OBSESİF KOMPULSİF BOZUKLUK HASTALARINDA NİKOTİN BAĞIMLILIĞI İLE DÜRTÜSELLİK, DEPRESYON VE ANKSİYETE DÜZEYİ İLİŞKİSİ
Anahtar Kelimeler:
Obsesif kom-pulsif bozukluk- nikotin bağımlılığı- dürtüsellik- anksiyete- depresif belirtilerÖzet
Amaç: Sigara içen ve içmeyen obse-sif kompulsif bozukluk (OKB) hastalarını karşılaştıran az sayıdaki çalışma, anksiye-te bozuklukları ile ilgili çalışmalardan daha farklı sonuçlara ulaşmıştır. OKB kompulsif ve impulsif özellikleri olan bir bozukluktur. Bağımlılık, kompulsivite ve dürtüsellik arasındaki ilişkinin incelenmesi, bu kavramların anlaşılmasına katkıda bulunacaktır.
Yöntem: Bu araştırmada sigara içen ve içmeyen OKB hastalarında dürtüsellik karşılaştırıldı. Daha sonra dürtüsellik, OKB ve bağımlılık şiddetleri ilişkisi incelendi. OKB, bağımlılık ve yüksek dürtüsellik izlenen diğer patolojik durumlara sıklıkla eşlik etmeleri nedeniyle depresyon ve anksiyete belirtileri de değerlendirildi. OKB tanısı alan 121 hastaya Yale-Brown Obsesyon Kompulsiyon Derecelendirme Ölçeği (Y-BOCS), Barratt Dürtüsellik Ölçeği-Versiyon 11 (BIS-11), Fagerström Nikotin Bağımlılık Testi (FTND), Hamilton Depresyon Derecelendirme Ölçeği-17 Madde (HDRS-17) ve Beck Anksiyete Ölçeği (BAI) uygulandı.
Bulgular: Hasta grubunda sigara içme yaygınlığı %42.14 olarak bulundu. Sigara içenler ve içmeyenler Y-BOCS, HDRS-17 ve BAI skorlarında farklılık göstermediler. BIS-11 toplam puanı ve plan yapmama alt ölçek puanı sigara içen grupta anlamlı biçimde yüksek bulundu. Sigara içen grupta Y-BOCS puanları, BIS toplam, kognitif ve plan yapmama puanları ile pozitif bağıntı gösterdi. Kompulsi-yon puanı ise sadece sigara içen grupta BIS toplam, kognitif ve plan yapmama alt ölçek puanları ile pozitif bağıntılı bulundu. FTND puanları ise BIS-11 toplam puanı, BIS-11 davranışsal dürtüsellik ve plan yapmama alt ölçek puanları, Y-BOCS ve BAI puanları ile bağıntılıyken, HDRS-17 puanı ile bağıntı bulunmadı.
Sonuç: Dürtüselliği fazla nikotin bağımlılarında daha şiddetli OKB, kom-pulsivitenin yüksek olması nedeniyledir. Bu sonuç kompulsivite, dürtüsellik ve bağımlılık ilişkisini desteklemektedir.
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