Şizofreni hastalarında bazı sosyodemografik özellikler ve tedavi ile ilişkili etkenler
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Dosyalar
Tarih
2007
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Ülkemizin daha az gelişmiş ve geniş aile sisteminin yaygın olarak yaşandığı Doğu ve Güneydoğu Anadolu bölgesinde yaşayan şizofreni hastalarını ele aldığımız çalışmamızın amaçları; şizofreni alt tiplerine göre hastaların sosyodemografik ve hastalığın klinik özelliklerini tanılamak, tedavide ilaç seçimi ve tedavi sürecini etkileyen etkenleri ve şizofreni hastalarında madde kullanım örüntüsünü belirlemektir. Yöntem: Çalışmaya Elazığ Ruh Sağlığı ve Hastalıkları Hastanesi'ne aileleriyle birlikte ayaktan başvuran ve yatırılarak tedavi edilmesine karar verilen, DSM-IV tanı ölçütlerine göre şizofreni tanısı konan 15-65 yaş arasında 329 erkek, 134 kadın olmak üzere toplam 463 hasta alındı. Bulgular: Hastalarımızın %87.5'i çalışmıyor, %26.3'ü okuryazar değil, %36.7'si ilkokul mezunuydu. Tüm hastaların %84.7'si alt gelir düzeyinde ve %60.3'ü bekardı. Hastalarımızın %62.4'ü paranoid, %22.7'si dezorganize, %8.2'si rezidüel ve %6.7'si farklılaşmamış şizofreni alt tip ölçütlerini karşılamaktaydı. Hastaların %17.1'i herhangi bir madde kullanmazken, %76.0'sı sigara kalan diğer hastalar ise sigara"ile birlikte alkol ve/veya esrar kullanmaktaydı. Tedavi başlarken ilk tercih edilen ilaç %95.9 ile tipik antipsikotikler olup son kullanılan ilaç seçiminde bu oran %76.3'e düşmekteydi. Tartışma: Hasta grubumuzda tipik antipsikotiklerin birinci tercih olması sürmektedir. Düzenli ilaç kullanımı hastanın hastaneye yatış sayısı ile güçlü pozitif; yaş, ailesiyle birlikte yaşama, tedavi süresi ve evli olma ile zayıf pozitif ilişkili görünüyordu. Hastanın hastane ya da hekimle sürekli iletişim içinde olması ve yakınlarından aldığı sosyal destek tedaviye olumlu katkı sağlamaktadır. Madde kullanımı, meslek, düşük ekonomik düzey, kullanılan ilk ilaç arasında görülen negatif ilişki düzenli ilaç kullanımını engellemekte gibi görünmektedir. Aile ve yakın çevrenin hastaya verdiği sosyal destek ve yine kültürümüzün önemli bir özelliği olan madde kullanımını engelleyici yönünü kullanarak tedaviye uyumu artırabiliriz. Kısıtlı ekonomik olanaklarımızı yan etkisi daha az ve negatif belirtilere daha etkili atipik antipsikotikleri kullanma oranını artırma yönünde kullanarak hastaların yaşam kalitelerini de yükseltip üretkenliklerini artırabiliriz.
Objective; To define clinical features and sociodemographic characteristics of patients with schizophrenia raccording to disease subgroups in the less developed East and South-Eastern regions of Turkey where people live in wide family systems, to determine the factors affecting treatment including drug selection and to figure out substance abuse pattern. Methods: Three hundred and twenty nine are male and 134 female, total 463 patients with ages ranging from 15-65 who presented to the state hospital outpatient clinic together with their families and who were decided to be admitted and treated jnpatiently were included in this study. Results: 87.5% of the patients were unoccupied, 26.3% were not able to read or write and 36.7% were primary school graduate. 84.7% of the patients were from lower socioeconomic group and 60.3% were single. 62.4% of the patients met the diagnosis criteria for paranoid, 22.7% disorganized, 8.2% residual and 6.7% undifferentiated types of schizophre­nia diagnosis. 17.1% have not used any substance while 76.0% were smoking and the remaining was smoking in addition to alcohol and/or marihuana. Typical antipsychotics were the first choice in drug .selection at the beginning of treatment with a percentage 95.9 (n=444) and this rate decreased to 76.3% in long term manage­ment. Discussion: Typical antipsychotics remained as the first choice in the treatment of our patients. Regular medication use seemed shows strong positive relation to hospitalization number but showed weak positive relation to age, living with the family, duration of treatment and being married. In other words, patients' being in constant relationship with his/her physician and receiving social support from their relatives had positive input in the treatment. Negative relation between the first used medication and substance abuse, occupation, low socioeconomic status seemed to prevent regular use of medications. We can increase compliance by using the support given by the family and the close social relationships as well as our culture's avoidance type impact on substance abuse. We can also increase life quality and productivity of our patients by directing our limited economical reserves toward use of atypical antipsychotics which have less side effects and more effect on negative symptoms of the disease.
Objective; To define clinical features and sociodemographic characteristics of patients with schizophrenia raccording to disease subgroups in the less developed East and South-Eastern regions of Turkey where people live in wide family systems, to determine the factors affecting treatment including drug selection and to figure out substance abuse pattern. Methods: Three hundred and twenty nine are male and 134 female, total 463 patients with ages ranging from 15-65 who presented to the state hospital outpatient clinic together with their families and who were decided to be admitted and treated jnpatiently were included in this study. Results: 87.5% of the patients were unoccupied, 26.3% were not able to read or write and 36.7% were primary school graduate. 84.7% of the patients were from lower socioeconomic group and 60.3% were single. 62.4% of the patients met the diagnosis criteria for paranoid, 22.7% disorganized, 8.2% residual and 6.7% undifferentiated types of schizophre­nia diagnosis. 17.1% have not used any substance while 76.0% were smoking and the remaining was smoking in addition to alcohol and/or marihuana. Typical antipsychotics were the first choice in drug .selection at the beginning of treatment with a percentage 95.9 (n=444) and this rate decreased to 76.3% in long term manage­ment. Discussion: Typical antipsychotics remained as the first choice in the treatment of our patients. Regular medication use seemed shows strong positive relation to hospitalization number but showed weak positive relation to age, living with the family, duration of treatment and being married. In other words, patients' being in constant relationship with his/her physician and receiving social support from their relatives had positive input in the treatment. Negative relation between the first used medication and substance abuse, occupation, low socioeconomic status seemed to prevent regular use of medications. We can increase compliance by using the support given by the family and the close social relationships as well as our culture's avoidance type impact on substance abuse. We can also increase life quality and productivity of our patients by directing our limited economical reserves toward use of atypical antipsychotics which have less side effects and more effect on negative symptoms of the disease.
Açıklama
Anahtar Kelimeler
Şizofreni, Sosyodemografik Değişkenler, Antipsikotik Tedavi, Madde, Schizophrenia, Sociodemographic Features, Treatment, Substance
Kaynak
Anadolu Psikiyatri Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
2