Bipolar bozukluğu olan hastalarda çocukluk çağı travması, çift uyumu ve cinsel işlevler arasındaki ilişki

Amaç: Bu çalışmada, remisyon dönemindeki bipolar bozukluk tanılı hastaların çift uyumunun ve cinsel işlevlerinin araştırılması ve çocukluk çağı travması öyküsünün çift uyumuna ve cinsel işlevlere olan etkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Kesitsel tipteki bu çalışma, remisyon döneminde bipolar bozukluğu olan 80 (46 kadın, 34 erkek) hasta ve 40 (25 kadın, 15 erkek) sağlıklı kontrolden oluşmaktadır. Katılımcılara sosyodemografik veri formu, çiftler uyum ölçeği (ÇUÖ), çocukluk çağı ruhsal travma ölçeği (CTQ-28), Arizona cinsel yaşantılar ölçeği (ASYÖ) uygulanmıştır. Bulgular: Hasta grubunda kontrol grubuna göre CTQ-28'in tüm alt ölçeklerinde ve toplam puanlarında istatistiksel olarak anlamlı derecede yüksek, ÇUÖ alt ölçek ve toplam puanlarında ise istatiksel olarak anlamlı daha düşük puanlar saptandı. Bipolar bozukluk tanılı hastaların %82,5'inde ve sağlıklı kontrollerin %57,5'inde cinsel işlev bozukluğu saptandı. Lineer regresyon analizi sonuçlarına göre yaş ve ÇUÖ-toplam puanı cinsel işlev bozukluğunu yordamaktadır. Sonuç: Bipolar bozukluk tanılı hastalarda sağlıklı kontrollere göre daha fazla çift sorunu, cinsel işlev bozukluğu ve travma öyküsü bulunmaktadır. Cinsel işlev ve çift uyumu karşılıklı olarak birbirini etkilemektedir. Çocukluk çağı travma öyküsü hem cinsel yaşamı hem de çift uyumunu olumsuz yönde etkilemektedir.

Relationship between childhood trauma, dyadic adjustment, and sexual functions in patients with bipolar disorder

Purpose: This study aimed to investigate the dyadic adjustment and sexual functions in patients with bipolar disorder (BD) during the remission period, and examine the effect of a history of childhood trauma on these. Materials and Methods: This cross-sectional study is consisted of 80 (46 female, 34 male) patients with bipolar disorder-1 and 40 (25 female, 15 male) healthy controls. The Dyadic Adjustment Scale (DAS), Childhood Trauma Questionnaire (CTQ-28), Arizona Sexual Questionnaire (ASEX) were administered to the participants. Results: The patient group showed significantly higher trauma scores in all subscales and total scores of the CTQ-28, and lower scores in the subscales and total score of DAS compared to the control group. 82.5% of bipolar patients and 57.5% of healthy controls were found to have sexual dysfunction (SED). According to the results of linear regression and multiple regression analyses, age and DAS-total score predicted SED, and male gender, absence of SED and CTQ-total score predicted DAS score. Conclusion: Patients with BD have more dyadic problems, sexual dysfunction, and trauma history than healthy controls. Sexual function and dyadic adjustment affect each other in two ways and a history of childhood trauma has a negative effect on both sexual function and dyadic adjustment.

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1. Burns DD, Sayers SL, Moras K. Intimate relationships and depression: Is there a casual connection? J Consult Clin Psychol. 1994;62:1033.
2. Muke SS, Ghanawat GM, Chaudhury S, Mishra SK, Verma AN, Singh AR. Marital adjustment of patients with substance dependence, schizophrenia and bipolar affective disorder. Med J Dr DY Patil Univ. 2014;7:133.
3. Ghaffari M. Spiritual well-being and dyadic adjustment: mediator effects for family strengths. Iran J Psychiatry Behav Sci. 2016;10:3.
4. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, et al. Lifetime and 12- month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64:543–52.
5. Huxley N, Baldessarini RJ. Disability and its treatment in bipolar disorder patients. Bipolar Disord. 2007;9:183–96.
6. Judd LL, Akiskal HS, Schettler PJ, Endicott J, Leon AC, Solomon DA, et al. Psychosocial disability in the course of bipolar I and II disorders: a prospective, comparative, longitudinal study. Arch Gen Psychiatry. 2005;62:1322–30.
7. Grover S, Nehra R, Thakur A. Bipolar affective disorder and its impact on various aspects of marital relationship. Ind Psychiatry J. 2017;26:114.
8. Rusner M, Carlsson G, Brunt DA, Nyström M. The paradox of being both needed and rejected: The existential meaning of being closely related to a person with bipolar disorder. Issues Ment Health Nurs. 2012;33:200–8.
9. Nagaraj AKM, Pai NB, Rao S. A comparative study of sexual dysfunction involving risperidone, quetiapine, and olanzapine. Indian J Psychiatry. 2009;51:265.
10. Downey JI. Driven sexual behavior in bipolar spectrum patients: psychodynamic issues. J Am Acad Psychoanal Dyn Psychiatry. 2011;39:77–92.
11. Hariri AG, Karadag F, Gurol DT, Aksoy UM, Tezcan AE. Sexual problems in a sample of the Turkish psychiatric population. Compr Psychiatry. 2009;50:353–60.
12. Dell’Osso L, Carmassi C, Carlini M, Rucci P, Torri P, Cesari D, et al. Sexual dysfunctions and suicidality in patients with bipolar disorder and unipolar depression. J Sex Med. 2009;6:3063–70.
13. Namli Z, Karakuş G, Tamam L. Assessment of dyadic adjustment and sexual functions in patients with bipolar disorder. Arch Neuropsychiatry. 2018;55:171.
14. Hyun M, Friedman SD, Dunner DL. Relationship of childhood physical and sexual abuse to adult bipolar disorder. Bipolar Disord. 2000;2:131–5.
15. Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry. 2005;186:121–5.
16. Spanier GB. Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. J Marriage Fam. 1976;15–28.
17. Fişiloğlu H, Demir A. Applicability of the Dyadic Adjustment Scale for measurement of marital quality with Turkish couples. Eur J Psychol Assess. 2000;16:214.
18. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27:169–90.
19. Sar V, Ozturk E, Ikikardes E. Validity and reliability of the Turkish version of Childhood Trauma Questionnaire. Turk Klin Tip Bilim Derg. 2012;32:4.
20. A. McGahuey C. The Arizona sexual experience scale (ASEX): reliability and validity. J Sex Marital Ther. 2000;26:25–40.
21. Soykan A. The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis. Int J Impot Res. 2004;16:531–4.
22. Drisya P, Bindumol K, Saleem TK, Narayan D. Marital problems among partners of patients with bipolar affective disorder. Indian J Psychol Med. 2019;41:448–54.
23. Lam D, Donaldson C, Brown Y, Malliaris Y. Burden and marital and sexual satisfaction in the partners of bipolar patients. Bipolar Disord. 2005;7:431–40.
24. Aizenberg D, Sigler M, Zemishlany Z, Weizman A. Lithium and male sexual function in affective patients. Clin Neuropharmacol. 1996;19:515–9.
25. Noble E. The negotiation of tactile relationships in the marital dyad of incest survivors (PhD Thesis). Texas Tech University, 1995.
26. Yehuda R, Lehrner AMY, Rosenbaum TY. PTSD and sexual dysfunction in men and women. J Sex Med. 2015;12:1107–19.
27. Ghormode D, Gupta P, Ratnani D, Aneja J. Evaluation of sexual dysfunction and quality of life in patients with severe mental illness: A cross-sectional study from a tertiary care center in Chhattisgarh. Ind Psychiatry J. 2019;28:75.
28. Kopeykina I, Kim HJ, Khatun T, Boland J, Haeri S, Cohen LJ et al. Hypersexuality and couple relationships in bipolar disorder: A review. J Affect Disord. 2016;195:1–14.
29. Nelson BS, Wampler KS. Systemic effects of trauma in clinic couples: An exploratory study of secondary trauma resulting from childhood abuse. J Marital Fam Ther. 2000;26:171–84.
30. Davidson G, Shannon C, Mulholland C, Campbell J. A longitudinal study of the effects of childhood trauma on symptoms and functioning of people with severe mental health problems. J Trauma Dissociation. 2009;10:57–68.
31. Frank E, Targum SD, Gershon ES, Anderson C, Stewart BD, Davenport Y, et al. A comparison of nonpatient and bipolar patient–well spouse couples. Am J Psychiatry. 1981;138:764-68.
32. Lutfey KE, Link CL, Litman HJ, Rosen RC, McKinlay JB. An examination of the association of abuse (physical, sexual, or emotional) and female sexual dysfunction: results from the Boston Area Community Health Survey. Fertil Steril. 2008;90:957– 64.