Bir grup tıp fakültesi öğrencisinde dürtü kontrol bozukluklarının görülme sıklığı ve klinik özellikleri

Amaç: Bu çalışmada dürtü kontrol bozukluklarının (DKB) tıp fakültesi öğrencileri arasındaki sıklığının ve ilişkili sosyodemografik ve klinik özelliklerin belirlenmesi amaçlanmıştır. Yöntem: Çalışmaya Eylül 2011-Haziran 2012 tarihleri arasında, Çukurova Üniversitesi Tıp Fakültesi’nde eğitim görmekte olan 277 4. ve 5. sınıf öğrencisi alındı. Demografik veri formu dolduruldu. Eksen I psikiyatrik bozuklukların belirlenmesinde DSM-IV için Yapılandırılmış Klinik Görüşme Ölçeği (SCID-I) kullanıldı. DKB yaygınlık oranı Minnesota Dürtü Kontrol Bozukluğu Görüşme Ölçeği’nin modifiye edilmiş şekli uygulanarak saptandı. Tüm hastalar, Barratt Dürtüsellik Ölçeği-11 (BIS-11) ve Belirti Tarama Listesi’ni doldurdu. Bulgular: Örneklem grubunda en az bir DKB eş tanısı konan hasta sıklığı %11.2 (s=31) idi. Başka türlü adlandırılamayan DKB dışlandığında bu oran %7.9’a düştü. En sık görülen DKB aralıklı patlayıcı bozukluk iken (%6.1) bunu trikotillomani (%2.5) izlemekteydi. Özkıyım girişimi DKB olan grupta anlamlı oranda yüksekti. Eksen I psikiyatrik bozukluk ek tanısı ve BIS-11’de ölçüldüğü üzere toplam dürtüsellik, plansız eylem ve motor dürtüsellik puanları DKB olan grupta DKB olmayan gruba göre istatistiksel olarak anlamlı düzeyde daha yüksek bulundu. Sonuç: Bu çalışmanın sonuçları DKB’nın genç erişkinlerde sık görülen, ancak tanı konmayan bozukluklar olduğunu göstermektedir. DKB, yaşam kalitesini ve ek hastalıkların gidişini etkilemektedir. Bu nedenle psikiyatrik görüşmelerde rutin olarak sorgulanmalı ve saptandığı takdirde etkin ve uygun bir şeklide tedavi edilmelidir.

Prevalence and characteristics of impulse control disorders in a group of medical students

Objective: To determine the prevalence of impulse control disorders (ICDs) among medical students and evaluatethe related sociodemographic and clinical features. Methods: A total of 277 students in the fourth and fifth year ofmedical school were included in the study. The study was conducted between September 2011 and June 2012 inCukurova University Medical School, Adana, Turkey. A demographic data form has been completed. The StructuredClinical Interview for DSM-IV (SCID-I) was used to determine axis I psychiatric disorders. The prevalence rates ofICDs were investigated by using the modified version of the Minnesota Impulse Disorders Interview. All patientscompleted Barratt Impulsiveness Scale Version 11 (BIS-11) and Symptom Check List-90. Results: The lifetimeprevalence of at least one ICD in our sample was 11.2% (n=31). When the participants with the diagnosis of ICDsnot otherwise specified were excluded the prevalence rate decreased to 7.9%. The most common ICD was intermittent explosive disorder (6.1%), followed by trichotillomania (2.5%). History of suicide attempts was significantlyhigher in the group with ICD. There was statistically significant difference between comorbidity of other Axis Ipsychiatric disorders and a significant difference was observed in terms of total impulsivity, non-planning activity,and motor impulsivity scores as determined by BIS-11 between groups with or without ICDs. Conclusion: ICDsmight be underdiagnosed in young adult populations. ICDs affect the quality of life, the course and outcome ofcomorbid disorders so it is important to ask for these disorders in regular psychiatric interviews and treating themin an appropriate and specific way.

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