Obsesif kompulsif bozuklukta high mobility group box-1 düzeyleri
The level of hi̇gh mobility group box-1 ((HMGB-1) i̇n obsesi̇ve compulsi̇ve di̇sorder
Yazar: ERKAN KAKDAŞ
Danışman: YRD. DOÇ. DR. MAHMUT BULUT
Dicle Üniversitesi / Tıp Fakültesi / Ruh Sağlığı ve Hastalıkları Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2015
Konu: Psikiyatri = Psychiatry
Dizin: Anksiyete = Anxiety ; Enzime bağlı immünosorbent testi = Enzyme-linked immunosorbent assay ; Obsessif davranış = Obsessive behavior ; Obsessif kompülsif bozukluk = Obsessive compulsive disorder ; Ölçekler = Scales ; İnflamasyon = Inflammation

Özet:
Amaç: Obsesif kompulsif bozukluk (OKB), kiúinin sosyal ve mesleki
Lúlevselli÷i üzerinde ciddi olumsuz etkileri olan, kronik seyirli, obsesyon ve/veya
kompulsiyonlarla karakterize bir hastalÕktÕr. OKB etiyopatogenezindeki
mekanizmalarÕn ço÷u hala belirsizli÷ini korumaktadÕr. ÇalÕúmamÕzda OKB
hastalarÕnda inflamasyonun geç mediatörlerinden birisi olan HMGB-1 düzeylerini,
OKB etyolojisindeki yerini ve bunun sosyodemografik, klinik özellikler ile iliúkisini
incelemeyi amaçladÕk.
Gereç ve Yöntemler: ÇalÕúmaya Dicle Üniversitesi TÕp Fakültesi Psikiyatri
poliklini÷ine baúvuran ve Psikiyatri uzmanlarÕ tarafÕndan DSM-V tanÕ kriterlerine
göre OKB tanÕVÕ almÕú 18-65 yaú arasÕnda 35 hasta ve yaú, cinsiyet, beden kitle
indeksi eúleútirilmiú 47 sa÷OÕklÕ kontrol grubu alÕndÕ. OKB tanÕVÕ almÕú hastalardan ve
kontrol grubundan bir kez kan örne÷i alÕndÕ ve ELøZA kitleri kullanÕlarak serum
HMGB-1 düzeyleri ölçülerek karúÕlaúWÕUÕldÕ. Tüm katÕOÕmcÕlara sosyodemografik veri
formu, Hamilton Depresyon De÷erlendirme ölçe÷i (HAM-D), Hamilton Anksiyete
De÷erlendirme ölçe÷i (HAM-A) uygulandÕ, ayrÕca hasta gruba Yale-Brown Obsesif
Kompulsif De÷erlendirme Ölçe÷i, Sheehan Yeti Yitimi ölçe÷i, Klinik Global øzlem
formu uygulandÕ.
Bulgular: OKB grubu serum HMGB-1 düzeyleri kontrol grubuna oranla
anlamlÕ olarak daha düúük düzeyde saptandÕ (t:4.58, p<0.01). Hasta grubun HMGB-1
düzeyleri ile hastalÕk süreleri arasÕnda istatistiksel olarak anlamlÕ pozitif korelasyon
vardÕ (ro=0.382, p=0.024). Hasta grubun HMGB-1 düzeyleri ile SYYDÖ puanlarÕ
arasÕnda istatistiksel olarak anlamlÕ pozitif korelasyon vardÕ (ro=0.467, p=0.05).
YBOKDÖ toplam puanlarÕ ortalamalarÕ ile HMGB-1 düzeyleri arasÕnda istatistiksel
olarak anlamlÕ korelasyon saptanmadÕ (ro=0.129, p>0.05). ROC analizinde HMGB-
1'in serum de÷erleri 44,72 ng / ml için % 68.6 duyarlÕOÕkta ve %78.7 özgüllükteydi.
Sonuç: ÇalÕúmamÕzda HMGB-1 düzeylerinin hastalarda kontrollere göre
daha düúük seviyelerde olmasÕ, nöroplastisitede azalma ve bozulmuú inflamatuar 
 iii
yanÕWÕn OKB patofizyolojisinde rol alabilece÷ini göstermektedir. Gelecekte OKB'de
HMGB-1 ve inflamasyon ile iliúkili daha kapsamlÕ çalÕúmalar yapÕlmasÕ
gerekmetedir.

Anahtar Kelimeler: Obsesif Kompulsif Bozukluk, High Mobility Group Box-1, ønflamasyon.

Abstract:
Objectives: Obsessive compulsive disorder (OCD) which has serious
negative impact on social and occupational functioning of a person is a disease
characterized by chronic course, obsessions and/or compulsions. Most of the
mechanisms in the pathogenesis of OCD remains still unclear.
In our study we aimed to examine HMGB-1 levels as one of the mediators of
inflammation in patients with OCD, its place in etiopathogenesis OCD and the
relationship between sociodemographic, clinical features of the patients OCD.
Material and Methods: 45 patients, who applied Dicle University Faculty of
Medicine Department of Psychiatry and diagnosed as OCD according to DSM-V
diagnosis criteria by psychiatry experts, aged between 18-65 years and age, gander,
body mass index matched 45 healthy control group was applied into the study.
Blood samples were taken once from both OCD and control groups and it was
compared by using the HMGB-1 levels that measured by ELISA kits.
Sociodemographic data form, Hamilton Depression RatingScale (HAM-D),
Hamilton Anxiety Rating Scale (HAM-A) were applied to all participants
Additionally Yale-Brown Obsessive Compulsive Rating Scale, Sheehan Disability
Scale, Clinical Global Impression were also applied to the patient group.
Results: The mean serum HMGB-1 levels o the patients were significantly
lower level than the control group. There was statistically significant positive
correlation (ro=0.382, p<0.05) between HMGB-1 levels of patient group and disease
duration. There was also statistically significant positive correlation (ro=0.467,
p<0.05) between HMGB-1 levels of patient group and SYYDÖ scores. There was no
statistically significant correlation between level of HMGB-1 and the YBOKDÖ
total score (ro=0.129, p>0.05). In the ROC analysis of HMGB-1 levels, for 44.72 ng
/ml, the sensitivity was 68.6% and the specificity was 78.7%.
Conclusion: In our study the levels of HMGB1 to be the lower compared with
controls patients. Lower HMGB-1 may be a sign of reduction at neuroplasticity and 
he impaired inflammatory response at the pathophysiology of OCD. Future
researchs should investigate the role of HMGB-1 and inflammation in OCD.
Key Words: Obsessive Compulsive Disorder, High Mobility Group Box-1,
Inflamation. In our study we aimed to examine HMGB-1 levels as one of the mediators of inflammation in patients with OCD, its place in etiopathogenesis OCD and the relationship between sociodemographic, clinical features of the patients OCD.