Bipolar Bozukluk Tip I'de Romatoid Artrite Kıyasla Evlilik Uyumu ve Aile İşlevselliği

Amaç: Evlili?in sa?lyk ve i?levsellik üzerinde etkili oldu?ubilinmektedir. Medeni hal önemli olsa da, evliliktekiuyum ve aile i?levselli?i seviyelerinin sa?lyk üzerinde dahafazla etki sahibi oldu?u bulunmu?tur. Kronik hastalyklar,evlilik uyumu ve aile i?levselli?i üzerinde olumsuz etkileresahip olabilirler. Çaly?mamyzda, bipolar bozukluk (BB) tipI ve romatoid artrit (RA) hasta ve e?leri arasyndaki evlilikuyumu ve aile i?levselli?ini kar?yla?tyrmayy amaçladyk.Gereç ve Yöntem: Çaly?ma örneklemi 49 BB tip I ve 48RA hastasy ve e?lerinden olu?maktaydy. BB-I hastalaryDSM-IV Eksen I Bozukluklary için Yapylandyrylmy? TanysalGörü?me, Hamilton Depresyon Derecelendirme Ölçe?i veYoung Mani Derecelendirme Ölçe?i ile de?erlendirilip veremisyon evresindeki hastalar çaly?maya dahil edildiler.RA hastalarydan sadece kronik evredekiler çaly?maya dahiledilirken akut evredekiler dy?landy. Ayryca RA hasta grubuve her iki e? grubu de?erlendirilip herhangi bir psikiyatrikbozukluk sahibi olanlar çaly?maya alynmady. Evlilik uyumuve aile i?levselli?i, "Berksun-Söylemez-Kavacyk EvlilikUyumu ve Aile Y?levselli?i Ölçe?iyle" de?erlendirildi. Buölçe?in üç alt ölçe?i bulunmaktaydy; 1.aile i?levi veuyum, 2.güven-sadakat-?iddet, 3.marital disfori. Ölçekteartan puanlar uyum ve i?levsellik kayby olarak yorumlanmaktaydy. Bulgular: BB-I hastalary, RA hastalaryylakar?yla?tyryldyklarynda daha yüksek evlilik uyumu ve ailei?levselli?i puanlary elde ettiler (p = 0,004). BB-I hastalarynyn e?leri de, RA hastalarynyn e?leriyle kar?yla?tyryldyklarynda daha yüksek puanlar elde ettiler (p = 0,001).E?ler arasynda puanlar kar?yla?tyryldy?ynda, RA hastalary vee?leri benzer puanlar elde ettiler. BB-I hastalarynyn e?leriise BB-I hastalaryndan daha yüksek puanlar elde ettiler.Sonuç: Remisyonda bile olsa BB-I, kronik a?rylarla seyreden bir hastalyktan daha fazla aile i?levselli?i alanyndakayba neden olmaktadyr. Bu, BB-I hastalarynyn tedavilerisyrasynda ele alynmalydyr. BB-I hastalarynyn e?lerinin kendilerinden daha fazla tatminsizlik ya?adyklary da akyldabulundurulmalydyr. Özellikle, e?in evlili?e uyumu önemlidir

Marital adjustment and family functioning in bipolar disorder type I in comparison with rheumatoid arthritis

Objective: Marriage is known to affect health and functioning. Beside the importance of the marital status, levels of marital adjustment and family functioning arefound to have greater impact on health. Chronic diseases could have negative effects on marital adjustmentand family functioning. Our aim in this study was tocompare marital adjustment and family functioningbetween bipolar disorder (BD) type I and RA patients andtheir spouses. Method: Study sample included 49 BDtype I and 48 RA patients and their spouses. BD patientswere evaluated by the Structured Clinical Interview forDSM-IV Axis I Disorders, the Hamilton Rating Scale forDepression, and the Young Mania Rating Scale. BDpatients in remission state and RA patients in chronicstate were included, patients in acute state were excluded. The patients with RA and their spouses and thespouses of the BD patients were evaluated fort he detection of comorbid psychiatric disorders and the individuals who had any psychiatric disorder were excluded fromthe study. Marital adjustment and family functioningwere assessed by using the "Berksun-Söylemez-KavacykMarital Adjustment and Family Functioning Scale". Thescale has three subscales; 1.family functioning andadjustment, 2.trust-loyalty-violence, and 3.marital dysphoria. Higher scores are interpreted as worse adjustment and functioning.Results: BD-I patients had highertotal marital adjustment and family functioning scorescompared to the RA patients (p = 0.004). Spouses of BDI patients had also higher scores than the spouses of RApatients (p = 0.001). When the scale is comparedbetween the spouses, RA patients and their partners hadsimilar scores. BD-I patients' partners had worse scoresthan the BD-I patients. Conclusion: BD-I even in remission state disrupts marital adjustment and family functioning more than a disease presenting with chronicpain. This result must be considered in treatment of theBD patients. It should be kept in mind that the spousesof BD patients are more dissatisfied with their marriagesthan the BD patients. Especially, adjustment of thespouse to the marriage is important

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