ERCAN ABAY, Aykan PULULAR, ÇAĞDAŞ ÖYKÜ MEMİŞ, Necdet SÜT

Edirne ili merkezindeki lise öğrencilerinde obsesif-kompulsif bozukluğun epidemiyolojisi

Amaç: Edirne ili merkezindeki lise öğrencileri arasında obsesif-kompulsif bozukluk (OKB) yaygınlığını araştırmak, OKB’nin sosyodemografik özelliklerini ve OKB belirtilerinin sıklığını saptamak. Yöntem: Çalışma, Edirne ili merkezindeki liselerde eğitim görmekte olan 1., 2. ve 3. sınıf öğrencileriyle yapıldı. Örneklem büyüklüğünü hesaplamada, toplumda OKB görülme yaygınlığı %3 olarak alındı ve il genelindeki 8037 öğrenciden, OKB yaygınlığını saptamak için, tolerans değeri %0.6 ve %95 güvenle 3107 öğrencinin seçilmesinin yeterli olduğu saptandı. Örneklem, il genelindeki liselerden cinsiyet ve öğrenci sayılarına göre yapılandırılarak tabakalı örnekleme yöntemiyle seçildi. İlki, katılımcının kendisinin dolduracağı sosyodemografik veri formu ve Maudsley Obsesif-Kompulsif Soru Listesi (MOKSL), ikincisi, görüşmeci aracılığıyla doldurulacak CIDI (Composite International Diagnostic Interview) OKB ölçeği ve CIDI’nin depresif bozukluk ve yaygın anksiyete bozukluğu olmak üzere toplam iki alt ölçeği de çalışmamıza dahil edildi. Biyoistatistik uzmanı yardımı ile yapılan çalışmada, normal dağılım kuramından hareketle MOKSL’den 25 ve üstü puan alan 117 öğrenci bir üst değerlendirmeye alındı. Böylece, önceden OKB açısından değerlendirmeyi hak eden öğrenciler belirlendi. Sonraki aşama olan CIDI ölçeği ile OKB’nin yanı sıra yaygın anksiyete bozukluğu (YAB) ve majör depresyon (MD) eş tanıları da incelendi. Bulgular: Toplam kırk kişiye OKB tanısı konmuş, OKB’nin nokta yaygınlığı %1.4 olarak bulunmuştur. Vakaların sosyodemografik özellikleri yönünden yapılan karşılaştırmada, vaka grubuyla, toplam 2856 öğrenciden MOKSL’den 25 ve üstü puan alan 117 kişi dışında kalan öğrencilerin eşit aralıklara bölünmesiyle elde edilen kontrol grubu arasında istatistiksel olarak anlamlı farklılık yoktu. En sık, bulaşma obsesyonu (%40) ve kontrol kompulsiyonu (%22.5) saptanmış, majör depresyon eş tanısı %47.5, yaygın anksiyete bozukluğu eş tanısı %5 oranında bulunmuştur. Sonuç: Çalışmamızda sosyodemografik özellikler literatürden farklı bulunmuştur ve bulgular kontrol grubundan istatistiksel olarak anlamlı farklılık göstermemiştir. Ergenlik dönemi, diğer yaş dönemlerinden farklı özellikler taşıyan, hassas bir dönemdir. Bu nedenle, bu yaş grubuyla çalışmanın güçlükleri çalışmamızda da gözlemlenmiştir. Psikiyatrinin tüm toplumda, özellikle ergenlik döneminde daha iyi anlaşılması için daha fazla bilgilendirici çalışmanın yapılması gerektiği öne sürülebilir.

Epidemiology of obsessive compulsive disorder at high school students in Edirne city center

Objective: To investigate the prevalence of OCD among high school students in Edirne city center, to determine sociodemographic features of OCD, and to determine frequency of OCD symptoms. Methods: The study was conducted with 9th, 10th, and 11th grade high school students in the Edirne city center. The frequency of OCD among the entire population was accepted on 3% in the calculation of sample size and 3107 students among 8037 province-wide students were enrolled to the study with a 0.6% tolerance and a 95% confidence level. The sample was selected from province-wide high schools using stratified sampling by weighing according to gender and the number of students. The sociodemographic data form and the Maudsley Obsessive-Compulsive Inventory (MOCI), which will be filled out by the participant, and the Composite International Diagnostic Interview (CIDI) and two subscales of the CIDI concerning major depression (MD) and generalized anxiety disorder (GAD), which were filled out by the interviewer, were used. In the study, conducted together with a biostatistician, 117 students who had a MOCI score of ≥ 25 were enrolled into the next stage of the assessment with respect to the normal distribution. Thus, the students who were eligible for assessment of OCD were also diagnostically-assessed in terms of co-morbid GAD and MD by the CIDI. Results: A total of 40 students were diagnosed with OCD, and the point prevalence of OCD was found to be 1.4%. Sociodemographic features of the cases were not statistically significantly different compared to the control group included students selected from the 2856 students, except 117 students who had a MOCI score of ≥ 25, obtained after dividing into equal intervals. Contamination obsessions and control compulsions were most frequently encountered (40% and 22.5%, respectively), and the frequency of co-morbid MD and GAD were 47.5% and 5%, respectively. Conclusion: In the present study, the sociodemographic features were different from the literature and the results were not statistically different compared to the control group. Puberty is a sensitive period that has different features from other age groups. Therefore, difficulties of working with such an age group were also observed in the present study. It is suggested that there is a need for more informative studies for a better understanding of psychiatric disorders in the population, particularly in adolescence.

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