İntihar amaçlı olmayan kendine zarar verme davranışı ve intihar ilişkisi; tanı, borderline kişilik bozukluğu ve mizaç ve karakter özelliklerinin rolü

Amaç: Bu çalışmada kendine zarar verme davranışında bulunan genç erişkinlerde intiharı önleme, tedavi ve tekrarını engellemede yol gösterecek klinik tanıları, borderline kişilik özelliklerini ve mizaç ve karakter özelliklerini tespit etmek amaçlanmaktadır.Gereç ve Yöntem: Ergen ve Genç Erişkin Psikiyatrisi İkinci basamak polikliniğinde izlenen 18-20 yaşları arasındaki kendine zarar verme davranışı olan 93 hasta Kasıtlı Kendine Zarar Verme Anketi, Kendine Zarar Verme Davranışı Anketi ile intihar girişimleri olanlar ve olmayanlar olmak üzere iki gruba ayrıldı. Sosyodemografik Veri Formu, SCID I ve SCID II uygulaması, Mizaç ve Karakter Envanteri ve Borderline Kişilik Envanteri uygulandı.Bulgular: Çalışmaya katılan olguların %48.4’ ünün intihar girişiminde bulunduğu, intihar girişiminde bulunanların %93.3’ünü kadınların oluşturduğu saptandı. İntihar girişimde bulunan grupta tekrarlayıcı kendine zarar verme davranışının, intihar düşüncesi, intihar tehditi ve intihar girişimlerinin, borderline kişilik bozukluğu tanısının, borderline psikopatolojinin intihar girişimi olmayan gruba göre anlamlı olarak daha fazla olduğu saptandı. Mizaç ve karakter özellikleri açısından iki grup arasında anlamlı farklılık saptanmadıSonuç: Kendine zarar verme davranışı olan olgular içinde kadın cinsiyet, kendine zarar verme davranışının sıklığı ve şiddeti, daha önceki intihar girişimleri ve borderline psikopatolojinin ağırlığı intihar girişimleri için risk faktörlerindendir.

Anahtar Kelimeler:

KENDİNE ZARAR VERME DAVRANIŞI, İNTİHAR, BORDERLİNE KİŞİLİK BOZUKLUĞU

Relationship between non suicidal self-injury and suicide: the role of diagnosis, borderline personality disorder and temperament and character profile

Purpose: The aim of this study is to determine clinical diagnosis which will lead to prevention, treatment and keeping from reoccurrence of suicide among young adults with self injury behavior, and to determine borderline personality characteristics and temperament and character features.Materials and Methods: 18-20 year old 93 patients followed in Adolescent and Young Adult Psychiatry second step clinic, have been given deliberate self harm inventory, self harm behavior questoinnarie. and divided into two groups as those who have attempted suicide and those who have not. These patients have been given socio-demographic data form, SCID I and II application, temperament and character inventory and borderline personality inventory.Results: 48.4% of the patients have attempted suicide and 93.3% of these attempts have been made by females. Repetitive self injury behavior, attempted suicide, using suicide as a threat and idea of suicide, borderline personality disorde and borderline psychopathology are significantly more frequent compared to the group of those who have not. No significant differences have been determined between the two groups with respect to temperament and character features. Conclusion: Self-mutilation of the facts in respect to men, female gender, borderline personality psychopathology, and those repetitive self-injurious behavior, past suicide attempt those who attempted suicide for the greater risk.

Keywords:

Self İnjury Behavior, Suicide Attempt, Borderline Personality Disorder,

PDF

___

Referans1. Clotuier P, Martin J,Allison K, Nixon M, Muehlenkamp J. Characteristics and Co- Occurrence of Adolescent Non Suicidal Self-Injury and Suicidal Behaviors in Pediatric Emergency Crisis Services. J .Youth Adolescense . 2009; Oct;24-5
Referans2.Ross S., Heath N. , A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescente. 2002;31, 67–77.
Referans3.Whitlock J., Eckenrode J., Silverman D. Self-injurious behaviors in a college population. Pediatrics.2006. 117, 1939–1948
Referans4. Favazza AR. Why patients mutilate themselves. Hosp Community Psychiatry. 1989; 40: 137-145
Referans5. Muehlenkamp JJ.,Gutierrez PM. Risk For suicide attemps among adolescents who engage in non- suicidal self injury. Archieves of Suicide Resarch. 2007;11:1-4
Referans6. Harrington R, Pickles A,vAglan A. Early adult outcomes of adolescents who deliberately poisened themselves. J.Am Acad Child Adolesc Psychiatry .2006;45:337-345
Referans7.Nock MK, Joiner TE, Gordon KH, Lyold-Richardson E. Non-suicidal self injury among adolescent: diagnostic corraletes and relations to suicide attemps. Psychiatry Res.2006 30;144(1):65-72
Referans8. Dougthery DM, Mathias CW. İmpulsivity and cilinical symptoms among adolescents with non suicidal self injury with or without attemped suicide. Psychiatry Res.2009 30;169(1):22-27
Referans9.Klonsky E. D., Muehlenkamp, J. J. Self-injury: A research review for the practitioner. Journal of Clinical Psychology.2007;63, 1045– 1056.
Referans10.Whitlock, J., Muehlenkamp, J., Eckenrode, J., Purington A., Baral Abrams, G., Barreira, P., Kress, V. Nonsuicidal self-injury as a gateway to suicide in young adults. Journal of Adolescent Health. 2013; 52(4), 486-492.
Referans11. Klonsky ED, Glenn CR. The Relationship between nonsuısıdal self-injury and attempt suicide :converging evidence from four samples.Journal of Abnormal psychology. 2013; 122(1):231-237.
Referans12.Boxer P. Variations in risk and treatment factors among adolescents engaging in different types of deliberate self-harm in an inpatient sample. Journal of Clinical Child and Adolescent Psychology. 2010; 39, 470–480.
Referans13.Sinclair J. M. A., Hawton, K., Gray, A. Six year follow-up of a clinical sample of self-harm patients. Journal of Affective Disorders. 2010;121, 247–252.
Referans14.Andover M. S., Gibb B. E. Nonsuicidal self-injury, attempted suicide, and suicidal intent among psychiatric inpatients. Psychiatry Research. 2010; 178, 101–105.
Referans15.Wilkinson P., Kelvin R., Roberts C., Dubicka B., Goodyear, I.. Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the adolescent depression antidepressants and psychotherapy trial. The American Journal of Psychiatry. 2011;168, 495–501.
Referans16. Valentina Del Bello, Norma Verdolini, Luca Pauselli, Luigi Attademo, Francesco Bernardini, Roberto Quartesan, Moretti, Personalıty and psychotic symptoms as predıctors of self harm and attempted suıcıde. Psychiatria Danubina. 2015; 27(1): 285–291.
Referans17. Taru Tschan, Claudia Peter‐Ruf, Marc Schmid and Tina In‐Albon .Temperament and character traits in female adolescents with nonsuicidal self-injury disorder with and without comorbid borderline personality disorder. Child Adolesc Psychiatry Ment Health .2017;11:4
Referans18. Gutierrez PM,Osman A,Barrios FX,Kopper BA Development and initial validation of the Self-harm Behavior Questionnaire. J Pers Assess. 2001 ;77(3):475-90.
Referans19. Gratz KL. Measurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory .J Psychopathology and Behavioral Assessment. 2001, 23(4)253–263.
Referans20. Saçarçelik G, “Kasıtlı Kendine Zarar Verme Davranışı Olan Ergenler ve Genç Erişkin Hastalarda Çocukluk Çağı Travmaları” adlı yayınlanmamış uzmanlık tezi, Bakırköy Prof Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Hastanesi, İstanbul 2008
Referans21. Özkürkçügil A, Aydemir Ö, Yıldız M, Esen Danacı A, Köroğlu E. DSM-IV eksen bozuklukları için yapılandırılmışklinik görüşmenin Türkçeye uyarlanması ve güvenilirlik çalışması. İlaç veTedavi Dergisi. 1999; 12:233-236
Referans22. Sorias S, Saygılı R, Elbi H. DSM-III-R Yapılandırılmış Klinik Görüşmesi Türkçe Versiyonu. SCID-II, Kişilik Bozuklukları Formu. Ege Üniversitesi Basım Evi, İzmir, 1998
Referans23. Leichsenring F. Development and first results of the Borderline Personality Inventory: a self report instrument for assessing borderline personality organization, J Pers Assess. 2006;86(1):11.
Referans24. Aydemir Ö, Demet M, Danacı A., Borderline Kişilik Envanterinin Türkçe’ye uyarlanması, güvenilirlik ve geçerliliği. Türkiye’de Psikiyatri. 2006;8(1):6-10
Referans25. Arkar H, Sorias O, Tunca Z ve ark. Mizaç ve Karakter envanterinin Türkçe formunun faktör yapısı geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi. 2005;16(3):190-204
Referans26.Whitlock J, Knox kl .The relationship between self -injuris behavior and suicide in a young adult population. Archives if pediatrics and adolescent Medicine .2007;161:634-640
Referans27.Lewinsohn PM,Rohde P, Seeley JR. Gender differences in suicide attempts from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry. 2001;40(4):427-34
Referans28.Hamza CA.,Stewart S., Willouhgby T.Examining the link between nonsuicidal slf-injury and suicidal behavior:A review of the literatüre and an integrated model.Clinical Psychology Review. 2012;32,482-495.
Referans29. Turner BJ., Layden BK., Butler SM., Chapman AL. How often, or how many ways: clarifying the relationship between non-suicidal self-injury and suicidality. Arch Suicide Res. 2013;17(4):397-415.
Referans30.Klonsky E.A., Olino T.M. Identifying clinically distinct subgroups of self injurers among young adults:latent Class Analysis.Journal of consulting and clinical psychology. 2008,76,22-27.
Referans31. Tang J., Yu Y., Wu Y., DuY., Ma Y., Zhu H., Zhang P.Association between Non-Suicidal Self-Injuries and Suicide Attempts in Chinese Adolescents and College Students: A Cross-Section Study . PLoS One6(4)17977.
Referans32Jacobson CM, Muehlenkamp JJ, Miller AL, TurnerJB .Psychiatric impairmentamong adolescent engaging in different types of delibrate self harm, Journal of child and adolescent psychlogy. 2008; 37,363-375
Referans33.Caes L, Muehlenkamp J, Vandereycken W, HamelinckL, Martens H, Claes S. Comparision of non suısıdal seff injurious behavior and suıscide attempts in patients admitted to a psychşatric crisis unit. Personalıty and indivudial differences . 2010;48,83-87.
Referans34. Guertin T, Lloyd –Richardson E, Spirito A, Donaldson D, Borges J. Self –mutilative behavior in adolescents who attempt suıcide by overpose. Journal of Amerivcam Academy of child and adolescent psychiatry . 2001;39,470-480.
Referans35.Bolognini, M., Plancherel, B., Laget, J., Stephan, P., and Halfon, O. Adolescents self-mutilation relationship with dependent behaviour. Swiss J. Psychol,2003;62, 241–249.
Referans36. Darche, M. A. Psychological factors differentiating self-mutilating and non-self-mutilating adolescent inpatient females. Psychiatr. Hosp.1990; 21, 31–35.
Referans37.Iannaccone, M., Cella, S., Manzi, S. A., Visconti, L., Manzi, F., and Cotrufo, P. My body and me: self-injurious behaviors and body modifications in eating disorders—preliminary results. Eat. Disord. 2013;21, 130–139.
Referans38..Klonsky ED, Oltmanns TF, Turkheimer E,Delibrate self harm in a non clinical population:prevelans and psychological correlates. Am J Psychıatry. 2003,160:1501-1508
Referans39.Mann JJ,Waternauxc, Hass GL,Malone KM Toward a clinical model of suısıdal behavior in psychiatric patients. Am J Psychiatry. 1999,156:181-189
Referans40.Bhatt M,Perera S,Zielinski L, Eisen RB,Yeung s,Profile of suıcide attempts and risk factors among psychiatric patients:A case control study . Plos One. 201813(2):e0192998.
Referans41.KoeningJ, Brunner R,Schmidt JM,Parzer P.Psychopathology and borderline personality associated with lifetime self injurious Behavior in adolescent psychiatric inpatients and detainees, Zeitschrift for kinder und jugendpsychiatrie und psychoterapie. 2017;45(6),441-451
Referans42.Merza K, Papp G, Molnar J, Szabo IK. Characteristics and Development of nonsuısıdal super self ınjury among borderline inpatients. Psychıatria Danubina. 2017;29,4,480-489.
Referans43. Levine AZ, Aljabari R, Dalrymple K, Zimmerman M. Nonsuısıdal self injury and suıcıde ;differences between those with and without borderline personalıty disorders . Journal of personalıty dısorders. 2018;32,385
Referans44. Adani AR, Naghibzadeh B, Asadpour Z, Khabazianzadeh .Temperament and character personality profile and affective temperaments in self-poisoning nonlethal suicide attempters. Psychiatry Res. 2015 ;30;229(1-2):394-400.
Referans45. Lee K,Lee HK,Kim SH Temperament and character profile of college students who have suicidal ideas or have attempted suicide . J Affect Disord. 2017 ;15;221:198-204.
Referans46. Mitsui N,Asakura S,Shimizu Y,Fujii Y,Kako Y,Tanaka T,Oba K,Inoue T,Kusumi ITemperament and character profiles of Japanese university students with depressive episodes and ideas of suicide or self-harm: a PHQ-9 screening study. Compr Psychiatry. 2013;54(8):1215-21.