REZİDÜEL ŞİZOFRENİDE BİLİŞSEL İŞLEVLER
Emine Özge Çöldür
Alsancak Nevvar Salih İşgören Devlet Hastanesi, Psikiyatri Kliniği, İzmir, Türkiye
Çöldür EÖ. Rezidüel Şizofrenide Bilişsel İşlevler. Aydemir Ö, Esen Danacı A, editörler. Psikiyatrik Bozukluklar ve Bilişsel İşlevler. 1. Baskı. Ankara: Türkiye Klinikleri; 2025. p.35-47.
ÖZET
Psikotik belirtiler için etkili farmakolojik tedavilere rağmen, psikotik bozukluğu olan hastalarda işlevsel sonuçlar genellikle hayal kırıklığı yaratmaktadır. Kronik şizofreni hastalarında kalıntı negatif belirtiler ve bilişsel belirtiler yaygındır. Hastaların büyük kısmında süregiden bilişsel belirtiler şizofreninin temel bir özelliğidir ve bunlar hastaların mesleki, sosyal ve ekonomik işlevsellikteki ciddi yetersizliklerinin başlıca nedenidir. Aynı zamanda yaşam kalitesinde azalmayla ilişkilidir. Şizofrenide çeşitli bilişsel alanlarda farklı şiddette yaygın etkilenme görülmektedir. Çalışmalara göre en sık etkilenen bilişsel işlevler; yürütücü işlevler, dikkat, algısal/motor işlemleme, vijilans, sözel öğrenme ve bellek, sözel ve işleyen bellek, sözel akıcılık şeklinde sıralanabilir. İlaç kullanımıyla hastalığın diğer belirtileri zaman içinde değişkenlik gösterse de bilişsel bozukluklar nispeten sabittir. Bozukluğun diğer belirtileriyle ilişkisiz ya da daha çok negatif ve dezorganize belirtilerle ilişkili görünmektedir. Bilişsel belirtiler yüksek riskli grupta, premorbid ve prodromal dönemde, ilk atak sırasında ve kronik hastalarda mevcuttur. Bazı bilişsel alanlar şizofrenide nörokognitif endofenotip adayıdır. Bilişsel belirtiler şizofreniye özgü değildir; bu sebeple tanı koydurucu değildir. Bilişsel işlevler tanı, tedavi yanıtının değerlendirilmesi ve klinik takipte önemli rol oynamaktadır.
Anahtar Kelimeler: Şizofreni; Bilişsel bozukluk; Nörobilişsel bozukluklar; Yürütücü işlevler
Kaynak Göster
Referanslar
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