Şizofrenide Aşağıdan Yukarıya Bilişsel Onarımın İşlevsellik Üzerindeki Etkisi

Year 2025, Volume: 17 Issue: 1, 95 - 106, 31.03.2025

Rukiyye Meryem Osmanoğlu , Şaziye Senem Başgül

https://doi.org/10.18863/pgy.1423865

Abstract

Kronik bir psikiyatrik bozukluk olan şizofreni hastalarında bilişsel bozukluklar, hastalık semptomlarının yanı sıra işlevsellikte de önemli bir etkiye sahiptir. Bilişsel onarım (cognitive remediation- BO) müdahaleleri, şizofreni hastalarında bilişsel işlevleri iyileştirmeyi amaçlayan bir tedavi yaklaşımıdır. Bu müdahaleler, bilişsel fonksiyonları doğrudan hedef alan "aşağıdan yukarıya" ve bilişsel işlevleri dolaylı olarak etkileyen "yukarıdan aşağıya" yaklaşımlar olarak sınıflandırılabilir. Bu çalışmada, şizofrenide aşağıdan yukarıya bilişsel onarım müdahalelerinin işlevselliğe katkısı incelenmiştir. Çalışmada, aşağıdan yukarıya bilişsel onarım müdahalelerinin, şizofreni hastalarında bilişsel işlevleri, sosyal işlevselliği ve yaşam kalitesini iyileştirebileceğine dair kanıtlar incelenmiştir. Alanyazın incelendiğinde ülkemizde aşağıdan yukarıya bilişsel onarım müdahalelerine yönelik araştırma ve programların bulunmadığı görülmüştür. Ülkemizde de aşağıdan yukarıya bilişsel onarıma yönelik programlar geliştirilmesi ve halihazırda uygulanan terapi ve rehabilitasyon çalışmalarına bu tür bilişsel onarım müdahalelerinin eklenmesi önerilmektedir. Gelecekte oluşturulabilecek aşağıdan yukarıya bilişsel onarım müdahale programlarında teknolojik imkanlardan faydalanılması, müdahalelerin süresi ve yoğunluğunun artırılması, motivasyon konusunun göz önünde bulundurulması ve müdahalelerin günlük yaşama entegrasyonunun sağlanabilmesinin etkililik, sürdürülebilirlik ve maliyet açısından önemli olduğu düşünülmektedir.

Keywords

Şizofreni, bilişsel onarım, işlevsellik, aşağıdan yukarıya yaklaşım, bilişsel rehabilitasyon, bilişsel bozukluk

Impact of Bottom-up Cognitive Remediation on Functioning in Schizophrenia

Abstract

In patients with schizophrenia, a chronic psychiatric disorder, cognitive impairments have a significant impact on functioning as well as symptoms. Cognitive remediation (cognitive remediation) interventions are a treatment approach that aims to improve cognitive functioning in patients with schizophrenia. These interventions can be categorized as "bottom-up" approaches that directly target cognitive functions and "top-down" approaches that indirectly affect cognitive functions. In this study, the contribution of bottom-up cognitive remediation interventions to functioning in schizophrenia was examined. The study provides evidence that bottom-up cognitive remediation interventions can improve cognitive functioning, social functioning and quality of life in patients with schizophrenia. When the literature is reviewed, it is observed that there is no research or programs about bottom-up cognitive remediation interventions in Türkiye. It is recommended that programs for bottom-up cognitive remediation interventions should be developed and utilized in Türkiye and they should be incorporated with the current therapy and rehabilitation approaches. It is important to benefit from technological opportunities, to increase the duration and intensity of interventions, to consider the issue of motivation and to ensure the integration of interventions into daily life, in creation of future bottom-up cognitive remediation intervention programs, in order to increase effectiveness, sustainability and cost-efficiency.

Keywords

Schizophrenia, cognitive remediation, functioning, bottom-up approach, cognitive rehabilitation, cognitive impairment

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