Pelin ZORLU KURTGÖZ, Omer BİLGİC, Tuba SAHİN, Nabi ZORLU

Şizofrenide klinik içgörünün psikiyatrik semptomlar ve bilişsel işlevler ile ilişkisi

Şizofrenide klinik içgörünün psikiyatrik semptomlar ve bilişsel işlevler ile ilişkisi Amaç: Şizofrenide bozulmuş içgörünün etiyolojisini anlamak; içgörü kazandırmak, tedavi uyumu ve tedavi yanıtları için etkili müdahale yöntemleri geliştirmek açısından önemlidir. Çalışmamızda, şizofreni hastalarında, klinik özellikler ve bilişsel işlevler ile klinik içgörünün farklı boyutları arasındaki ilişkinin araştırılması amaçlanmıştır.Yöntem: Çalışmaya DSM-5'e göre şizofreni tanı kriterlerini karşılayan 59 hasta alınmıştır. Tüm olguların ilaç tedavisi sürmektedir ve son 3 ay içinde hastane yatışı ve ilaç tedavisinde değişiklik olmamıştır. Hastalar pozitif ve negatif sendrom ölçeği (PANSS), Akıl Hastalığına İçgörüsüzlük Ölçeği (AHİÖ), Wisconsin Kart Eşleme Testi (WKET), Stroop Testi, İşitsel Üçlü Sessiz Harf Sıralaması Testi (İÜSHST) ve İz Sürme Testi ile değerlendirilmiştir.Bulgular: Ortalama yaş 41.1±10.3 yıl olarak saptanmıştır. Çalışmaya alınan hastaların %71.2'si erkek (s=42) ve %28.8'i (s=17) kadındır. Hastalığın ortalama başlangıç yaşı 24.6±7.6 yıl, hastalığın ortalama süresi 16.5±9.4 yıl ve ortalama hastanede yatış sayısı 2.6±2.8 olarak saptanmıştır. PANSS pozitif ve genel puanlarının AHİÖ toplam puanı için, PANSS genel puanı ve hastalık süresinin AHİÖ-hastalığın farkında olma puanı için, PANSS pozitif ve genel puanlarının AHİÖ-tedavi etkisinin farkında olma puanı için ve PANSS genel puanı ve hastalık başlangıç yaşının AHİÖ-sosyal sonuçların farkında olma puanı için öngördürücü olduğu saptanmıştır.Sonuç: Klinik içgörü ile ilişkili olabilecek etkenlerin değerlendirildiği bu çalışmada, şizofreni hastalarında klinik içgörünün pozitif ve genel semptomlarla ilişkili olduğu ancak, negatif semptomlar ve nörokognitif bozulma ile ilişkili olmadığı saptanmıştır

Associations of Psychiatric Symptoms and Neurocognition with Clinical Insight in Schizophrenia

Associations of psychiatric symptoms and neurocognition with clinical insight in schizophreniaObjective: It is important to understand the etiology of impaired insight in schiophrenia in order to develop effective interventions to improve disorder awareness, treatment adherence, and recovery outcomes. The current study aims to explore the relationship of clinical domains and neurocognitive functions with different dimensions of clinical insight among patients with schizophrenia.Methods: A total of 59 patients who met the diagnostic criteria for schizophrenia according to DSM-5 were recruited in the study. All patients were receiving outpatient treatment and were in fairly stable clinical conditions as defined by the absence of hospitalizations or changes in medication within the last three months. Patients were evaluated by Positive and Negative Symptoms Scale (PANSS), Scale to Assess Unawareness of Mental Disorder (SUMD), The Wisconsin Cart Sorting Test (WCST), Stroop-Test, Auditory Consonant Trigram Test (ACT) and Trail Making Test (TMT).Results: Mean age was 41.1±10.3 years. Of the total 59 patients, 71.2% (n=42) were male and 28.8% (n=17) were female. Mean age of onset for illness was 24.6±7.6 years, mean duration of illness was 16.5±9.4 years and mean number of hospitalizations was 2.6±2.8. According to our findings, PANSS positive and general scores were predictors for SUMD-total score, PANSS general score and duration of illness were predictors for SUMD-awareness of mental illness score, PANSS positive and general scores were predictors for SUMDawareness of the need for treatment score, PANSS general score and age of onset of schizophrenia were predictors for SUMD-awareness of the social consequences of disorder score.Conclusion: This study examined clinical insight, psychopathology and various domains of neurocognitive functioning. Our results suggest that clinical insight is associated with positive and general symptoms but not with negative symptoms and neurocognitive impairment in patients with schizophrenia

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