anadolu klin Anatolian Clinic the Journal of Medical Sciences 2149-5254 2458-8849 Hayat Sağlık ve Sosyal Hizmetler Vakfı 10.21673/anadoluklin.778315 Health Care Administration Sağlık Kurumları Yönetimi Epilepsi Hastalarında Yaşam Kalitesine Psikosomatik Açıdan Yaklaşım A Psychosomatic Approach to Quality of Life in Patients with Epilepsy https://orcid.org/0000-0002-1466-6466 Atar Ayse Terzi SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL ÜMRANİYE SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ https://orcid.org/0000-0001-7387-8840 Gıca Şakir NECMETTİN ERBAKAN ÜNİVERSİTESİ, MERAM TIP FAKÜLTESİ https://orcid.org/0000-0002-9908-0535 Kurtulmuş Yasemin Özel Muayene Hekimi https://orcid.org/0000-0002-9227-9373 Güleç Hüseyin SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL ERENKÖY RUH VE SİNİR HASTALIKLARI SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ 01 30 2021 26 1 36 44 08 08 2020 08 27 2020 Copyright © 1933, Anadolu Kliniği Tıp Bilimleri Dergisi 1933 Anadolu Kliniği Tıp Bilimleri Dergisi

Amaç: Bu çalışmanın amacı, epilepsi hastalarında psikososyal işlevselliği; klinik olarak anlamlı ve belirgin psikolojik faktörleri olan hastaları tanımlamayı amaçlayan Psikosomatik Araştırmalar için Tanı Ölçütleri (PATÖ) sınıflandırma sistemi kullanarak değerlendirmek ve Ruhsal Bozuklukların Tanısal ve İstatistiksel El Kitabı (DSM) ile karşılaştırarak farklılıklar olup olmadığını göstermektir. Ayrıca psikosomatik tanıların hastalık sürecindeki yaşam kalitesi üzerine etkisi araştırılarak PATÖ sisteminin geçerliliğini göstermek amaçlanmıştır.Gereç ve Yöntemler: Çalışmaya Epilepsi Özel Dal Polikliniğinden yönlendirilen ardışık yüz epilepsi hastası ve 53 sağlıklı gönüllü kontrol grubu dahil edildi. Tüm katılımcılarla yapılandırılmış PATÖ ve SCID-I görüşmeleri yapıldı. Katılımcılar Kısa Form-36 (SF-36) ve Sosyodemografik Veri Formu kullanılarak araştırıldı.Bulgular: Hastaların %87’si DCPR sistemi ile ve hastaların % 82'si DSM ile tanı kriterlerini karşıladı (χ2(1,N=100) = 4,539, p=0,04). Epilepsili hastalarda tanı sistemlerinin SF-36 skorları üzerindeki etkisi hiyerarşik regresyon modeli ile incelendiğinde, PATÖ sistemindeki tanıların birçok SF-36 alt ölçek puanını daha iyi yorumladığı bulundu.Sonuç: Epilepsili hastalarda, PATÖ sendromları DSM'den daha yüksek oranda psikolojik sıkıntı tespit etmiştir. PATÖ sınıflandırmasındaki sendromlar hastaların düşük yaşam kalitesi ile ilişkilendirilmiştir. PATÖ sınıflandırması epilepsili hastalarda geçerlidir ve hastaların daha kapsamlı değerlendirilmesinde avantajları olabilir.

Aim: The aim of this study was to evaluate psychosocial functionality in patients with epilepsy using the Diagnostic Criteria for Psychosomatic Research (DCPR) classification system that aims to identify patients with clinically significant and relatively weighted psychological factors and to compare it with the Diagnostic and Statistical Manual of Mental Disorders (DSM). In addition, it was aimed to validate the DCPR system by investigating the effects of psychosomatic diagnoses on the quality of life in the disease process.Materials and Methods: One hundred consecutive patients with epilepsy who were referred to the Epilepsy special branch outpatient clinic were included in the study. The control group consisted of 53 healthy volunteers. All participants underwent structured DCPR and SCID-I interviews and were investigated using the Short Form-36 (SF-36) and a Sociodemographic Data Form.Results: Eighty-seven percent of the patients met the diagnostic criteria with the DCPR system while 82% of the patients met the diagnostic criteria with DSM (χ2(1, N =100) = 4.539, p = 0.04). Examination of the effect of diagnostic systems on SF-36 scores in patients with epilepsy with the hierarchical regression model showed that diagnoses in the DCPR system predicted most of the SF-36 subscale scores better.Conclusion: The DCPR system could detect psychological distress at a higher rate than DSM in patients with epilepsy. Syndromes in the DCPR classification were associated with poor quality of life in the patients. The DCPR classification is therefore valid in patients with epilepsy and may have advantages in a more comprehensive evaluation of patients.

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