Dergi Ara >>
Yıl:2009; Cilt: ; Sayı: 1>> Özet
Psike Dergi; 2009;(1):53-65
Erken başlangıçlı obsesif kompulsif bozukluk
O Karamustafalıoğlu, UE Uzun
Şişli Etfal Eğt. Araş. Hastanesi
Obsesif kompulsif bozukluk (OKB), diğer anksiyete bozukluklarından özellikle erkek hastalarda erken başlangıç göstermesi, hastalığın kronik seyretmesi, yüksek eştanı içermesi, anksiyolitiklere kötü yanıt vermesi, düşük plasebo yanıtının olması ve antidepresanlarla daha uzun süre yüksek dozda tedavi gerektirmesi gibi sebeplere ayrılır. Ayrıca, diğer anksiyete bozukluklarında amigdala disfonksiyonuna odaklanılırken, OKB'de bu durum görüntüleme çalışmalarında belirgin değildir. OKB hastalarında, fenomenolojik benzerlikler olmasına rağmen ilaç tedavilerine yanıttaki farklılıklar, çocukluk çağında sık görülmesi, farklı semptom içeriklerine sahip olması ve aile de hastalık hikayesinin fazla olması gibi sebeplerle bir alt gruplamaya gidilmesi gerekmektedir. Biz bu yazıda jüvenil hasta grubu ile yetişkin hasta grubunu karşılaştıran çalışmalardan çok yetişkin hasta grubunda farklı başlangıç yaşına sahip grupları karşılaştıran çalışmaları derledik. Sonuç olarak, sorun erken başlangıçlı hastaların yetişkinlik dönemlerinde de geç başlangıçlı hastalara göre farklı cinsiyet, semptom profili, tedavi yanıtı, eştanı, kişilik özellikleri, ailevi yatkınlık, genetik ve nöropsikolojik farklılıklar gösterip göstermediği ile ilgilidir.
Early onset obsessive-compulsive disorder
Obsessive compulsive disorder (OCD) differs from other anxiety disorders particularly with its early onset in males, chronic course, high comorbidity, poor response to anxiolytics and placebo, and need for longer treatment with antidepressants at higher doses. Although amygdala dysfunction is underlined in other anxiety disorders, it is not investigated in studies of brain imaging in OCD. Despite the phenome-nological similarities among OCD patients there is a need for subtyping because of some factors such as difference in response to pharmacological treatment, frequent onset in childhood, a wide range of symptom profiles and more cases in family history. In this review we examined the studies comparing the different age groups of onset in adults with OCD instead of the studies comparing juvenile onset OCD with adult onset OCD. In conclusion the question is whether adult patients with early onset OCD differ from adult patients with late onset OCD in terms of gender, symptom profiles, response to treatment, comorbidity, personality traits, familial tendency, genetics and neuropsychology.

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