Şizofreni Hastalarının Kraniyofasiyal Morfometrisi

Yıl 2017, Cilt: 6 Sayı: 2, 10 - 18, 01.10.2017

Mehmet Demir Emre Atay Mehmet Kemal Tümer Mustafa Çiçek Ahmet Gül Abdurrahman Altındağ Mehmet Dokur Niyazi Acer

Öz

Bu çalışma ile psikiyatrik sorunu olmayan kontrol grubu ile şizofreni hastalarında kraniyofasiyal bölgede yapılan antropometrik ölçüm değerlerinin karşılaştırılması amaçlanmıştır. Bu çalışmada 35 şizofreni hastası ile 35 kontrol grubu değerlendirildi. Olguların yüzlerine Frankfurt horizontal planını gösteren ince bir metal tel yapıştırıldı. Sonra her olgunun aynı sabit mesafeden 1 m dijital fotoğrafları lateral ve frontal görüntüleri çekildi. Dijital görüntülerde uzunluk ölçümünde Imagej programı, eğim ölçümünde ise Screen Protractor 4.0 programı kullanıldı. Ölçülen değerlerin ortalamalarının istatistiksel olarak karşılaştırılmasında Independent-Samples T testi kullanıldı. Çalışmamızda şizofreni hastalarında burun kökü derinliği 1.20±0.20 cm; p=0.004 , kafatası uzunluğu 18.04±0.86 cm; p=0,040 , biokuler genişlik 7.54±2.26 cm; p=0.000 , sağ göz fissür eğimi 0.15±0.89o;p=0.001 ve sol göz fissür eğimi 0.25±1.52o; p=0.005 ölçümleri kontrol grubuna göre düşük bulunurken, üst dudak yüksekliği 2.30±0.30 cm; p=0.013 , sol commissura palpebrarum lateralis ile heliks kökü arasındaki mesafe 7.77±0.66 cm; p=0,041 , kafatası yüksekliği 10.49±1.39 cm; p=0.000 , interkantal genişlik 4.35±2.60 cm; p=0.000 , alın eğimi 16.63±4.83o; p=0.001 ve yüzü sol maksiller derinliği 12.42±1.07 cm; p=0.004 sağlıklı kontrol grubuna göre daha yüksek bulunmuştur. Çalışmanın şizofreni hastalarının kraniyofasiyal bölgeye ait yüz yapısının daha iyi anlaşılmasına katkı sağlayacağı düşüncesindeyiz

Anahtar Kelimeler

Şizofreni, Kraniyofasiyal, Morfometri

Craniofacial Morphometry of Schizophrenia Patients

Öz

The aim of this study was to compare the anthropometric measurements made in the craniofacial region of schizophrenic patients with non-psychiatric control group. In this study, 35 schizophrenic patients and 35 control groups were evaluated. A thin metal wire was affixed to the faces showing the Frankfurt horizontal plan. Then, digital photographs lateral and frontal views of the same fixed distance 1 m of each person were taken. On the digital photos length measurements were made by Imagej program and inclination measurements were made by Screen Protractor 4.0 for Windows. The Independent-Samples T test was used to statistically compare the averages of the measured values. We found that patients with schizophrenia had a lower nasal root depth 1.20±0.20 cm; p=0.004 , head length 18.04±0.86 cm; p=0,040 , biocular width 7.54±2.26 cm; p=0.000 , right palpebral fissure inclination 0.15±0.89o;p=0.001 and left palpebral fissure inclination 0.25±1.52; p=0.005 values than control groups, but they had a higher upper lip height 2.30±0.30 cm; p=0.013 , distance between left commissura palpebrarum lateralis and helix root 7.77±0.66 cm; p=0,041 , head height 10.49±1.39 cm; p=0.000 , intercanthal width 4.35±2.60 cm; p=0.000 , forehead inclination 16.63±4.83o; p=0.001 ve left maxillar depth of face 12.42±1.07 cm; p=0.004 . We think that the study will contribute to a better understanding of the facial structure of the craniofacial region of schizophrenia patients

Anahtar Kelimeler

Schizophrenia, Craniofacial, Morphometry

Kaynakça

• Kuhn R. Eugen Bleuler's concepts of psychopathology. Hist Psychiatry 2004; 15: 361- 66.
• Van Wijngaarden B, Schene A, Koeter M, Becker T, Knapp M, Knudsen HC, et al. People with schizophrenia in five countries: conceptual similarities and intercultural differences in family caregiving. Schizophr Bull 2003; 29(3): 573-86.
• Soygür H, Aybaş M, Hınçal G, Aydemir Ç. Şizofreni hastaları için yaşam niteliği ölçeği: güvenilirlik ve yapısal geçerlik çalışması. Düşünen Adam 2000; 13(4): 204-10.
• Öztürk O, Uluşahin A. Ruh sağlığı ve bozuklukları, şizofreni (11. Baskı), Nobel Tıp Kitabevleri, Ankara 2008: 242-324.
• Erol A. Şizofreni ve diğer psikotik bozukluklar: Şizofrenide klinik özellikler ve tanı ölçütleri kullanılan ölçekler. Soygür H, Alptekin K, Atbaşoğlu EC, Herken H (Editöler). Türkiye Psikiyatri Derneği Yayınları Ankara 2007: 166- 95.
• Ulaş H, Taşlıca S, Alptekin K. Şizofrenide nörofizyolojik belirleyicilerin (endofenotip) yeri. Klinik Psikiyatri 2008; 11(Ek 4): 12-9. genetik
• Jones P, Cannon M. The new epidemiology of schizophrenia. Psychiatr Clin North Am 1998; 21: 1-25.
• Cannon TD, Kaprio J, Lönnqvist J, Huttunen M, Koskenvuo M. The genetic epidemiology of schizophrenia in a Finnish twin cohort. A population-based modeling study. Arch Gen Psychiatry 1998; 55(1): 67-74.
• Ismail B, Cantor-Graae E, McNeil TF. Minor physical anomalies in schizophrenia: cognitive, neurological and other clinical correlates. J Psychiatr Res 2000; 34: 45-6.
• Walker E. Developmentally moderated expressions of the neuropathology underlying schizophrenia. Schizophr Bull 1994; 20: 453-80.
• Weinberger DR. From neuropathology to neurodevelopment. Lancet 1995; 346: 552-7.
• Diewert VM, Lozanoff S. A morphometric analysis of human embryonic craniofacial growth in median plane during primary plate formation. J Craniofac Genet Dev Biol 1993; 13:147-61.
• Waddington JL, Lane A, Larkin CO, Callaghan E. The neurodevelopmental basis of schizophrenia: cinical dysmorphogesis and roots of a lifetime trajectory of disease. Biol Psychiatry 1999; 46: 31-9.
• Hennessy RJ, Baldwin PA, Browne DJ, Kinsella A, Waddington JL. Three dimensional surface imaging and geometric morphometrics resolve frontonasal dysmorphology in schizophrenia. Biol Psychiatry 2007; 61: 1187-94.
• Lane A, Kinsella A, Murphy P, et al. The anthropometric assessment of dysmorphic features in schizophrenia as an index of its developmental origins. Psychol Med 1997; 27: 1155-64.
• McGrath J, El-Saadi O, Grim S, Chapple B, Chant D, Lieberman D, Mowry B. Minor physical anomalies of head and face in patients with psychosis. Arch Gen Psychiatry 2002; 59: 458-64.
• Elizarraras–Rivas J, Fragoso-Herrera R, Cerdan- Sanchez LF, et al. Minor physical anomalies and anthropometric measures in schizophrenia: A pilot study from Mexico. Schizophr Res 2003; 62: 285- 87.
• Compton MT, Brudno J, Kryda AD, Bollini AM, Walkeer EF. Facial measurement differences between patients with schizophrenia and non- psychiatric controls. Schizophr Res 2007; 93(1-3): 245-52.
• Couly G, LeDouarin NM. Head morphogenesis in embryonic avian chimeras: evidence for segmental pattern in the ectoderm corresponding to neuromeres. Development 1990; 108: 543-58.
• Green MF, Bracha S, Satz P, Christenson C. Preliminary evidence for an association between minor physical anomalies and second trimester neurodevelopment in schizophrenia. Psychiatry Res 1994; 53: 119-27.
• O'Callaghan E, Larkin E, Kinsella A, Wadding JL. Familial, obstetric and other clinical correlates of minor physical anomalies in schizophrenia. Am J Psychiatry 1991; 148: 479-83.
• Kelly BD, Lane A, Agartz I, et al. Craniofacial dysmorphology in Swedish schizophrenia patients. Acta Psychiatr Scand 2005; 111: 202-7.
• Henriksson KM, Wickstrom K, Maltesson N, Ericsson A, Karlsson J, Lindgren F, et al. A pilot study of facial, cranial and brain MRI morphometry in men with schizophrenia Part-2 Psychiatry Res Neuroimaging 2006; 147: 187-95.
• Mishra V, Sharma S, Kulsreshtha V, Kumar V, Gurunani KC. Anthropometerical association of the schizophrenia. J Clin Diagn Res 2012; 6(10): 1620-23. dysmorphology with
• Compton MT, Chan RC, Walker EF, Buckley PF. Minor physical anomalies: potentially informative vestiges of fetal developmental disruption in schizophrenia. Int J Dev Neurosci 2011; 29: 245- 50.
• Deutsch CK, Levy DL, Price SF, et al. measures Quantitative dysmorphology in a family study of schizophrenia and bipolar illness. Schizophr Bull 2015; 41(6): 1309-16. of craniofacial
• Hennessy RJ, Baldwin PA, Browne DJ, et al. Three-dimensional laser surface imaging and geometric morphometrics resolve frontonasal dysmorphology in schizophrenia. Biol Psychiatry 2007; 61: 1187-94.
• Moberg PJ, Roalf DR, Gur RE, Turetsky BI. Smaller nasal volumes as stigmata of aberrant neurodevelopment in schizophrenia. Am J Psychiatry 2004; 161: 2314-6.
• Hennessy RJ, Baldwin PA, Browne DJ, et al. Frontonasal dysmorphology in bipolar disorder by 3D laser surface imaging and geometric morphometrics: comparisons with schizophrenia. Schizophr Res 2010; 122: 63-71.
• Lin AS, Chang SS, Lin SH, et al. Minor physical anomalies and craniofacial measures in patients with treatment-resistant schizophrenia. Psychol Med 2015; 45(9): 1839-50.