Meliha EROĞLU ZENGİN, Gonca KARAKUŞ, LUT TAMAM

Bipolar disorder and suicide

Amaç: Bipolar bozukluk hastalarında özkıyım girişimiyle ilgili risk faktörleri halen tam olarak bilinmemektedir. Çalışmamız, bu hastalarda özkıyım girişiminin sıklığı, özkıyım şekilleri ve özkıyımla ilişkili klinik özellikleri değerlendirmeyi amaçlamaktadır. Yöntem: Çukurova Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı Bipolar Bozukluk Birimi’ne ayaktan başvuran 122 hasta çalışmaya alınmıştır. Duygudurum Bozukluğu Hasta Kayıt ve İzleme Formu ve DSM- IV Eksen I bozuklukları için Yapılandırılmış Klinik Görüşme Ölçeği (SCID-I) kullanılmıştır. Ölçekler, hastalarla ve hasta yakınlarıyla yapılan görüşmeler ve takip dosyaları ışığında doldurulmuştur. Bulgular: Ayaktan izlenen bipolar bozukluk hastalarında özkıyım girişimi sıklığı %19.7 olarak saptanmıştır. Çalışmamız, özkıyım girişimiyle kadın cinsiyet, hastalığın ciddiyetini gösteren hastalık süresi, tedavisiz hastalık süresi (latans), hastaneye yatış sayısı, geçirilmiş toplam dönem sayısı, depresif dönem sayısı, karma dönem sayısı ve ailede psikiyatrik hastalık öyküsünün olması gibi klinik özellikler arasında anlamlı bir ilişki olduğunu göstermiştir. Sonuç: Çalışmamız, bipolar bozukluk hastalarında özkıyım girişimi sıklığının yüksek olduğunu göstermiştir. Tedavisiz hastalık süresinin azaltılması, duygudurum dönemlerinin önlenmesi, depresif ve karma dönemler sırasında özkıyım riskinin değerlendirilmesi tedavinin ana hedeflerinin başında gelmelidir. Özkıyımla ilgili uyarıcı belirtilerin saptanması bipolar bozukluk hastaları arasında riskli grubun ayırt edilmesine ve özkıyımın önlenmesine yardımcı olabilir.

Bipolar bozukluk ve özkıyım

Bipolar disorder and suicide Objective: The risk factors associated with suicidal behaviour in bipolar patients are not clear yet. We aimed to evaluate the frequency of suicide attempt, type of suicide attempt and significant clinical characteristics associated with suicide attempts. Methods: One hundred twenty two consecutive patients, from Bipolar Disorder Unit of Çukurova University, Faculty of Medicine, Department of Psychiatry, are included in this study. “Affective Disorders Patient Registry Form” was developed by Bipolar Disorder Unit and SCID-I were used in this study to collect the data. These forms are filled in through interviews with patients and their relatives, and evaluation of inpatient files. Results: The prevalence of suicide attempt was 19.7% in the outpatient group. Lifetime history of suicidal behavior was significantly associated with following characteristics: being a woman, depression as a first episode and indicators of severity of bipolar disorder including duration of illness, duration of untreated illness (latency), number of hospitalization, number of total mood episodes, number of depressive episodes, number of mixed episodes, positive familial psychiatric disorder history. Conclusion: Our study showed that patients with bipolar disorder have a high rate of suicide attempt. Reduction of the duration of untreated illness, prevention of mood episodes, assessment of suicide risk during depressive and mixed episodes should be the main targets of the treatment. Detection of warning signs about suicide among patients with bipolar disorder may help to distinguish the risky group and prevent suicide.

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