ŞİZOFRENİ HASTALARINDA VE BİRİNCİ DERECE YAKINLARINDA OBSESİF KOMPULSİF SEMPTOMLARIN ARAŞTIRILMASI

Yıl 2015, Cilt: 5 Sayı: 2, 10 - 15, 01.06.2015

Ali İrfan Gül , Yıldırım B. Doğan

Öz

Amaç: Şizofreni ve Obsesif Kompulsif Bozukluk (OKB) arasında düşünce sürecindeki bozukluk, algı patolojisi
ve klinik gidiş açısından örtüşmeler olduğu bildirilmiştir. Bu çalışmanın amacı şizofreni hastalarında ve birinci
derece yakınlarında obsesif kompulsif belirtileri araştırmaktır.

Gereç ve Yöntemler: Ankara üniversitesi tıp fakültesi psikiyatri kliniğine başvuran ve en az 5 yıldır şizofreni
tanısı ile tedavi gören 30 olgu ve birinci derece yakınları olarak bunların anneleri çalışma grubunu oluşturdu.
Herhangi bir psikiyatrik tanı almamış 29 gönüllü ve anneleri kontrol grubunu oluşturdu. Herbir olguya Mauds- ley Obsesif Kompulsif Soru Listesi (MOKSL) ve Belirti Tarama Listesi (SCL-90R) uygulandı.

Bulgular: Şizofreni hastalarında karşılaştırma grubuna göre MOKSL puanları (P<0.001) ve SCL-90R-OKB altöl-
çek puanları (P<0.001) ile SCL-90R-Global Semptom İndeksi (GSI) puanları (P<0.001) anlamlı derecede yüksek
bulundu. MOKSL ve SCL-90R-OKB altölçek puanları şizofreni hastalarının birinci derece yakınlarında (annelerin- de) karşılaştırma grubunun annelerine göre yüksek bulundu, fakat istatistiksel olarak anlamlı değildi (P>0.05). Sonuç: Çalışmamızın sonuçları şizofreni hastalarında obsesif kompulsif belirtilerin oldukça yüksek olduğunu göstermektedir. Ayrıca şizofreni hastalarının annelerinde de obsesif kompulsif belirtiler yüksek bulunmuştur. Bu sonuç şizofreni ve OKB arasında geçiş olabileceğini akla getirmektedir.

Anahtar kelimeler: Şizofreni; Obsesif kompulsif belirtiler; Birinci derece yakınlar

ABSTRACT
Objective: It is reported that there is a relationship between schizophrenia and Obsessive Compulsive
Disorder (OCD) in terms of disorder of thought process, perception and clinical course. The aim of this study
was to investigate whether there is a relationship between obsessive-compulsive symptoms in patients with schizophrenia and first-degree relatives of patients with schizophrenia.

Material and Methods: 30 Patients with at least five years history of schizophrenia admitted to Ankara
University Faculty of Medicine and their first-degree relatives enrolled to study. 29 healthy individuals with
free of any psychiatric disorder and their relatives compromised of the control group. Maudsley Obsessive- Compulsive Questionnaire (MOCI) and the Symptom Checklist (SCL-90R) were applied to all subjects. Results: MOCI scores and the SCL-90-OCD subscale scores and the SCL-90R-Global Symptom Index (GSI) scores were significantly higher in patients with schizophrenia than the control group.( P <0.001, P <0.001, P
<0.001 respectively) MOCI and the SCL-90-OCD subscale scores were found higher compared to the mothers of the comparison group but were not statistically significant (P> 0.05) in first-degree relatives of patients with schizophrenia (their mother)

Conclusion: The results of our study showed that obsessive-compulsive symptoms in schizophrenia patients
are quite high. Moreover, obsessive-compulsive symptoms were also high in mothers of patients with
schizophrenia, Brings to mind that, There may be a transition between schizophrenia and OCD.

Key words: Schizophrenia, Obsessive-compulsive symptoms, First-degree relatives

Anahtar Kelimeler

Şizofreni, Obsesif kompulsif belirtiler; Birinci derece yakınlar

Kaynakça

• Westphahl G. Über zwangsvorstellungen. Archiv Psychiatr Nervenkrankheiten. 1878;8: 734-750.
• Karno M, Golding JM. Obsessive compulsive disorder In: Robins LN, Regier DK, eds. Psychiatric disorders in America New York, NY: Free pres; 1991; s:204-219.
• Weisman MM, Bland RC, Canino GJ, Greenvald S, Hwu HG, Kyoon C, ve ark, for he Cross National Collaborative Group. The cross national epidemiology of obsessive-compulsive disorder. J Clin Psychiatry 1994; 55(3 suppl): 5-10.
• DSM-IV-Diagnostic and statistical manual of mental disorders. 4. Edition Washington, DC: The A. A 1994.
• Karno M, Golding JM, Sorenson SB, Burham MA. The epidemiology of obsessive compulsive disorder in five US communities. Arch Gen Psychiatry.1988; 45(12): 1094-1099.
• Angst J. The epidemiology of obsessive compulsive disorder. Current Insight in obsessive compulsive disorder, Hollender E, Zohar J, Marazziti D (Ed); Wiley J and Englan S.1994; s: 93-104.
• Nicolini h, Orozco B, Guiffra L, Paez F, Mejia J, Carmona MS, Sidenberg D, Fuente JR. Age of onset, gender and severity in obsessive compulsive disorder: A study on Mexican population. Salud Mental. 1997; 20(2): 1-4.
• Nicolini H, Cruz C, Camerena B, Paez F, Fuente JR. Understanding the genetic basis of obsessive compulsive disorder. CNS Spectrums. 1999; 4(5): 32-48.
• Alsobrook II JP, Leckman JF, Goodman WK, Rasmussen SA, Pauls DI. Segregation analysis of obsessive compulsive disorder using symptom-based factor scores. Am J Med Genet. 1999; 88(6): 669-675.
• Fyer AJ. Anxiety disorder: Genetics. In Kaplan and Sadock’s Comprehensive Texbook of Psychiatry 7th Edition, eds. Sadock BJ et Sadock VA. Lipprincott Williams and Wilkins: Philedelphia, 2000; 1462.
• Nectadt G, Samuels J, Riddle M, Bienvenu OJ 3rd , Liang KY, LaBuda M, ve ark. A family study of obsessive compulsive disorder. Arch Gen Psychiatry. 2000; 57(4): 358-363.
• Cruz C, Camarena B, King N, Paez F, Sidenberg D, de la Fuente JR,ve ark. Increased prevalence of the seven repeat variant of the dopamine D4 receptor gene in patients with obsessive compulsive disorder with tics. Neuroscience Letters. 1997; 231(1): 1-4.
• Nicolini H, Cruz C, Camarena B, Orozco B, Kennedy JL, King N, ve ark. DRD2, DRD3 and 5HT2Areceptor genes polymorphisms in obsessive compulsive disorder. Molecular Psychiatry. 1996; 16(1): 461-465.
• Üçok A. Tükel R, Üçok GÖ, Şaylan M, Türksoy Karalı N, Çalıkuşu C, Keser V. Şizofreni Hastalarında Obsesif Kompulsif Belirtilerin ve Bozukluğun Sıklığı. Psikiyatri Psikoloji Psikofarmakoloji Dergisi. 1998;6 (2): 107-110.
• Eisen JL, Rasmussen SA. Obsessive compulsive disorder with psychotic features. J Clin Psychiatry. 1993; 54(10): 373- 3
• Berman I, Merson A, Viegner B, Losonczy, Pappas D, Green AI. Obsessive and compulsions as a distrinct cluster of symptoms in schizophrenia: A neuropsychological study. J Nerv Ment Dis. 1998; 186(3): 150-156.
• Ghaemi SN, Zarate CA, Popli AP, Pillay SS, Cole JO. Is there a relationsheep between clozapine and obsessive- compulsive disorder? A retrospective chart review. Compr Psychiatry.1995; 36(4): 267-270.
• Derogatis L R. SCL-90: Administiration, scoring and procedure manual-l fort the revised version. Baltimore, 19 Dağ İ. Belirti Tarama Listesi (SCL-90-R)’ nin üniversite öğrencileri için güvenilirliği ve geçerliliği. Türk Psikiyatri Dergisi. 1991; 2(1) : 5-12.
• Hodgson RJ, Rachman S. Obsessonal-Compulsive complaints. Behavioral and Research Therapy. 1977; 15(5): 389-3
• Erol N, Savaşır I. Maudsly Obsesif kompulsif soru listesi, Ulusal psikiyatri ve nörolojik bilimler kongresi bilimsel çalışma kitabı. Ankara, 1988; s: 107-114.
• Insel TR, Akiskal HS. Obsessive compulsive disorder with psychotic features: A phenomenologic analysis. Am J Psychiatry. 1986; 143(12): 1527-1533.
• Yaryura-Tobias JA, Campisi TA, McKay D, ve ark. Schizophrenia and obsessive compulsive disorder: Shared aspects of pathology. Neur Psych Brain Res. 1995; 3: 143
• Fenton WS, Mc Glashhan TS. The prognostic significance of obsessive compulsive symptoms in schizophrenia. Am J Psychiatry. 1986; 143(4): 437-441.
• Berman I, Kalinowski A, Berman SM, Lengua J, Green AI. Obsessive and compulsive symptoms in chronic schizophrenia. Compr Psychiatry. 1995; 36(1): 6-10.
• Rasmussen SA, Tsuang MT. Epidemiology and clinical features of obsessive compulsive disorder. Obsessive- Compulsive Disorders: Theory and management. Jenike MA, Baer L, Minichiello WE (Ed), Chicago, Year Book, 1986a; s.23
• Hwang MY, Hollender E. Shcizo-obsessive disorders. Psychiatric Annals. 1993; 23(7): 396-401.
• Bermanzohn P, Siris S. Comorbidity in schizophrenia. Presented at the annual meeting of the American Psychiatric Association. Miami, FL, 1995.
• Toren P, Samuel E, Weizman R, Golomb A, Eldar S, Laor N. Emergence of transient compulsive symptomps during treatment with clothiapine. I Am Acad Child Adolesc Psychiatry. 1995; 34(11): 1469-1472.
• Lewis SW, Chitkara B, Reveley AM. Obsessive-compulsive disorder and schizophrenia in three identical twin pairs. Psychological Medicine. 1991; 21(01): 135-141.