Soner Çakmak, Mahmut Onur KARAYTUĞ, Ufuk BAL, Lut Tamam, Ali TAŞDEMİR

Bir grup şizofreni hastasında prodromal evrede risk belirteçlerinin retrospektif değerlendirilmesi

Amaç: Bu çalışmanın amacı şizofreni hastalarında prodromal evrede risk belirleyicilerin şizofreni gelişiminde anlamlılığını ve bu belirleyicilerin şiddeti ile şizofreni gelişme süresi arasındaki bağıntıyı araştırmaktır.Gereç ve Yöntem: Çalışmaya şizofreni tanısı almış olan, 18 yaş üstü hastalar dahil edilmiştir. Şizofreni prodromal evre risk belirleyicisi olarak SOPS (Prodromal Sendromlar Ölçeği) uygulanmış, ölçek puanları hesaplanmış ve hastaların SIPS (Prodromal Sendromlar İçin Yapılandırılmış Görüşme)’e göre adlandırılan risk sendromları ölçütlerine göre sınıflandırması yapılmıştır. Bulgular: Yüz hastanın 68’inde prodromal belirtiler saptanmıştır. 68 hastanın 47’si SIPS Hafif Pozitif Prodromal Sendrom (APPS), 20’si Kısa Aralıklı Psikotik Belirti Sendromu (BIPS), 24’ü Genetik Risk ve Yüksek Klinik Risk Kötüleşmesi (GRDS), 67’si Psikotik Sendrom (PS), 44’ü DSM-5 HPS ölçütlerini karşılamıştır. SOPS ölçek belirtilerinin anlamlılığına bakılmıştır. Ölçek belirtilerinden grandiozite, algısal anormallikler/varsanılar, düşünce fakirliği, bir rolün işlevinde kötüleşme, garip davranış ve görünüm, normal strese azalmış tolerans’ın APPS, BIPS ve DSM-5 HPS risk gruplarında anlamlı olarak bulunmuştur. Sonuç: Prodromal belirtilerin psikoz ve şizofreni gelişme olasılığını normal populasyona göre belirgin oranda artırdığı açıktır. Ancak riskin belirleyici ölçütlerin daha özelleştirilmesi ve ayrıntılandırılması, ölçütlerde nörobiyolojik risk faktörlerinin de araştırılarak ortaya konulması risk gruplarının daha güvenilir şekilde belirlenmesine ve prodromal dönemde hastalığın tanınmasına yardımcı olacaktır

Anahtar Kelimeler:

Şizofreni, prodrom, risk sendromları

Retrospective evaluation of risk determinants in prodromal period with a group of schizophrenia patients

Purpose: This study aims to investigate the significance of risk determiners in the occurence of schizophrenia. and the link between the severity of determiners and the duration to full-blown schizophrenia.Material and Methods: Patients older than 18 years old, diagnosed with schizophrenia are included in our study. SOPS (Scale of Prodromal Symptoms) is applied to determine the risk of schizophrenia prodromal period, scale scores are calculated and patients are classified in accordance to risk syndrome criteria defined in SIPS (Structured Interview for Prodromal Symptoms). Results: Prodromal symptoms are detected in 68 of 100 patients. Of those 68 patients, 47 met the criteria for Attenuated Positive Prodromal Syndrome (APPS), 20 met the criteria for Brief Intermittent Psychotic Syndrome (BIPS), 24 met the criteria for Genetic Risk and Deterioration Syndrome (GRDS), 67 met the criteria for Psychotic Syndrome (PS), 44 met the criteria for Attenuated Psychosis Syndrome (APS) in DSM-5. Grandiosity, perceptual abnormalities/hallucinations, poverty of thought, deterioration in a role functioning, peculiar behaviour and appearance, decreased tolerance to normal stress are manifested to be meaningful in APPS, Conclusion: It’s clear that prodromal symptoms are increasing markedly the odds of psychosis and schizophrenia occurance in respect to normal population. Nevertheless, further customization and elaboration of risk determining criteria, searching and displaying neurobiological risk factors among criteria, will help to reliably identify risk groups and detect disorder in prodromal period.

Keywords:

Schizophrenia, prodrome, risk syndromes,

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