Erkek opiyat kullanım bozukluğu hastalarında kendine zarar verici davranış ve intihar girişimi öyküsünün dürtüsellik ve bazı klinik verilerle ilişkisi
Bu çalışmanın amacı, madde bağımlılığının etiyolojisinde, sürmesinde, tedavinin gidişinde ve bağımlılığın depreşmesinde önemli rolü olduğu bilinen dürtüselliğin erkek opiyat kullanım bozukluğu hastalarında kendine zarar verici davranış ve intihar girişimi öyküsü ile ilişkisini araştırmaktır. Yöntem: Opiyat kullanım bozukluğu (KB) tanısı almış 95 kişi çalışmaya alındı. Hastalardan kendine zarar verici davranışı (KZVD) ve intihar girişimi öyküsü (İGÖ) olan (Grup 1), yalnız KZVD olan (Grup 2) ve hiç biri olmayan (Grup 3) şeklinde üç grup oluşturuldu. Katılımcılara Sosyodemografik Form, Barratt Dürtüsellik Ölçeği-11 (BIS-11), Beck Depresyon Ölçeği (BDÖ), Beck Anksiyete Ölçeği (BAÖ) uygulandı. Bulgular: Yaş ortalaması açısından Grup 1 ile Grup 3 arasında, Grup 1’de daha düşük olmak üzere anlamlı farklılık vardı. Çalışıyor olma oranı açısından Grup 1 ile Grup 3 arasında Grup 3’te daha yüksek olacak şekilde anlamlı farklılık vardı. Çocukluk çağı istismar öyküsü açısından Grup 1’in Grup 2 ve Grup 3 ile arasında anlamlı farklılık görüldü. BDÖ ve BAÖ puanları; Grup 1 ile Grup 3 arasında ve Grup 1 ile Grup 2 arasında Grup 1’de daha yüksek olacak şekilde anlamlı farklılık vardı. BIS-11; motor ve motor dürtüsellik puanı açısından Grup 1’de daha yüksek olacak şekilde Grup 3 ile arasında anlamlı farklılık varken; Grup 2’nin Grup 1 ve Grup 3 ile arasında farklılık yoktu; kontrolünü sağlayamama puanında Grup 1 ile Grup 2 arasında Grup 1’de daha yüksek olacak şekilde anlamlı farklılık görüldü. Grup 2 ile Grup 3 arasında yaş, iş durumu, çocukluk çağı istismar öyküsü, BDÖ, BAÖ ve BIS-11 puanları açısından farklılık görülmedi. Sonuç: İntihar girişimi ve KZVD etiyolojisinde dürtüsel- liği içeren, tedaviyi güçleştiren ve depreşmede etkili olan etkenlerdir. Ancak KZVD’ın tek başına anlamlı oranda yüksek dürtüsellik ve artmış depresyon ve anksiyete ile birlikte olmadığını ve İGÖ’nün ve KZVD’nin birlik-teliğinin yüksek dürtüsellik ve artmış anksiyete ve depresyonla birlikte olduğunu göz önünde bulundurarak yapılan psiko- terapötik yakla
The relationship between self mutilative behavior, suicide attempt history and impulsivity and some clinical variables in male opiate- dependent patients
Objective: The aim of this study is to investigate the relationship between self-mutilative behavior (SMB), suicide attempt history (SAH) and impulsivity which is known to play an important role in the etiology, duration, course of treatment, and relapse of addiction in male patients with opiate use disorder. Methods: Ninety five inpatient people diagnosed with opiate use disorder were included in the study. There were three groups according to their clinical findings: Group 1 included the patients with SMB and SAH, Group 2 included the patients with only SMB and Grup 3 included the patients showing none of these behaviors. The Sociodemographic Form, Barratt Impulsivity Scale- 11 (BIS-11), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered. Results: In terms of age there was a significant difference between the Group 1 and Group 3, to be lower in Group 1. There was a significant difference between Group 1 and Group 3 in terms of job status to be higher in Group 3. There was a significant difference between Group 1 and Group 2 and 3 in terms of childhood abuse history. There was a significant difference between Group 1 and Group 3, and between Group 1 and Group 2 to be higher in Group 1 In terms of BDI and BAI scores. There was a significant difference between Group 3 and Group 1 in terms of BIS-11 motor and motor impulsivity subscores to be higher in Group 1; thus there was no difference between Group 2 and Group 1 and 3. There was a significant difference between Group 1 and Group 2 to be higher in Group 1 in terms of self-control. There were no differences in terms of age, job status, childhood abuse history, BDI, BAI and BIS-11 scores between Group 2 and Group 3. Conclusion: Suicide attempt and SMB include impulsivity in etiology, make treatment difficult and is effective on relapse. However, psychotherapeutic approaches considering that SMB alone is not associated with significant impulsivity and increased depression and anxiety, and that the association of SAH and SMB is associated with increased impulsivity and increased anxiety and depression, may improve treatment success in opiate use disorder. (Anatolian Journal of Psychiatry 2019; 20(1):29-37)
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