Minör Fiziksel Anomalilerin Klinik ve Eşik Altı Psikotik Belirtilerle İlişkisi

Abstract

Objectives: Minor physical anomalies (MPA) are markers of neurodevelopmental disturbance. Supporting the neurodevelopmental model of schizophrenia, MPA’s were consistently found to be elevated; however, their relationship with psychotic symptoms are inconsistent. Recent evidences suggest that subclinical psychotic symptoms (SPS) are widely prevalent in the general population – constituting a psychosis continuum. In this regard, SPS in healthy individuals may also be associated with disturbance in neurodevelopment albeit to a lesser extent than schizophrenia. The aim of this study is to examine the relationship of MPA’s with psychotic as well as SPS. Materials and Methods: Subjects with schizophrenia and related disorders as the patients’ group (PG) (n=55) were compared to a group of healthy control subjects (CG) (n=61) with a comprehensive MPA assessment. We also examined the relationship of psychotic symptoms in the PG and SPS in the CG with MPA count and location. Results: In most topographical locations, MPA amount was significantly elevated in the PG than the CG. MPA’s were correlated with the number of psychotic episodes as well as overall severity of illness in the PG. Cranio-facial anomalies were associated with positive symptoms, and particularly ear anomalies were significantly associated with symptoms of disorganization. Similarly, in the CG, positive-SPS was associated with MPA’s in the cranio-facial area. Negative psychotic symptoms and negative-SPS were not associated with MPAs. Conclusion: We report the first evidence that SPS in healthy individuals may be associated with cranio-facial MPAs which may be informative on the neurodevelopmental model of psychosis. Our results also suggest an association between cranio-facial MPAs and positive disorganization symptom domains in the psychosis continuum.

Keywords

• Minor Physical Anomalies
• Neurodevelopment
• Psychotic Symptoms
• Subclinical Psychotic Symptoms

Minör Fiziksel Anomalilerin Klinik ve Eşik Altı Psikotik Belirtilerle İlişkisi

Abstract

Amaç: Minör fiziksel anomaliler (MFA) nörogelişimde bozulmanın işaretleyicileridir. Şizofrenide sağlıklı kontrollere göre daha sık görülmektedirler ve bu bulgu hastalığın nörogelişimsel modelini desteklemektedir. Ancak MFA’ların psikotik belirtilerle ilişkisi konusunda literatür tutarsızdır. Öte yandan, güncel kanıtlar sağlıklı kişilerde eşik altı psikotik belirtilerin (EAPB) yaygın biçimde görülebildiğini göstermekte ve bu durum psikotik deneyimin sürekliliğine işaret etmektedir. Öyleyse, sağlıklı kişilerde EAPB’nin şiddeti-şizofrenide olduğundan daha hafif derecede olsa da MFA şiddetiyle ilişkili olabilir. Bu çalışmanın amacı MFA’ların şizofreni spektrum bozuklukları olgularında psikotik belirtilerle, sağlıklı kimselerde ise EAPB ile ilişkisini araştırmaktır. Gereç ve Yöntem: Şizofreni spektrum bozuklukları olgularından oluşan olgu grubu (OG) (n=55), sağlıklı kimselerden derlenen bir kontrol grubuyla (KG) (n=61) kapsamlı bir MFA taramasına tabi tutulmuştur. Klinik grupta pozitif ve negatif belirtilerin şiddetiyle, kontrol grubunda ise EAPB’nin şiddetiyle MFA’ların sayı ve lokalizasyonları arasındaki ilişkiler incelenmiştir. Bulgular: Ölçüm yapılan çoğu topoğrafik bölgede MFA puanları KG’ye göre OG’de daha yüksektir. OG’de psikotik atak sayısı ve genel hastalık şiddeti MFA puanlarıyla koreledir. Kraniyo-fasiyal anomalileri pozitif belirtilerle ve özellikle kulak anomalileri dezorganizasyon boyutuyla ilişkili bulunmuştur. Benzer olarak KG’de EAPB’nin pozitif boyutuyla kraniyo-fasiyal MFA’ların arasında ilişki bulunmuştur. Negatif belirtiler ve EAPB’nin negatif boyutuyla MFA’ların arasında bir ilişki bulunmamıştır. Sonuç: Çalışmamız sağlıklı popülasyonda eşik altı psikotik yaşantılarla kraniyo-fasiyal anomaliler arasında bir ilişki olabileceğine dair ilk bildirimdir. Sonuçlar psikozun sürekliliği bağlamında, özellikle kraniyo-fasiyal MFA’larla pozitif belirtiler ve dezorganizasyon boyutu arasında bir ilişki olduğuna işaret etmekte olup, bu bulgu psikozun nörogelişimsel etiyolojisine ilişkin ipuçları sağlayabilir.

Keywords

• Minor Fiziksel Anomaliler
• Nörogelişim
• Psikotik Belirtiler
• Eşik Altı Psikotik Belirtiler

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