COVID-19 Döneminde Obsesif Kompulsif ve İlişkili Bozukluklar
Özet
COVID-19 pandemisinin obsesif kompulsif bozukluk (OKB) üzerindeki çok yönlü etkilerini ele alan bu bilimsel metin, küresel salgının getirdiği belirsizlik ve katı hijyen tedbirlerinin hem mevcut OKB hastalarında semptom alevlenmelerine yol açtığını hem de sağlıklı bireylerde bulaş kaygısını artırarak "COVID Stres Sendromu" gibi yeni klinik tablolar oluşturduğunu bildirmektedir. Pandeminin erken dönemlerinde özellikle yıkama ve temizlik kompulsiyonu olan bireylerin, sağlık çalışanlarının ve çocukların bu psikososyal stresörlerden daha fazla etkilendiği ve teletıp hizmetleri ile ilaç tedavilerinin bu süreçte kritik birer seçenek haline geldiği vurgulanmaktadır. İşin nörobiyolojik boyutunda ise SARS-CoV-2 enfeksiyonunun tetiklediği sistemik inflamasyonun ve "sitokin fırtınasının" santral sinir sisteminde hasara yol açarak yeni başlayan OKB vakalarını ve komorbid nöropsikiyatrik belirtileri doğrudan tetikleyebileceği hipotezi sunulmaktadır. Buna bağlı olarak, geleneksel anti-obsesyonel ilaçların (fluvoksamin gibi) anti-inflamatuar etkilerinden yararlanılabileceği ve gelecekte anti-sitokin tedavilerinin bu süreçte yeni yaklaşımlar sunabileceği değerlendirilmektedir.
The scientific text, examining the multifaceted effects of the COVID-19 pandemic on obsessive-compulsive disorder (OCD), reports that the uncertainty of the global outbreak and strict hygiene measures caused symptom exacerbations in existing OCD patients and increased contamination anxiety in healthy individuals, creating new clinical pictures like "COVID Stress Syndrome". It is emphasized that during the early phases of the pandemic, particularly individuals with washing and cleaning compulsions, healthcare professionals, and children were more affected by these psychosocial stressors, making telemedicine services and pharmacotherapy critical options in this process. On the neurobiological side, the hypothesis is presented that systemic inflammation and the "cytokine storm" triggered by the SARS-CoV-2 infection could cause central nervous system damage, thereby directly triggering new-onset OCD cases and comorbid neuropsychiatric symptoms. Accordingly, it is evaluated that the anti-inflammatory effects of traditional anti-obsessional drugs (such as fluvoxamine) could be leveraged, and anti-cytokine therapies might offer novel approaches in this context in the future.
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