Aripiprazol ile İyileşen “İç Görüşü Kısıtlı” Obsesif Kompulsif Bozukluk Tanılı Bir Ergen ve Literatürün Gözden Geçirilmesi

Abstract

Iç görü §ü kisitli" Dbsesif Kompulsif Bozukluk (OKB) tanimi, DKB spektrumunda en agir gidi; ve sonlanim ile karakterize,.daha karma;ik bir klinik seyir gösteren, standart farmakolojik ve bilimsel davrani §çi tedavilere kötü yanit veren ve daha kötü prognoz ile ili §kilendirilen bir grup hastayí kapsamaktadir. Standart OKB tedavisine yanitm bu alt grupta kisitli olmasi nedeniyle SSRI tedavisinin bir atipik antipsikotik eklenmeslni eneren yaymiar bulunmaktadir. Bu makalede belirtileri ba;ladiktan 3 yil sonra, belirtilerinin agirlajmasi nedeniyle políklinigimize ba §vuran "iç görü;ü kisitli OKB" tanisi dücünülen, a §in degerlenmi? dücünceleri bulunan 15 yaçmda bir erkek ergen, standart BOT ve farmakolojik tedavilerden yanit alinamamasi üzerine SSRI tedavisine aripiprazol eklenmesi sonrasi belirtilerinin kaybolmasi ve eski i §levselligine geri dönmesi nedeniyle ele almmi;tir. Olgu temelinde tam, ayincí tam ve tedavi ile ilgili bilgiler degerlendirllmi §, olgunun klinik seyrina dair veríler payla §ilmi §tir. (Nöropsikiyatri Ar^ivi 2011; 48:215-20) Anahtar kelimeler "Iç görüsü kisitli" OKB, aripiprazol, ayirici tam, ergen, atipík antipsikotikier ABSTRACT Obsessive compulsive disorder (DCD) with poor insight is one of the most severe disorders of OCD spectrum and has a poor prognosis. Compared with other OC spectrum disorders, it has different prognosis and treatment response. There are several studies suggesting augmentation of selective serotonin reuptake inhibitor (SSRI) treatment and cognitive behavioral therapy (CBT) with atypical antipsyohotics due to poor response to standard DCD treatment in this subgroup. In this article, we aim to discuss a 15-year-old male adolescent who was suspected to have OCD with poor insight and had overvalued ideas and had responded poorly to SSRI and CBT treatments. After we added aripiprazole to SSRI, his symptoms totally disappeared and the former functioning waj achieved. Based on this case,we aim to discuss the diagnosis, differential diagnosis and treatment of DCD with poor insight and to share the data on the prognosis In our patient (Archives of Neuropsychiatry 2011; 48:215-20)

Cognitive-Behavioral Therapy of Obsessive-Compulsive Disorder in Children and Adolescents

“…Poor insight in children and adolescents with OCD is associated with severity of symptoms and loss of functionality and has a great influence on duration and success of treatment [62,63]. Poor insight in OCD causes patients not to recognize their symptoms as a problem and results in reduced treatment motivation and treatment success.…”