Şizofrenide görülen dikkat bozukluğu sağaltıma yanıt yönünden negatif belirtilere mi yoksa pozitif belirtilere mi paralel bir seyir gösteriyor

Amaç: Bu çalışma, şizofrenide görülen dikkat bozukluğunun sağaltıma yanıt yönünden negatif belirtilere mi yoksa pozitif belirtilere mi benzer bir seyir izlediğini araştırmak amacıyla düzenlendi. Yöntem: Çalışma, DSM-IV tanı ölçütlerine göre şizofreni tanısı alan, akut alevlenme dönemindeki 27 hasta ile gerçekleştirildi. Çalışmaya alınan hastalar, ağızdan bir antipsikotik alıyorlarsa bir hafta, depo preparut enjeksiyonu yapılmışsa iki hafta süreyle ilaçsız bırakıldılar. İlaçtan arınma dönemini tamamlayan hastalar iki psikiyatri uzmanı tarafından, altı hafta boyunca haftada bir kez. Negatif belirtileri Değerlendirme Ölçeği, Pozitif belirtileri Değerlendirme Ölçeği, UKU Yan Etki Ölçeği ve Kısa Psikiyatrik Değerlendirme Ölçeği (KPDÖ) kullanılarak değerlendirildiler. Bulgular: Sağaltım öncesi elde edilen skorlarla sağaltım haftaları boyunca bulunan skorlar karşılaştırıldığında, beş pozitif belirti skorunun tümünde ve dikkat bozukluğu skorunda anlamlı azalma olduğu görülürken, dikkat bozukluğu dışındaki negatif belirtilerin hiç birisinde anlamlı bir azalma gözlenmedi. Toplam pozitif belirti skoru (F=21.36, p=.000) ve dikkat bozukluğu skoru (F'=5.48, p=.001)l) anlamlı düzeyde düşmekteydi. Dikkat bozukluğu dışındaki negatif belirtilerin toplam skorunda ise istatistik anlamlılık düzeyinde bir değişme olmadı. KPDÖ depresvon-anksiyete alt ölçeği skorunda anlamlı bir değişiklik görülmedi. UKU ile ölçülen nörolojik yan etki skorlarıysa negatif belirtilerden duygulanımda düzleşme, istemsizlik-apati ve anhedoni-toplumsal çekilme ile pozitif korelasyon gösterirken, dikkat bozukluğu ve düşüncenin yoksullaşması ile ilişkili bulunmadı. Sonuç: Elde edilen bulgular, dikkat bozukluğunun antipsikotik sağaltma yanıtının negatif belirtilere değil pozitif belirtilere paralel bir seyir izlediğini göstermekledir.

Is the treatment response of attention impairment in schizophrenia associated with negative symptoms or positive ones?

Objective: in this study, we aimed to investigate if the treatment response of attention impairment in schizophrenia is associated with negative symptoms or positive symptoms. Method: We recruited 27 subjects diagnosed as schizophrenia according to DSM-IV. All patients, had been assessed by two psychiatrists using Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, UKU Side Effect Rating Scale and Brief Psychiatric Rating Scale after a wash out period which was one week for oral antipsychoties and two weeks for long acting injections. Follow up assessments had had been done weekly for six weeks. Results: When the baseline scores were compared with the ones assessed during six weeks treatment period, we found that all five of the positive symptom scores and attention impairment scorc decrcased at statistically significant level. On the other hand, we found no significant decrease in negative symptom scores during six week treatment. Total score of positive symptoms (F=21.36, p = .000) and attention impairment score decreased (F=5.48, p=.001). BPRS depression-anxiety scores of the patients have not shown significant change. UKU neurologic side effect scores were correlated with affective flaltening. avolition-apathy and anhedomia-asociality, but not correlated with alogia and attention impairment. Conclusion: These results indicated that the treatment response of attention impairment to antipsychotic medication is similar to the response of positive symptoms but not to the response of negative symptoms.

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