Zekeriya BAHÇE, Ömer BÖKE, AHMET RİFAT ŞAHİN, Ali Cezmi ARIK, Hatice GÜZ, GÖKHAN SARISOY, SALİHA BAYKAL

Obsesif kompulsif bozukluğun eşlik ettiği şizofreni hastalarında yaşam kalitesi ve işlevsellik

Amaç: Bu çalışmada obsesif kompulsif bozukluğun eşlik ettiği şizofreni hastalarında belirtiler ile işlevsellik ve yaşam kalitesi arasındaki ilişkiyi ortaya koymak amaçlandı. Yöntem: Çalışma Ondokuz Mayıs Üniversitesi Psikiyatri Polikliniği’ne başvuran, 17’şer hastadan oluşan 3 grup ile yürütüldü. Birinci grupta obsesif kompulsif bozukluğun eşlik ettiği şizofreni hastaları ardışık olarak çalışmaya alındı. İkinci gruptaki şizofreni ve 3. grupdaki obsesif kompulsif bozukluk (OKB) hastaları yaş, cinsiyet, eğitim durumu ve hastalık süresi açısından obsesif kompulsif bozukluğun eşlik ettiği şizofreni grubuyla eşleştirilerek seçildi. Çalışmaya katılanlara sosyodemografik bilgi formu, Pozitif ve Negatif Semptom Ölçeği (PANSS), Yale-Brown Obsesif Kompulsif Ölçeği (YBOKÖ), İşlevselliğin Genel Değerlendirmesi Ölçeği (İGD), Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği Kısa Formu (DSÖYKÖ-K) uygulandı. Sonuçlar: Obsesif kompulsif bozukluğun eşlik ettiği şizofreni ve şizofreni hastalarının OKB’lilere göre DSÖYKÖ-K sosyal alan alt ölçek ve İGD puanlarının daha düşük olduğu saptandı. Şizofreni ve obsesif kompulsif bozukluğun eşlik ettiği şizofreni hastalarında işlevselliğin PANSS pozitif, genel psikopatoloji ve toplam skorları ile olumsuz yönde ilişkili olduğu belirlendi. Obsesif kompulsif bozukluğun eşlik ettiği şizofreni hastalarında sosyal alan yaşam kalitesi skorlarının YBOKÖ obsesif kompülsif skoru ile olumsuz ilişkili olduğu, OKB hastalarında ise işlevsellik, fiziksel ve psikolojik alan yaşam kalitesi skorlarının YBOKÖ obsesif kompülsif skoru ile olumsuz yönde ilişkili olduğu saptandı. Tartışma: Bu çalışmanın sonuçlarına göre OKB’un eşlik ettiği şizofreni hastalarının işlevselliğinin ve sosyal alan yaşam kalitesinin şizofreniyle benzerlik gösterdiği saptandı. OKB’un eşlik ettiği şizofreni hastalarında psikotik belirtilerin şiddetinin işlevsellikle ilişkili olduğu, ancak yaşam kalitesi ile ilişkili olmadığı görüldü. Ayrıca OK belirtilerin şiddetinin sosyal alan yaşam kalitesi ile ilişkili olabileceği sonucuna varıldı.

Anahtar Kelimeler:

Şizofreni, Zihinsel bozuklukların manuel tanı ve istatistiği, Obsesif-kompulsif bozukluk, Psikiyatrik durum derecelendirme ölçekleri, Yaşam kalitesi

Functionality and quality of life in obsessive-compulsive disorder with schizophrenia

Objective: The aim of this study was to determine the relationship between symptoms of obsessive-compulsive disorder comorbid with schizophrenia, and quality of life and functioning. Materials and methods: The study was designed on 3 groups of patients, each group consisting of 17 patients who were admitted to Ondokuz Mayıs University Psychiatry Clinic. The first group consisted of schizophrenia patients with comorbid obsessive-compulsive disorder. The second group includes patients with schizophrenia only, whereas patients with a diagnosis of obsessive compulsive disorder (OCD) only formed the third group. The second and third group were age, illness duration and gender matched with the first one. The patients were evaluated with, sociodemographic data form, Positive and Negative Syndrome Scale (PANSS), Yale- Brown Obsessive Compulsive Scale (YBOCS), Global Assessment of Functioning (GAF), World Health Organization Quality of Life Brief form (WHOQOL). Results: Schizophrenia patients with OCD and schizophrenia-only patients presented with lower scale scores as to WHO-QOL social relationships domain subscale and GAF points than OCD-only patients. Functionality was negatively correlated with PANSS positive, general psychopathology and total scores in schizophrenia-only and schizophre-nia-OCD groups. WHOQOL social relationships domain sub-scale was negatively correlated with YBOCS in schizophrenia-OCD group.Moreover, functionality and WHOQOL physical, psychological domain subscales was negatively correlated with YBOCS scores in OCD-only patients. Conclusion: Functionality and social relationships domains in schizophrenia-OCD patients showed similar patterns with schizophrenia-only patients. Severity of psychotic symptoms was correlated with functionality but not with total quality of life scores in oschizophrenia-OCD patients. Beside, severity of obsessive compulsive symptoms was related with social relationships domain of life quality in schizophrenia-OCD group patients.

Keywords:

Schizophrenia, Diagnostic and Statistical Manual of Mental Disorders, Obsessive-Compulsive Disorder, Psychiatric Status Rating Scales, Quality of Life,

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