Anahtar Kelimeler
ilaç kullanmamış
şizofreni
madde kullanımı
klinik özellikler
Öz
Amaç: Bu çalışmanın amacı, ilk atak psikoz (FEP) tanısı almış, ilaç-naif ve hastalığı yakın zamanda başlamış bireylerle şizofreni hastalarını madde ve sigara kullanımı açısından karşılaştırmak ve bu değişkenlerin sosyodemografik ve klinik özelliklerle ilişkisini incelemektir.
Yöntem: Çalışmaya 56'sı ilaç-naif FEP, 51’i ise şizofreni olgusu olmak üzere toplam 107 hasta dahil edilmiştir. Klinik değerlendirme için Klinik Genel İzlenim - Şiddet Ölçeği (CGI-S), Negatif Belirti Değerlendirme Ölçeği (SANS), Pozitif Belirti Değerlendirme Ölçeği (SAPS) ve Şizofrenide Depresyon için Calgary Ölçeği (CDSS) gibi standart ölçekler kullanılmıştır. Bulgular: Madde kullanımı, şizofreni hastalarında (%41,2), FEP hastalarına (%25,0) göre daha yaygındı. Her iki grupta da madde kullanımı, artmış sigara ve alkol tüketimi ile birlikte daha yüksek klinik şiddet ile ilişkilidir. Özellikle, madde kullanan FEP hastalarında depresif ve negatif semptomlar anlamlı şekilde daha yüksektir ve hastalık şiddeti artmıştır. Şizofreni grubunda ise madde kullanımı, SAPS, SANS ve CGI-S skorlarının yüksekliği ile ve daha sık özkıyım davranışı ile ilişkilidir.
Sonuç: Madde kullanımı, hem FEP hem de şizofreni hastalarında semptom yükünü, davranışsal düzensizlikleri ve genel klinik şiddeti artırmaktadır. Psikotik bozukluklarda olumsuz sonuçları azaltmak için erken dönemde tarama yapılması ve ikili tanıya yönelik tedavi stratejilerinin entegrasyonu büyük önem taşımaktadır.
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