Sebla GOKCE, Arzu ÖNAL SÖNMEZ, Canan YUSUFOĞLU, YASEMİN YULAF, İBRAHİM ADAK

Erken dönem uyumsuz şemaların ergenlik dönemi depresif bozuklukla ilişkisi

Amaç: Bu çalışmanın amacı, kliniğe başvuran ergenlerin erken dönem uyumsuz şemalarının depresif bozuklukla ilişkisini araştırmak ve depresif bozukluk tanısı konan ergenlerin erken dönem uyumsuz şemalarını, depresif bozukluk dışında psikiyatrik tanı konan ergenlerin erken dönem uyumsuz şemaları ile karşılaştırmaktır. Yöntem: Ocak-Mayıs 2016 tarihleri arası Erenköy Ruh ve Sinir Hastalıkları Hastanesi Çocuk ve Ergen Psikiyatri Polikli-niği'ne başvuran, Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı Do?rdu?ncu? Baskı (DSM-IV) tanı o?lc?u?tlerine göre depresif bozukluk tanısı konan 80 ergen ve depresif bozukluk dışı psikiyatrik bozukluk tanıları konan 138 ergen çalışmaya alınmıştır. Sosyodemografik form uzmanlar tarafından, çocuk ve ergenler için Erken Dönem Uyumsuz Şema Ölçekler Takımı (ÇEŞÖT) ergenler tarafından doldurulmuştur. Sonuçlar: Çalışmaya alınan 11-18 yaşları arasındaki 218 ergenin (145 kız, 73 erkek) yaş ortalaması 14.8'dir. Depresif bozukluk tanısı konmayan klinik gruba dikkat eksikliği hiperaktivite bozukluğu, anksiyete bozukluğu, obsesif kompulsif bozukluk, davranım bozukluğu, karşıt olma karşı gelme bozukluğu, travma sonrası stres bozukluğu tanıları konmuştur. Kusurluluk/utanma, kuşkuculuk ve kötüye kullanılma, duygusal yoksunluk, terk edilme ve tutarsızlık, başarısızlık, kendini onaylamama, karamsarlık şema puanları depresif bozukluk tanılı ergenlerde kontrol grubuna göre istatistiksel olarak anlamlı düzeyde daha yüksek bulunmuştur. Regresyon analizi ile kusurluluk/utanma, kuşkuculuk/kötüye kullanılma, terk edilme ve tutarsızlık, kendini onaylamama şemaları depresif bozukluk ile ilişkili bulunmuştur. Tartışma: Ergenlik döneminde sıklıkla atlanmakta olan ve tedavi edilmediğinde intihar, madde kullanımı, obezite gibi sağlık sorunlarına yol açan depresif bozukluk, dünya genelinde önemli bir halk sağlığı sorunu olarak görülmektedir. Daha önce yapılan çalışmalarda ve bu çalışmada depresif bozukluk ile ilişkilendirilen şemalar daha çok kopukluk ve reddedilmişlik alanı içinde bulunan, birincil bakım verenleri ile güvenli bağlanma gereksinmesinin giderilmemesi sonucu gelişen şemalardır. Ergenlik dönemi depresif bozukluk tedavisinde depresyon ile ilişkilendirilen uyumsuz şemaların belirlenmesi ve tedavide bu şemalar üzerine odaklanılması önemlidir.

Relation between early maladaptive schemas of adolescents and depressive disorder

Objective: The aim of this study is to investigate relation between depressive disorder and early maladaptive schemas of adolescents and to compare early maladaptive schemas of adolescents diagnosed with depressive disorder with schemas of adolescents diagnosed with other psychiatric disorders. Methods: Eighty adolescents with depressive disorder and 138 adolescents with other psychiatric disorders who had been diagnosed through Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) between January and May 2016 in Erenköy research and training hospital for psychiatry and neurology child and adolescent outpatient clinic were enrolled in this study. The sociodemographic form of the patients was filled out by the clinicians. The Early Maladaptive Schema Questionnaires Set for Children and Adolescents was filled out by adolescents. Results: There were 145 females and 73 males in the study. The mean age of the adolescents was 14.8 years. The control group was consisted of attention deficit hyperactivity disorder, anxiety disorders, obsessive compulsive disorder, conduct disorder, oppositional defiant disorder and post-traumatic stress disorder. Defectiveness/shame, mistrust/abuse, emotional deprivation, abandonment/instability, failure, non-self-approval, negativity/ pessimism schema scores were significantly greater in adolescents diagnosed with depressive disorder than the control group. There was a statistically significant relation between the schemas of defectiveness/shame, mistrust/abuse, abandonment/instability, non-self-approval and depressive disorder in regression analysis. Discussion: Adolescent depressive disorder, frequently a missed diagnosis that when not treated can lead to health problems such as suicide, drug abuse and obesity, is accepted as an important public health issue. Consistent with literature, schemas under the title of disconnection and rejection and other directedness are related with the depressive disorder in adolescence and associated with the relationship of the primary caregivers and the children. Revealing maladaptive schemas and focusing on these schemas is important in adolescence depressive disorder treatment.

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