Gökhan UMUT, Zeren ALTUN ÖZTÜRK, Birim S. DANIŞMANT, İlker KÜÇÜKPARLAK, NESRİN KARAMUSTAFALIOĞLU

Relationship between treatment adherence, ınsight and violence among schizophrenia ınpatients in a training hospital sample

Amaç: Bu çalışmada şizofreni hastalarında şiddet davranışı ile içgörü, klinik belirtiler ve tedavi uyumu arasındaki ilişkinin incelenmesi amaçlanmıştır. Yöntem: Çalışmaya, Bakırköy Ruh ve Sinir Hastalıkları Hastanesinde DSM-IV-TRye göre şizofreni tanısıyla yatarak tedavi tedavi gören, 20-65 yaş arasındaki rastgele yöntemle seçilmiş 104 olgu dahil edilmiştir. Hastalara, İçgörünün Üç Bileşenini Değerlendirme Ölçeği (İÜBDÖ), Açık Saldırganlık Ölçeği (ASÖ) ve Pozitif ve Negatif Sendrom Ölçeği (PANSS) uygulanmıştır. Bulgular: Tedavi uyumu içgörü düzeyi ile ilişkili bulunmuştur. Tedaviye uyum göstermeyen olguların ASÖ puanlarının, uyum gösteren olgulardan anlamlı düzeyde yüksek olduğu saptanmıştır. İÜBDÖ ile PANSS pozitif ve PANSS negatif puanı arasında ters yönde anlamlı ilişki saptanmış, fakat PANSS genel psikopatoloji puanı ile anlamlı düzeyde ilişki saptanmamıştır. ASÖ puanı ile PANSSın yalnızca PANSS pozitif alt ölçeği toplam puanı arasında ilişki bulunmuştur. ASÖ ile İÜBDÖ arasında ilişkili bulunmamıştır. Sonuç: Örneklemimizde, tedavi uyumunun içgörü ile pozitif, saldırganlıkla negatif yönde ilişkili olduğu; saldırganlığın da hastalık şiddeti ile ilişkili olduğu saptanmıştır. Kurumsal veya toplum bazlı çalışmalarla ve ayaktan takip edilen hastaların psiko eğitimiyle tedavi uyumu artırılmalıdır. Böylece hastalık şiddeti azaltılarak saldırgan davranışların en aza indirilmesi sağlanabilir.

Bir eğitim hastanesinde yatarak tedavi gören şizofreni hastalarında tedavi uyumu, içgörü ve agresyon ilişkisi

Relationship between treatment adherence, insight and violence among schizophrenia inpatients in a training hospital sample Objective: The aim of the study was to explore the correlation of violent behavior with insight, clinical symptoms and treatment adherence in patients with schizophrenia. Method: 104 randomly selected inpatients between 20 and 65 years of age, treated with a diagnosis of schizophrenia according to DSM-IV-TR criteria at Bakırköy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry were included in the study. The Schedule For Assessment of Three Components of Insight (SAI), Overt Aggression Scale (OAS), Positive and Negative Syndrome Scale (PANSS) Turkish forms were applied to the patients. Results: Treatment adherence was correlated with insight levels. Mean OAS scores of non-adherent patients were significantly higher than patients with treatment adherence. SAI scores were inversely correlated with PANSS positive and negative symptoms, but not correlated with PANSS general psychopathology scores. The OAS scores were found to be correlated with PANSS positive symptoms scores merely. There was no correlation between SAI and OAS scores. Conclusion: The results indicate that treatment adherence is correlated positively with insight and negatively with aggression. Aggression and severity of illness are correlated as well in our sample. Community-based treatment programs and psychoeducation of outpatients should be conducted to maintain treatment adherence. Thus, violent behavior could be minimized by diminishing the severity of illness.

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