ONUR YILMAZ, M.Alpay ATEŞ, Ü. Başar SEMİVZ, Recep TÜTÜNCÜ, Yasin BEZ, Ayhan ALGÜL, Hakan BALIBEY, Cengiz BAŞOĞLU, Servet EBRİNÇ, Mesut ÇETİN

Bipolar bozukluk hastalarında çocukluk çağı travmaları: Aleksitimi ve dissosiyatif yaşantılarla ilişkileri

Amaç: Bipolar bozukluk (BB) hastalarında çocukluk döneminde yaşanan travmatik olayları araştıran çalışmalar sınırlıdır ve bildiğimiz kadarıyla hastalarda aleksitimi ve dissosiyatif deneyimleri araştıran bir çalışma yoktur. Bu çalışmada çocukluk çağı travmaları ve ilişkili dissosiyatif ve aleksitimik özellikler yanında çocukluk çağı travması (ÇT) olan ve olmayan BB hastaları arasındaki farklılıkların tanımlanması amaçlanmıştır. Yöntem: Psikiyatri polikliniğine başvuran 70 BB hastası ve 70 sağlıklı kontrol çalışmaya alındı. DSM-IV Eksen-I Bozukluklar için Yapılandırılmış Klinik Görüşme (SCID-I), Dissosiyatif Yaşantılar Ölçeği (DES), Çocukluk çağı Travma Anketi (CTQ) ve Toronto Aleksitimi Ölçeği (TAS-20) uygulandı. Bulgular: BB hastalarının CTQ ve TAS-20 alt ölçek ve toplam puanları ve DES puanı sağlıklı kontrollere göre anlamlı oranda daha yüksekti. Psikopatolojik davranışlar, nöbet ve intihar girişimi sayısı çocukluk çağı travması olan BB hastalarında olmayanlara göre daha yüksekti. Ek olarak, cinsel istismar ve aleksitimi toplam puanı arasında 'duyguları tanımlamada güçlük' açısından pozitif korelasyon bulundu. Ortalama DES puanı ile 'duyguları tanımlamada güçlük', 'duyguları tarif etmede güçlük' alt ölçekleri, aleksitimi toplam puanı ve nöbet sıklığı arasında pozitif korelasyon bulundu. Sonuç: Bu sonuçlar, BB'de koruyucu ruh sağlığının önemini vurgulamış ve özellikle BB hastalarını değerlendirirken çocukluk çağı travma/arının sorgulanması gerekliliğini açığa çıkarmıştır.

Childhood traumas in patients with bipolar disorder: association with alexithymia and dissociative experiences

Objective: The number of studies investigating the traumatic events experienced during childhood period in patients with bipolar disorder (BD) are limited and to our knowledge no previous study was conducted about alexithymia and dissociative experiences of these patients as well. Besides investigation of childhood traumas and associated dissociative and alexithymic properties, identification of the differences between BD patients with and without childhood trauma (CT) was aimed in this study. Methods: Among the admissions to the psychiatry outpatient clinic, 70 BD patients and 70 healthy control subjects were included into the study. Structured Clinical Interview for DSMIV Axis-I Disorders, Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ) and Toronto Alexithymia Scale (TAS-20) were administered. Results: Mean subscale and total scores of patients with BD in both CTQ and TAS-20, and mean DES score were found to be significantly higher than healthy control subjects. Psychopathological acts, number of episodes and suicide attempts were higher in the BD patients with childhood trauma history than that of the BD patients without any history of childhood trauma. Additionally, positive correlations were found between 'sexual abuse' and alexithymia total score along with 'difficulty identifying feelings' subscale score. Moreoever, mean DES score was also found to be positively correlated with 'difficulty identifying feelings' subscale score, 'difficulty to describe feelings' subscale score, alexithymia total score, and episode frequency. Conclusion: These results highlight the importance of protective mental health in the treatment of BD and reveal that childhood traumas should be questioned when evaluating patients especially with the diagnosis of BD.

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