Oğuzhan KILINÇEL, Saygın EKER, Şenay KILINÇEL

Remisyon dönemi bipolar bozuklukta zihin kuramı işlev bozukluğu

Amaç: Zihin kuramı (ZK) bireyin sosyal etkileşimde rol oynayan sosyal bilişsel yeteneklerini tanımlamak için kullanılan bir kavramdır ve duygu durum bozukluklularının kliniğinde ve sosyal problemlerini açıklamakta önemli bir rolü olabilir. Bu çalışmanın amacı, remisyon döneminde olan bipolar bozukluk (BB) hastalarında sağlıklı kontrollere göre zihin kuramı yetilerinde bozukluk olup olmadığı ve ZK kusurunun cinsiyet, eğitim düzeyi, hastalık süresi, atak sayısı, hastaneye yatış öyküsü, öz kıyım girişimi öyküsü gibi klinik değişkenler ve sosyal uyum ile ilişkisini araştırmaktır. Yöntemler: Çalışma kesitsel dizaynda tasarlanmış ve remisyon döneminde olan 50 BB hastası ve 50 sağlıklı katılımcıdan oluşan kontrol grubu dahil edilmiştir. Demografik bilgiler ve hastalık öyküsü alınmış, Beck Depresyon Envanteri (BDE), Beck Anksiyete Envanteri (BAE), İma Testi, Gözler Testi, Sosyal Uyum ve Kendini Değerlendirme Ölçeği (SUKDÖ), Muhakeme Becerisi (MB) testleri uygulanmıştır.Bulgular: Gruplar arasında yaş, cinsiyet ve BDE puanları arasında anlamlı fark yoktu. İma testi (P=0,001), Gözler Testi (P=0,001), SUKDÖ (P=0,007) ve MB (P=0,001) puanları kontrol grubunda anlamlı olarak yüksek idi. İma testi ve MB arasında anlamlı pozitif korelasyon vardı (r=0,430, P=0,001). Göz Testi ile yaş (r=-0,555, P=0,001), hastalık süresi (r=-0,554, P=0,001), manik atak sayısı (r=-0,590, P=0,001) ve MB (r=0,343, P=0,050) arasında korelasyon saptandı. Lojistik regresyon analizi ile kontrol grubunun hasta grubu ile kıyaslandığında Gözler testinde her puan artışı ile 1,2 kat (P=0,001), İma testinin her puan artışı 1.3 kat (P=0,003) ilişkili olduğu gözlendi.Sonuç: ZK kusurunun, diğer özellikleri ne olursa olsun BB düzelme döneminde olan bireyi sağlıklılardan ayıran önemli bir etmen olduğu saptanmıştır. ZK kusurunun BB’nin temel patolojisinde yer aldığı ve patolojinin varlığını etkilediği düşünülmüştür.

Anahtar Kelimeler:

Bipolar bozukluk, Remisyon fazı, Zihin Kuramı, Sosyal Kognisyon

Theory of mind deficits in bipolar disorder in remission

Aims: Theory of Mind (ToM), a concept used to describe an individual's social cognitive abilities that play roles in social interaction, may have a significant role in explaining the clinical variables and social problems of affective disorders. This study aims to determine whether ToM functions are impaired in Bipolar Disorder (BD) compared to healthy controls as well as investigate the association between clinical variables of ToM deficit and social competence. Methods: A total of 50 patients diagnosed with BD who were in remission and 50 healthy control subjects were included in this cross-sectional study. Demographic data and medical history of participants were assessed, and Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Eyes test, Hinting Task, Social Adaptation and Self-Evaluation Scale (SASS), Wechsler Adult Intelligence Scale-Revised (WAIS-R) tests were administered. Results: There were no significant differences with regards to age, gender and BDI scores between patient and control groups. Hinting test (P=0.001), Eyes test (P=0.001), SASS (P=0.007) and WAIS-R (P=0.001) scores were higher in the control group. There was a significant correlation between Hinting Test and WAIS-R (r=0.430, P=0.001), and between Eyes Test and age (r.-0.590, P=0.001), duration of bipolar disorder (r=-0.554, P=0.001), number of manic attacks (r=0.590, P=0.001) and WAIS-R (r=0.343, P=0.050). Logistic regression analysis showed that compared to the patient group, control group was related to Eyes test by 1.2-fold for each point increase in Eyes test (P=0.001) and 1.3-fold for each point increase in Hinting test (P=0.003).Conclusion: ToM deficit was an essential factor that separated BD patients in remission from healthy individuals. ToM deficit may play a role in the essential pathology or affect the presence, or even onset, of BD.

Keywords:

Bipolar Disorder, Remission phase, Theory of Mind, Social Cognition,

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