Şizofreni tanılı hastalar ve ilk atak psikoz hastaları ile hastaların sağlıklı kardeşlerindeki CRP ve D vitamini düzeylerinin bilişsel işlevler açısından sağlıklı kontrol grubu ile karşılaştırılması
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Şizofreni; duygulanım, düşünce, davranış ve bilişsel bozuklukları içeren çeşitli belirti ve bulgularla seyreden kronik bir hastalıktır. Hastalığın etiyolojisine yönelik birçok hipotez mevcuttur; bu hipotezlerden son dönemde üzerinde durulan konulardan ikisi, endofenotipik özellikler ve inflamatuar süreçlerdir. Bu amaçla, şizofreni etyopatogenezinde inflamatuar süreçler araştırılmış; endofenotipik özellikler açısından hastaların birinci derece yakınları da çalışmalara dâhil edilmiştir.Hastalarda sosyal yükü arttıran, tedavide kısmen daha dirençli olan ve işlevsellikte büyük oranda düşmeye neden olan bilişsel bozuklukların da önemi vurgulanmak gerekirse bu amaçla çalışmamızda, şizofreni hastaları, onların sağlıklı kardeşleri ve sağlıklı kontrollerden oluşan gruplar çalışmamıza dâhil edilmiştir. Gruplarda, nöron büyüme, gelişme ve farklılaşmasında önemli rolü olan D vitamini ve inflamatuar faz reaktanı olan CRP düzeyleri ile nöropsikolojik testlerle ölçülen bilişsel işlevler arasındaki ilişki incelenmiştir. Gereç ve Yöntem: Bu çalışmaya, psikotik bozukluk tanısıyla başvuran hastalar ile şizofreni tanısı almış kardeşi bulunan bireyler ve sağlıklı kişiler dâhil edilmiştir. Hasta grubu, psikotrop ilaçları en az bir aydır kullanmayan, 18-60 yaş arasında DSM-5 tanı kriterlerine göre Şizofreni ve ya Kısa Psikotik Bozukluk tanısı koyulan 36 hastadan oluşurken, kardeş grubu şizofreni tanısı almış kardeşi olan 31 sağlıklı gönüllüden oluşmuştur. Kontrol grubu ise, herhangi tıbbi ya da psikiyatrik hastalığı olmayan 31 kişiden oluşturulmuştur. Tüm gruplara WCST, Stroop Testi, İz Sürme Testi, Rey İşitsel Sözel Öğrenme Testi ve Sayı Dizisi Testi, bu testlerin uygulama eğitimini almış araştırıcı tarafından uygulanmıştır. Yine tüm gruplarda, inflamasyon düzeyini belirlemek amacıyla, kan örneği alınarak serum CRP ve D vitamini düzeyleri ölçülmüştür. İstatistiksel analizler SSPS 22.0 paket programı ile yapılmıştır. Bulgular: Hasta grubuyla kardeş grubu ve kontrol grubu bilişsel işlevler açısından karşılaştırıldığında, hastaların psikomotor hız, bilgi işlemleme hızı, frontal sistem aracılı karmaşık dikkat, dikkati odaklayabilme, çalışma belleği, kısa süreli bellek, uzun süreli bellek ve serbest hatırlama işlevlerinde kontrol grubuna göre bozulma saptanmış olup; ayrıca hasta grubunda perseveratif eğilimin arttığı görülmüştür. Kardeş grubu bilişsel işlevler açısından, kontrollere göre geriye bozucu etki ilişkili bellekte bozukluk saptanmış olup, diğer alanlarda anlamlı bir fark bulunmamıştır. D vitamini düzeyleri açısından her üç grup arasında fark saptanmamıştır. D vitamini düzeyleri ile bilişsel işlevler açısından incelendiğinde, Stroop testi ile ortaya koyulan işlemleme hızı, veri işleme ve seçici dikkat alanlarında D vitamini düşüklüğü ile ilişkisi ortaya koyulmuştur. CRP düzeyleri ise, hasta grubunda kardeş ve kontrol grubuna göre yüksek bulunmuştur. CRP düzeyleri ile seçici dikkat, bilişsel inhibisyon becerisi, işlemleme hızı, set değişikliği yapabilme, kısa süreli ve uzun süreli bellek işlevleri arasında ilişki var olduğu saptanmıştır. Tartışma ve Sonuç: Çalışmamızda elde edilen bulgular; şizofreninin endofenotipik özellikleri ve inflamasyonla ilişkisi açısından bazı önemli farklılıkları ortaya koymuştur. CRP düzeylerindeki yükselme, hastalıktaki artmış inflamatuar süreçlerle ilişkili olabilir. Hastalarda daha fazla olmak üzere, kardeşlerde de saptanan bilişsel bozuklukların inflamatuar mekanizmalarla ilişkisinin ve endofenotipik özelliğinin ortaya koyulması için daha fazla çalışmaya ihtiyaç duyulmaktadır. Anahtar Kelimeler: Şizofreni, endofenotip, kardeş, D vitamini, CRP, inflamasyon
Introduction and Aim: Schizophrenia is a chronic illness consisting of affective, thought, behavior and cognitive disorders and showing a variety of symptoms and findings. Many hypotheses have been developed on the etiology of the illness. The two of the research subjects that have been emphasized recently are endophenotypic characteristics and inflammatory processes. This study examines the inflammatory processes in schizophrenia etiopathogenesis. Also, first degree relatives of the patients are included in the study. Cognitive disorders, which are partially resistant in the treatment should be focused because they increase social burden of patients and lower functionality. Therefore, the study includes schizophrenia patients, their healthy siblings and healthy groups. The relationship between Vitamin D, which has a important role in growing, developing and differentiating neurons; CRP levels, which is a inflammatory phase reactant and cognitive functions measured by neuropsychological tests. Methods: The participants of the study include the patients having psychotic disorder diagnosis, the individuals whose siblings have schizophrenia diagnosis and healthy individuals. The patient group consists of 36 patients who have not used psychotropic drugs at least for a month, are between 18-60 ages, have been diagnosed as schizophrenia or brief psychotic disorder. On the other hand, the sibling group consists of 31 healthy volunteers whose siblings have been diagnosed as schizophrenia. The control group includes 31 healthy volunteers who do not have any psychiatric illness. The data were collected by WCST, Stroop Test, Trail-making Test, Rey Auditory Verbal Learning Test and Digit Span Test. The tests were administered by the researcher who has been specially trained. Additionally, The CRP and vitamin D levels of the participants were measured to determine the inflammatory levels of the groups. The data were analysed in SPSS 22.0 package program. Findings: When the patient group is compared with sibling group and control group in terms of cognitive functions, psychomotor speed, information processing speed, complex attention functioning with frontal system, focusing attention, working memory, short term memory, long term memory and free recall functions of the patients are disrupted compared to the control group. Also, it is shown that the perseverative tendency of the patients has increased. Impairment is observed in the memory related to retroactive interference of the sibling group compared to the control group in terms of cognitive functions. Another significant difference could not be found in the other areas. There is no significant difference in the levels of vitamin D in the groups. Examining the levels of vitamin D and cognitive functions, the processing speed, information processing and selective attention measured with Stroop Test have a relationship between low vitamin levels. The CRP levels of the patients are higher than the sibling and control group. A relationship between the CRP levels and selective attention, cognitive inhibition ability, processing speed, set change, short term and long term memory functions has been found. Discussion and Conclusion: The findings of the study reveal endophenotypic characteristics of schizophrenia and some significant differences in terms of its relationship with inflammation. Increasing CRP levels may relate to increasing inflammatory processes of the illness. Although they are higher in the patients, the relationship between cognitive disorders diagnosed in the sibling group and inflammatory mechanisms; and their endophenotypic characteristics should be handled in other studies. Keywords: Schizophrenia, endophenotype, siblings, Vitamin D, CRP, inflammation
Introduction and Aim: Schizophrenia is a chronic illness consisting of affective, thought, behavior and cognitive disorders and showing a variety of symptoms and findings. Many hypotheses have been developed on the etiology of the illness. The two of the research subjects that have been emphasized recently are endophenotypic characteristics and inflammatory processes. This study examines the inflammatory processes in schizophrenia etiopathogenesis. Also, first degree relatives of the patients are included in the study. Cognitive disorders, which are partially resistant in the treatment should be focused because they increase social burden of patients and lower functionality. Therefore, the study includes schizophrenia patients, their healthy siblings and healthy groups. The relationship between Vitamin D, which has a important role in growing, developing and differentiating neurons; CRP levels, which is a inflammatory phase reactant and cognitive functions measured by neuropsychological tests. Methods: The participants of the study include the patients having psychotic disorder diagnosis, the individuals whose siblings have schizophrenia diagnosis and healthy individuals. The patient group consists of 36 patients who have not used psychotropic drugs at least for a month, are between 18-60 ages, have been diagnosed as schizophrenia or brief psychotic disorder. On the other hand, the sibling group consists of 31 healthy volunteers whose siblings have been diagnosed as schizophrenia. The control group includes 31 healthy volunteers who do not have any psychiatric illness. The data were collected by WCST, Stroop Test, Trail-making Test, Rey Auditory Verbal Learning Test and Digit Span Test. The tests were administered by the researcher who has been specially trained. Additionally, The CRP and vitamin D levels of the participants were measured to determine the inflammatory levels of the groups. The data were analysed in SPSS 22.0 package program. Findings: When the patient group is compared with sibling group and control group in terms of cognitive functions, psychomotor speed, information processing speed, complex attention functioning with frontal system, focusing attention, working memory, short term memory, long term memory and free recall functions of the patients are disrupted compared to the control group. Also, it is shown that the perseverative tendency of the patients has increased. Impairment is observed in the memory related to retroactive interference of the sibling group compared to the control group in terms of cognitive functions. Another significant difference could not be found in the other areas. There is no significant difference in the levels of vitamin D in the groups. Examining the levels of vitamin D and cognitive functions, the processing speed, information processing and selective attention measured with Stroop Test have a relationship between low vitamin levels. The CRP levels of the patients are higher than the sibling and control group. A relationship between the CRP levels and selective attention, cognitive inhibition ability, processing speed, set change, short term and long term memory functions has been found. Discussion and Conclusion: The findings of the study reveal endophenotypic characteristics of schizophrenia and some significant differences in terms of its relationship with inflammation. Increasing CRP levels may relate to increasing inflammatory processes of the illness. Although they are higher in the patients, the relationship between cognitive disorders diagnosed in the sibling group and inflammatory mechanisms; and their endophenotypic characteristics should be handled in other studies. Keywords: Schizophrenia, endophenotype, siblings, Vitamin D, CRP, inflammation
Açıklama
Tıp Fakültesi, Psikiyatri Ana Bilim Dalı
Anahtar Kelimeler
Psikiyatri, Psychiatry
