Esin Evren KILIÇASLAN, Güler ACAR, Sevgin EKŞİOĞLU, Sermin KESEBİR, Ertan TEZCAN

The Effect of Delusion and Hallucination Types on Treatment Response in Schizophrenia and Schizoaffective Disorder

Sanrı ve varsanı tiplerinin şizofreni ve şizoaffektif bozuklukta tedavi yanıtına etkisi. Amaç: Sanrı tiplerinin sosyodemografik ve kültürel ne gibi değişkenlerden etkilendiği konusunda fazla sayıda çalışma olmasına rağmen sanrı tipinin tedaviye yanıtına etkisi konusunda fazla sayıda çalışma bulunmamaktadır. Biz bu çalışmada sanrı ve varsanı tiplerinin şizofreni ve şizoaffektif bozukluk tanısı ile yatarak tedavi gören hastalarda, tedavi yanıtına etkisini araştırmayı amaçladık.Yöntem: Çalışmamıza şizofreni ve şizoaffektif bozukluk tanılarıyla ardışık olarak yatarak tedavi gören ve klinik görüşme sonucunda Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı Yeniden Gözden Geçirilmiş Dördüncü Baskı (DSM-IV-TR) tanı ölçütlerine göre şizofreni ve şizoaffektif bozukluk tanısı doğrulanan 116 hasta alındı. Sanrı tiplerini belirlemek amacıyla Gross ve arkadaşlarının sanrı sınıflandırma sistemi kullanıldı. Varsanılar işitsel, görsel, işitsel-görsel olarak kaydedildi. Hastaların tedavi yanıtı ise yatış ve çıkıştaki Pozitif ve Negatif Sendrom Ölçeği (PANSS) puanlarının farkı ve yatış süresi ile değerlendirildi.Bulgular: Sanrı tiplerinin tedavi yanıtına etkisi araştırıldığında; dini ve büyüklük sanrıları olan hastaların, olmayan hastalara göre yatış sürelerinin istatistiksel açıdan anlamlı derecede daha uzun olduğu saptandı. Ayrıca büyü yapılma sanrısı olan hastalarda yatış ve çıkıştaki PANSS puanları arasındaki fark daha azdı. Varsanıların tipi, PANSS puanları arasındaki farkı ve tedavi süresini değiştirmemekte idi. Sonuç: Çalışmamız büyüklük sanrıları, dini sanrılar ve büyü yapılması sanrılarının olumsuz tedavi yanıtı ile ilişkili olduğunu göstermektedir. Sanrı tiplerinin şizofreni spektrumunda hastanede yatış süresi ve tedavi yanıtı üzerine etkisi olduğu söylenebilir.

Sanrı ve varsanı tiplerinin şizofreni ve şizoaffektif bozuklukta tedavi yanıtına etkisi

The effect of delusion and hallucination types on treatment response in schizophrenia and schizoaffective disorder. Objective: While there are numerous studies investigating what kind of variables, including sociodemographic and cultural ones, affect the delusion types, not many studies can be found that investigate the impact of delusion types on treatment response. Our study aimed at researching the effect of delusion and hallucination types on treatment response in inpatients admitted with a diagnosis of schizophrenia or schizoaffective disorder.Method: The patient group included 116 consecutive inpatients diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV-TR in a clinical interview. Delusions types were determined using the classification system developed by Gross and colleagues. The hallucinations were recorded as auditory, visual and auditory-visual. Response to treatment was assessed according to the difference in the Positive and Negative Syndrome Scale (PANSS) scores at admission and discharge and the duration of hospitalization. Results: Studying the effect of delusion types on response to treatment, it has been found that for patients with religious and grandiose delusions, statistically the duration of hospitalization is significantly longer than for other patients. On the other hand, in patients with a delusion of being bewitched, the difference between their PANSS scores at admission and discharge was lower. The types of hallucination did not affect the difference in PANSS scores nor the duration of treatment. However, in case of visual hallucinations, PANSS scores for psychotic exacerbation were higher.Conclusion: This study shows the association of negative treatment response with delusions of grandiosity and being bewitched and religious delusions. It can be said that delusion types in the schizophrenia spectrum may affect the duration of hospitalization and treatment response.

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