Ömer KARDAŞ, Burcu KARDAŞ, Hatice Serpil ERERMİŞ

Çok erken başlangıçlı şizofreni ve erken başlangıçlı şizofreni hastalarında sosyodemografik ve klinik özellikler

Amaç: Bu araştırmadaki amacımız, nadir görülen ve hakkında sınırlı sayıda çalışma olan erken başlangıçlı şizofreni (EBŞ) ve çok erken başlangıçlı şizofreni (ÇEBŞ) tanısıyla izlenen hastaların sosyodemografik verileri, cinsiyet ve başlangıç yaşının klinik görünüm üzerine etkisini ve tedavi özelliklerini tartışmaktır. Yöntem: Çalışmamızda Psikoz- Affektif Biriminde izlenen ve kontrollere düzenli gelen 22 hastanın dosya bilgileri geriye dönük olarak değerlendiril- miştir. Hastaların sosyodemografik özellikleri, klinik özellikleri, ilk ve son klinik belirtileri, Klinik Global İzlenim (KGİ)- şiddet, KGİ-yan etki ve KGİ-iyileşme puanları, kullandıkları ilaçlar ve ilaç yan etkileri kaydedilerek istatistiksel değer- lendirme yapılmıştır. Sonuçlar: Bu grup 11 erkek ve 11 kız hastadan oluşmaktadır. Yaş aralığı 13-19, yaş ortala- ması 16.5±1.5 yıldır. Hastalığın başlama yaşı 6-17 yaş arasında olup ortalama 13.7±2.6 yıl olarak bulunmuştur. Tedavi başlanmasına kadar geçen süre en az 6 ay, en çok 8 yıl olup ortalama 2±1.8 yıl olarak bulunmuştur. Hastalığın başlama yaşı açısından sekizinin (%36.4) ÇEBŞ, 14’ünün (%63.6) EBŞ olduğu görülmüştür. ÇEBŞ kızlarda, EBŞ erkeklerden anlamlı düzeyde daha fazla bulunmuştur. İşitsel varsanı kızlarda erkeklere göre anlamlı düzeyde fazla bulunmuştur. Alınma sanrıları EBŞ’de, dezorganize davranışlar ÇEBŞ’de anlamlı düzeyde fazla bulunmuştur. Risperidon 17 (%77.3), olanzapin 8 (%36.4), aripiprazol 12 (%54.5), klozapin dört (%18.2), ketiyapin ve klorpromazin birer (%4.5) olguda kullanılmıştır. Hiçbir olguda ilaç kesilmesini gerektirecek yan etkiye rastlanma- mıştır. Ekstrapiramidal sistem yan etkileri erkeklerde kızlara göre anlamlı düzeyde fazla bulunmuştur. Tartışma: EBŞ ve ÇEBŞ işlevsellikte bozulmaya yol açan ve yıkımla giden psikiyatrik hastalıklardır. Bu hastalıklar farklı klinik görünümlerde olabilirler. EBŞ ve ÇEBŞ’de etkin tedavi ile işlevsellikte önemli düzelmeler sağlanabilir. EBŞ ve ÇEBŞ’nin izleme ve tedavisiyle ilgili örneklem grubunun genişletildiği ileriye dönük çalışmalara gereksinim vardır. (Anadolu Psikiyatri Derg 2018; 19(6):615-623)

Sociodemographic and clinical characteristics of the very early onset schizophrenia and early onset schizophrenia

Objective: Our aim in this research is discuss characteristics of treatment and gender and age of onset on clinical appearance on effects, sociodemographic data of patients followed with the diagnosis of early onset schizophrenia (EOS) and very early onset schizophrenia (VEOS), which are rare and limited in number. Methods: In our study, patients who are followed up in Psychosis-Affective Unit come regularly to controls 22 patients’ file information have been evaluated as retrospectively. Statistical evaluation was performed by recording the socio-demographic char- acteristics, clinical characteristics, first and last clinical indications, Clinical Global Impression (CGI)-severity, CGI side effects and CGI-improvement scores, medications used and drug side effects of the patients. Results: This group consists of 11 male and 11 female patients. The age range is from 13 to 19 and the average age is 16.5±1.5. The age of onset of the disease is between 6 and 17 years, with a mean of 13.7±2.6. The average of treatment duration since the onset of the disease is minimum 6 months- maximum of 8 years, with an average of 2±1.8 years. Eight (36.4%) cases are VEOS and 14 cases (63.6%) are EOS when the age of onset of the disease is examined. It was noted that the early onset was significantly higher in females and the early onset was significantly higher in males. The auditory hallucinations were determined significantly higher in female cases than male cases. The refer- ence delusions were found to be significantly higher in EOS, disorganized behaviors were found to be significantly higher in VEOS. Risperidone was used in 17 (77.3%), olanzapine in eight (36.4%), aripiprazole in 12 (54.5%), clo- zapine in four (18.2%), quetiapine and chlorpromazine (%4.5) in one. The adverse effects that required cut medicine any cases were not observed. Extrapyramidal system side effects were found to be significantly higher in male pa- tients than in female patients. Discussion: EOS and VEOS are psychiatric diseases that cause deterioration in functioning and go to ruin. These diseases may be in different clinical manifestations. Important remedies can be recorded with effective treatment and functionality in EOS and VEOS. There is a need for prospective studies to expand the sample group on follow-up and treatment of EOS and VEOS. (Anatolian Journal of Psychiatry 2018; 19(6):615-623)

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