Travma sonrası stres bozukluğu belirti profilinin cinsel ve cinsel olmayan travma tiplerine göre karşılaştırılması

Amaç: Travma sonrası stres bozukluğunda (TSSB) altta yatan travmanın hastalığın remisyon ve belirti şiddeti ile ilgili olabildiği bilinmektedir. Araştırmalar, cinsel travmaya uğrayan TSSB hastalarının, diğer travma türlerine uğrayanlara göre TSSB belirtilerini daha yüksek, daha şiddetli ve kalıcı yaşadıklarını göstermiştir. Bildiğimiz kada- rıyla, Türkiye’de literatürde cinsel travma ile cinsel olmayan travmaları karşılaştıran bir çalışma yoktur. Bu doğrultu- da, çalışmamızda TSSB hastalarında travma tipleri ve belirti şiddetindeki farklılıkları araştırmak amaçlanmıştır. Yöntem: Araştırmanın örneklemini, iki psikiyatrist tarafından tanısı doğrulanan, 29’u cinsel travma sonrası gelişen ve 47’si cinsel olmayan travma sonrası gelişen 76 ardışık gönüllü TSSB hastası oluşturmuştur. Araştırmanın verileri araştırmacılar tarafından Klinisyen Tarafından Uygulanan Travma Sonrası Stres Bozukluğu Ölçeği (CAPS) uygula- narak ve Sosyodemografik Form, Beck Depresyon Ölçeği (BDÖ), Beck Anksiyete Ölçeği ve Dissosiyatif Yaşantılar Ölçeği (DYÖ) içeren formlarla toplanmıştır. Bulgular: TSSB tanısıyla çalışmaya alınan hastaların 38’i (%50) kadın, 38’i (%50) erkektir. Katılımcıların yaş ortalaması 32.66±8.27 yıldır. İki grup arasında yaş ve cinsiyet açısından ista- tistiksel olarak anlamlı fark bulunmuştur. Ayrıca, hastaların başvuru şekli, tedavisiz geçen süre, BDÖ, DYÖ, CAPS- kaçınma veya küntleşme, CAPS-aşırı uyarılmışlık ve CAPS-toplam puanlarında iki grup arasındaki fark istatiksel olarak anlamlı bulunmuştur. Çok değişkenli lojistik regresyon analizi, cinsel travması sonrası TSSB olma olasılığına başvuru şekli ve CAPS toplam puanının öngördürücü olduğunu göstermiştir. Sonuç: Cinsel travma sonrası TSSB gelişen hastaların, cinsel olmayan travma sonrası TSSB gelişen hastalara göre daha şiddetli belirtiler yaşadığı, tedavi için daha çok kendi isteği ile başvursa da başvuru süresinin uzun olduğu saptanmış ve literatür ışığında tartı- şılmıştır. (Anadolu Psikiyatri Derg 2019; 20(5):470-476)

Comparison of posttraumatic stress disorder symptom profile according to sexual and non-sexual trauma types

Objective: It is known that the underlying trauma may be related to the remission and symptom severity of the disease in posttraumatic stress disorder (PTSD). Studies have shown that PTSD patients exposed to sexual trauma experience higher, more severe and permanent PTSD symptoms than those exposed to other types of trauma. However, as far as we know there is no study comparing sexual trauma with non-sexual trauma in Turkey. In this study, it was aimed to investigate differences in trauma types and symptom severity in PTSD patients. Methods: The sample of the study consisted of 76 consecutive volunteer PTSD patients who 29 patients developed after sexual trauma and 47 patients developed after non-sexual trauma, whose diagnosis was confirmed by two psychi- atrists. The researchers collected the data of the research by applying the Clinician-Applied Post Traumatic Stress Disorder Scale (CAPS) and forms including the Sociodemographic Form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (UAE) and Dissociative Experiences Scale (DES). Results: Thirty-eight (50%) of the patients included in the study with the diagnosis of PTSD were 38 (50%). The mean age of the participants was 32.66±8.27 years. A statistically significant difference was found between the two groups in terms of age and gender. In addition, there was a statistically significant difference between the two groups in terms of application types, duration untreat- ment period, BDI, DES, CAPS-avoidance or blunting, CAPS-Hyper arousal and CAPS-total scores. Multivariate logistic regression analysis showed that the likelihood of applying PTSD after sexual trauma and CAPS total score were predictive. Conclusion: Patients who developed PTSD after sexual trauma had more severe symptoms than patients with PTSD after non-sexual trauma, long-term admission for treatment, although the admission period is longer and was discussed in the light of the literature. (Anatolian Journal of Psychiatry 2019; 20(5):470-476)

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