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- W177766790 abstract "OZET: Bir universite psikiyatri kliniinde durtu kontrol bozukluu s›kl›¤› Amac: Dier ruhsal bozukluklarda olduu gibi durtu kontrol bozukluklar›n›n (DKB) da psikiyatrik bozukluklarla bir arada bulunmas›, hastalarda tan› konmas›n› guc- lefltirir ve uygulanacak tedaviyi, hastal›¤›n gidiflini olumsuz etkiler. Bu bozukluklar rutin psikiyatrik muayene s›ras›nda ve yar› yap›land›r›lm›fl goruflmelerde sorgulan- mad›¤› icin, s›kl›kla tan› konmas› gucleflir ve tedavisinde gecikmeler olur. Durtu kontrol bozukluklar› kategorisi uzun zamand›r yayg›n olarak kullan›lan iki s›n›flan- d›rma sisteminde de yer almas›na karfl›n, bu konu uzerinde az say›da cal›flma ya- p›lm›flt›r. Bu cal›flmada, konuya katk›da bulunmak amac›yla klinikte yatmakta olan bir psikiyatrik hasta grubunda durtu kontrol bozukluklar›n›n s›kl›¤›n›n ve iliflkili klinik ve sosyodemografik deiflkenlerin deerlendirilmesi amaclanm›flt›r. Yontem:Psikiyatri kliniimize 6 ayl›k bir sure icerisinde yatan 103 eriflkin hasta cal›flmaya dahil edilmifltir. Hastalar›n DSM-IV'e gore eksen I tan›lar›n› belirlemek icin DSM-IV icin yap›land›r›lm›fl klinik goruflme olcei kullan›ld›. Durtu kontrol bo- zukluklar› saptamak icin Minnesota Durtu Kontrol Bozukluu Goruflme Olce- ¤i'nin modifiye edilmifl flekli hastalara uyguland›. Durtusellik icin Barratt Durtu- sellik Olcei-11(BDO-11) kullan›ld›. Ayr›ca tum hastalar Zuckerman Heyecan Ara- ma Olceini de tamamlad›lar. Bulgular: Psikiyatrik yatan hasta orneklem grubunda en az bir durtu kontrol bo- zukluu efltan›s› alan hasta s›kl›¤› %37.9 (n= 39) idi. En s›k gorulen durtu kontrol bozukluu kompulsif sat›n alma iken (n= 17, %16) bunu aral›kl› patlay›c› bozuk- luk (n= 15, %14) ve patolojik kumar bozukluu (n= 7, %7) izlemekteydi. Kleptoma- ni tan›s› konulan herhangi bir hasta yoktu. Durtu kontrol bozukluu efltan›s› ko- nan ve konmayan hastalar aras›nda yafl, cinsiyet, medeni hal, hastaneye yat›fl say›s› yonunden anlaml› bir farkl›l›k yoktu. Bununla birlikte, eitim suresi, ilk has- taneye yat›flta konulan birincil tan› ve birincil tan›n›n bafllang›c yafl› ac›s›ndan durtu kontrol bozukluu efltan›s› alan grup farkl›l›k gosteriyordu. Eitim suresi durtu kontrol bozukluu efltan›s› alan grupta daha fazla iken, birincil hastal›¤›n bafllang›c yafl› bu grupta daha dufluktu.Sadece kompulsif sat›n alma bozuklu- ¤u efltan›s› alan hastalar durtu kontrol bozukluu efltan›s› almayan hastalara gore daha gencti (31.5 y›la karfl›l›k 39.5 y›l). Dier tum durtu kontrol bozuklukla- r› efltan›lar› aras›nda demografik ve klinik ozelliklere gore yap›lan karfl›laflt›rma- larda anlaml› bir farkl›l›k saptanmad›. BDO-11'de olculdu¤u uzere, toplam dur- tusellik , plans›z eylem ve motor durtusellik skorlar› durtu kontrol bozukluu efl- tan›s› olan grupta olmayan gruba gore daha yuksekti. Aral›kl› patlay›c› bozuklu- ¤u ve kompulsif sat›n alma bozukluu olan hastalar›n toplam durtusellik skor- lar› durtu kontrol bozukluu olmayan hastalara k›yasla anlaml› olarak yuksekti. Tart›flma: Bu cal›flma sonuclar› kliniimize baflvuran hastalar›n ortalama ucte birinin DSM-IV'e gore en az bir durtu kontrol bozukluu efltan›s› ald›klar›n› gos- termektedir. Bulgular›m›z daha once ozgul tan›l› hasta gruplar›nda yap›lm›fl iki Frans›z cal›flmas› ve iki farkl› hastanede eriflkin yatan psikiyatrik hasta grubun- da durtu kontrol bozukluu s›kl›¤›n› araflt›ran bir Kuzey Amerika cal›flmas›n›n sonuclar›yla uyumlu bulunmufltur. Durtu kontrol bozukluklar›n oldukca s›k oran- da gorulmesi ve buna bal› olarak psikiyatrik bozukluklar›n seyri s›ras›nda orta- ya c›kabilecek komplikasyonlardan kac›nabilmek icin, psikiyatristlerin bu bozuk- luklar›n fark›nda olmal› ve gerekli tedavi yaklafl›mlar›n› sergilemelidirler. Anahtar sozcukler: Durtu kontrol bozukluklar›, yatan hastalar, kompulsif sat›n alma, durtusellik, heyecan arama Klinik Psikofarmakoloji Bulteni 2008;18:153-161 ABSTRACT: Impulse control disorders in an inpatient psychiatry unit of a university hospital Objective: Like other comorbid disorders, comorbidity of impulse control disorders (ICDs) in various psychiatric disorders may complicate the diagnostic work-up of patients which might further influence the outcome and the treatment. As these disorders are not routinely screened for in regular psychiatric evaluations and several commonly used semi-structured interviews, it is highly probable that these disorders may go unrecognized and untreated. Despite the inclusion of ICD category under two widely used classification systems a long time ago, relatively little research has been done on this area. We conducted this study to find out the frequency of ICDs and search for relevant clinical and sociodemographic variables in a group of psychiatric inpatients. Method: One hundredandthree consecutive adult patients hospitalized in our psychiatric inpatient unit within 6 months period were included in the study. Axis I diagnoses were rendered using a Structured Clinical Interview for DSM-IV (SCID-I). ICDs were investigated with using the modified version of Minnesota Impulsive Disorders Interview. Impulsivity was measured with the Barratt Impulsiveness Scale Version 11 (BIS-11). Also all patients completed Zuckerman Sensation Seeking Scale Form V. Results: The prevalence rate for all comorbid ICD in this sample was 37.9% (n= 39). The most common ICD subtype was compulsive buying (CB) (n= 17, 16%) followed by intermittent explosive disorder (IED) (n= 15, 14%) and pathological gambling (n= 7, 7%). There were no cases meeting the criteria for kleptomania. There was no statistical difference between the characteristics of patients with and without ICDs with regards to age, sex, marital status, and number of hospitalizations. Some characteristics of the ICD(+) group (i.e. duration of education, primary admission diagnosis, and age of onset for primary diagnosis) were significantly different from ICD(-) patients. The duration of education in ICD(+) group was significantly longer than ICD(-) group. On the other hand, age at onset for primary psychiatric disorder in ICD(+) inpatients was lower than ICD(-) inpatients. Only patients with comorbid CB were significantly younger than ICD(-) group (31.5 vs 39.5 respectively). The comparison of sociodemographic and clinical variables among all other ICD subgroups did not show any significant differences. A significant difference was observed between ICD(+) and ICD(-) groups in terms of total impulsivity, nonplanning activity, and motor impulsivity scores as determined by BIS-11. Total impulsivity score was significantly higher in patients with IED and CB than ICD(-) group. Discussion: The results of this study revealed that about one third of patients admitted to our inpatient unit had at least one co-morbid impulse control disorder according to DSM-IV TR. Our findings are consistent with the results of two earlier French studies conducted among specific group of patients and another North American study searching for impulse control disorders in adult psychiaric inpatient units of two different hospitals.The high prevalence rate of impulse control disorders among psychiatric inpatients should alert mental health professionals to look for and treat these disorders in order to avoid any further complications." @default.
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- W177766790 title "Impulse Control Disorders in an Inpatient Psychiatry Unit of a University Hospital" @default.
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