Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Şizofreni Hastalarında Şiddetle İlişkili Faktörler: Retrospektif Bir Çalışma
Factors Related to Violence in Patients with Schizophrenia: A Retrospective Study
Mustafa AKANa , Nusret AYAZb , Şükrü KARTALCIc
aMalatya Turgut Özal Üniversitesi Tıp Fakültesi, Ruh Sağlığı ve Hastalıkları ABD, Malatya, Türkiye
bMalatya Turgut Özal Üniversitesi Tıp Fakültesi, Adli Tıp ABD, Malatya, Türkiye
cİnönü Üniversitesi Tıp Fakültesi, Ruh Sağlığı ve Hastalıkları ABD, Malatya, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2023;20(2):86-92
doi: 10.5336/forensic.2022-94751
Article Language: TR
Full Text
ÖZET
 Amaç: Şizofreni hastalarının diğer ruhsal bozukluğu olan hastalara göre ya da genel topluma göre şiddete başvurma olasılıkları daha yüksektir. Antisosyal kişilik özelliklerinin şizofrenili hastalarda şiddet için risk faktörü olabileceği öne sürülmüştür. Bu araştırmanın amacı, şiddet eylemi olan şizofreni hastalarında, şiddet eylemi olmayan şizofreni hastalarını karşılaştırarak şiddetli ilişkili faktörleri değerlendirmek ve antisosyal kişilik özelliklerin şiddet eylemlerinde etkisini incelemektir. Gereç ve Yöntemler: 2016-2017 yılları arasında adli amaçlı psikiyatri kliniğine getirilen şiddete başvurmuş şizofreni hastaları ve aynı yıl psikotik alevlenmeyle kliniğe getirilen şiddet öyküsü olmayan şizofreni hastaları araştırmaya alınmıştır. Hastaların dosyaları retrospektif incelenerek, bazı sosyodemografik veriler ve dosyalarda yer alan psikiyatrik ölçek puanları kaydedilmiştir. Belirlenen tarihlerde adli amaçlı kliniğe getirildiği tespit edilen 20 hasta, psikotik alevlenmeyle kliniğe getirilen 20 hasta ile karşılaştırılmıştır. Bulgular: Şiddet eyleminde bulunan hastaların 16'sı (%80) erkek, 4'ü (%20) kadındı. Şiddet eylemi olmayan grupta hastaların 13'ü (%65) erkek, 7'si (%35) kadındı. Hastaların yaş ortalaması 33,32±8,65 idi. Her iki grup, antisosyal kişilik özellikleri açısından karşılaştırıldığında, aralarında istatistiksel olarak anlamlı farklılık saptanmamıştır. Şiddet eylemi olan grupta, karşılaştırma grubuna göre istatistiksel olarak anlamlı şekilde daha yüksek Pozitif Belirtileri Değerlendirme Ölçeği puanı, daha düşük ilaç uyumu bulunmuştur (sırasıyla p=0,01, p=0,02). Sonuç: Şizofreni hastalarında şiddet, antisosyal kişilik özelliklerinden ziyade hastalığın kendi unsurlarıyla ilişkili olabilir. Şizofrenide şiddetle ilişkili risk faktörlerini belirlemede daha geniş örneklemler ile yapılacak, daha iyi yapılandırılmış gelecek çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Adli psikiyatri; şizofreni; şiddet; retrospektif araştırma
ABSTRACT
 Objective: Patients with schizophrenia are more likely to resort to violence than patients with other mental disorders or the general population. It has been suggested that antisocial personality traits may be a risk factor for violence in patients with schizophrenia. The aim of this study is to compare violence-related factors in patients with schizophrenia with violent acts and to examine the effect of antisocial personality traits on violent acts by comparing them with schizophrenic patients without violence. Material and Methods: Schizophrenic patients who were brought to the psychiatry clinic forensically between 2016-2017 and who had resorted to violence and schizophrenic patients without a history of violence were included in the study. The files of the patients were reviewed retrospectively, and some sociodemographic data and psychiatric scale scores in the files were recorded. Twenty patients in forensic group were compared with 20 patients who were brought to the clinic with psychotic exacerbation. Results: In the forensic group, 16 (80%) of the patients were male and 4 (20%) were female. The average age of the patients was 33.32±8.65. When both groups were compared in terms of antisocial personality traits, no statistically significant difference was found between them. In the forensic group, statistically significantly higher Scale for the Assessment of Positive Symptoms scores and lower drug compliance were found compared to the non-forensic group (p=0.01, p=0.02, respectively). Conclusion: In this study, violence in patients with schizophrenia may be related to the disease itself rather than antisocial personality traits. There is a need for better structured future studies with larger samples to identify risk factors associated with violence in schizophrenia.

Keywords: Forensic psychiatry; schizophrenia; violence; retrospective research
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