Psikotik bozukluğu olan yatan erkek hastalarda psikoaktif madde kullanımının klinik değişkenler ile ilişkisi

Year 2020, Volume: 45 Issue: 4, 1783 - 1791, 27.12.2020

Mahmut Onur Karaytuğ Lut Tamam Mehmet Emin Demirkol Zeynep Namlı Caner Yeşiloğlu

Abstract

Amaç: Çalışmamızda bir bölge ruh sağlığı ve hastalıkları hastanesinde yatarak tedavi gören psikotik bozukluk tanılı hastalarda eşlik eden psikoaktif madde(PAM) kullanımının sosyodemografik özelliklerle ilişkisinin ve klinik özellikler üzerine olası etkilerinin tespit edilmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmamıza DSM-5’e göre psikotik bozukluk tanısı konmuş, yatarak izlenen 110 hasta dahil edilmiştir. Tüm katılımcıların arşiv-dosya incelemesi ile sosyodemografik veri formuna ve hastaların sigara, alkol, PAM kullanımı, yatış sayısı, hastalık süresi, son yatış süresi, intihar ve başkalarına zarar verme girişimi öyküsü gibi klinik özelliklerine ulaşıldı. Yatış esnasında tespit gerekliliği ve yasal sorun geçmişi araştırıldı.
Bulgular: Psikotik bozukluğu olan 110 hastanın %30,9’unun (N=34), psikoaktif madde kullanmakta olduğu görüldü. Madde kullanan hastaların %17,3‘ünün esrar, %7,3’ünün amfetamin, %0,9’unun kokain, %0,9’unun eroin, %2,7’sinin inhaler ve %1,8’inin çoklu madde tercih ettiği görülmüştür. Psikoaktif madde kullanan hastaların yaş ortalaması, kullandığı antipsikotik sayısı, uygulanan tespit oranı, yasal sorun yaşama, alkol ve sigara kullanımı ve homisid girişimi oranı psikoaktif madde kullanmayanlardan anlamlı olarak farklıydı.
Tartışma: Psikotik bozukluklarda madde kullanım komorbiditesi küçümsenmeyecek oranlarda görülmektedir. Psikoaktif madde kullanan hastalarda daha fazla antipsikotik kombinasyonu kullanılması, yatış sırasında daha çok tespit uygulanması, homosidal girişim ve yasal sorun geçmişinin fazla olması gibi elde edilen sonuçlar, madde kullanımının psikotik bozukluk tanılı hastaların takip ve tedavisini güçleştirdiğini desteklemektedir.

Keywords

psikoz, psikoaktif madde, yatan hasta

The relationship of psychoactive substance use with clinical variables in male inpatients with psychotic disorder

Abstract

Purpose: We aimed to determine the relationship between psychoactive substance (PAS) use and sociodemographic and clinical characteristics in patients with psychotic disorders in a regional mental health and disease hospital.
Materials and Methods: We included 110 inpatients diagnosed with psychotic disorders according to DSM-5 criteria. We investigated clinical records to determine the patients' sociodemographic data and characteristics, such as smoking, alcohol, use of PAS, number of hospitalizations, duration of the disorder and last hospitalization, suicide attempts, and attempted harm to others. We also investigated whether the medical staff applied physical restraints during the hospitalization and the presence of legal problems.
Results: Thirty-four (30.9%) of 110 patients with a psychotic disorder were using psychoactive substances. The preferred substances were 17.3% cannabis, 7.3% amphetamine, 0.9% cocaine, 0.9% heroin, 2.7% inhaler, respectively. We found that the PAS users differed from not users with age, the number of antipsychotics used, the rate of restraints, legal problems, alcohol and smoking, and homicide attempts.
Conclusion: Comorbidity of substance use in psychotic disorders is seen at rates that cannot be underestimated. The results obtained such as using more antipsychotic combinations in patients using psychoactive substances, application of more detection during hospitalization, homocidal intervention and high legal problem history support that substance use makes the follow-up and treatment of patients diagnosed with psychotic disorders difficult.

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