epilepsy are fairly common entities. They might have a relationship as evidenced by the overlapping symptomatology, comorbidity rates and possibly shared underlying pathophysiological mechanisms. Methods: One hundred and twenty epilepsy patients were screened with the Structured Clinical Interview for DSM-III-R (SCID-P) to determine the panic disorder comorbidity rate. The patients with epilepsy and panic disorder were compared with both patients with pure epilepsy and patients with panic disorder only (a control group consisting of 12 patients with panic disorder only who have been randomly selected among the patients participated to another panic disorder study). Results: Six (%5.0) of the 120 epilepsy patients were diagnosed to have a comorbid panic disorder. These patients’ panic attacks were indistinguishable from the panic attacks of the patients with panic disorder only (n=12). None of the investigated sociodemographic, clinical and electrophysiological variables could differentiate the panic disorder-epilepsy patients (n=6), from the pure epilepsy patients (n=114). No association was found between temporal lob abnormalities and epilepsy-panic disorder comorbidity. Conclusions: The prevalance of panic disorder among the epilepsy patients is higher than the normal population. However, in this study no evidence of a specific etiological association between epilepsy and panic disorder has been demonstrated. This finding suggests that epilepsy and panic disorder may not involve a common pathophysiological mechanism. Nevertheless, the clinical association between panic disorder and epilepsy is still meaningfull in terms of differential diagnosis.

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