Yeme Bozukluğu ve Bipolar Bozukluk Birlikteliği

Yeme bozuklu?u özellikle genç kadynlarda syk görülür.Yemenin kysytlanmasy, tykynyrcasyna yeme, kusma, laksatifkullanymy hastaly?yn tany koydurucu özellikleridir.Toplumda görülme orany genç kadynlarda AnoreksiyaNervosa için %0.3 ve Bulimia Nervosa için %1 olup obesiteyi de bu grup içinde alyrsak %5-10 olarak saptanmy?tyr. Bipolar yelpazesinde bu oran %1-5 arasyndabildirilmektedir. Her iki hastalykta yer alan depresif bulgular e? tany ile ilgili ara?tyrmalary ba?latmy?tyr. Bipolarbozuklu?u olan hastalardaki yeme bozukluklarynyn veyeme bozukluklu hastalardaki bipolar bozuklu?unya?amboyu yaygynlyk oranlarynyn toplum örneklemlerindeve klinik çaly?malarda, kysmen e?ikalty ve bu bozukluklarynspektrum belirtileri de dahil olmak üzere bu hastalyklarynkomorbiditesinin yüksek oranda oldu?u gösterilmi?tir.Bulimik davrany?lar, dürtüsellik ve affektif bozukluklargenetik yatkynlyk veya erken ya?am travmasynyn sonucuolarak serotonerjik nörotransmisyondaki bozuklukla ili?kili olabilir. Bipolar bozukluk ve beraberinde yeme bozuklu?u olan hastalara farmakolojik tedavi yakla?ymlary hersendromun tedavisinin di?eri üzerindeki olasy yan etkilerinin incelenmesine ihtiyaç duyar ve her ikisine deyarayabilecek ajanlarla bazen her iki sendromun datedavisi olasydyr. Bazy vakalarda, duygudurum düzenleyicilerinin monoterapi olarak kullanylmasy veya serotonerjikilaçlara eklenmesi yardymcy olabilir. Bu da her ikihastaly?yn etiyolojik olarak benzer patofizyolojikmekanizmalarla ortaya çykty?ynyn bir kanyty olabilir.

Comorbidity of Eating Disorders and Bipolar Disorder

Eating disorders are common disorders especially inyoung women. Food restriction, binge eating, vomiting,purging are diagnostic features of the disorder. Theprevalence in young women is reported as %0.3 forAnorexia Nervosa and as %1 for Bulimia Nervosa while itreaches to %5-10 if obesity is included to the clinic.Eating disorders are common in bipolar patients so thatthe clinicians should be careful while treating these disorders. The prevalence rate is reported as %1-5 in bipolar spectrum disorders. Depressive symptoms that maybe seen in both disorders led studies about comorbidity.Authors investigating the lifetime comorbidity of eatingdisorders in patients with BD and comorbidity of BD inpatients with eating disorders in community surveys andin clinical studies showed that comorbidity of these disorders is high. Most of these studies include subtresholdclinical cases and all spectrum symptamotology. Bulimicbehaviors, impulsivity and affective disorders may bedue to serotonergic neurotransmission disorder as aresult of genetic vulnerability or early life trauma.Pharmacologic treatment approaches to patients withBD and a comorbid eating disorder require examinationof the possible adverse effects of the treatment of eachsyndrome on the other. Both disorders may be managedwith agents that might be beneficial to each at the sametime. Use of mood stabilizers alone or as adjunct to serotonergic agents may be beneficial in some of the cases.This may be due to the similar pathophysiological mechanisms of both of the disorders.

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