Psikosomatik Hastalıklarda Mizaç ve Karakter

Psikosomatik hastalıkların etiyolojisinde kişiliğin önemli bir rol oynadığı düşünülmektedir. Bu ilişkinin anlaşılabilmesi için kişiliği psikobiyolojik modele göre değerlendirme olanağı veren Mizaç ve Karakter Envanteri ile yapılan çalışmaların önemli katkılar sağlayabileceği öne sürülmüştür. Bu konudaki literatürü irdelemek amaçla 19912009 yılları arasında Mizaç ve Karakter Envanteri ile yapılmış tüm çalışmalar Medline (Pubmed) ve Türk Psikiyatri Dizini veritabanlarında taranmış ve somatizasyon, dermatolojik hastalıklar, baş ağrısı, fiziksel tıp, göğüs ağrısı, irritabl barsak sendromu, astımlı hastalarda yapılmış çalışmalar incelenmiştir. Çalışmaların sonuçlarına bakıldığında en önemli ortak sonuç zarardan kaçınma puanlarının yüksek bulunmasıdır. Depresyon ve anksiyetenin etkisi kontrol edildiğinde de zarardan kaçınma puanlarının halen yüksek olması bu mizaç boyutunun psikosomatik hastalıkların gelişimi için hem durumsal hem de süreklilik gösteren bir özellik taşıdığını ve serotonerjik sistemin bu sürece katıldığını doğrulamaktadır. Kişiliğin bir olgunluk düzeyine erişmesinde temel unsur kabul edilen kendine yetmenin birçok çalışmada normal sağlıklı kontrollerden düşük düzeyde bulunması, bu hastalarda sürecin kişiliği etkilediğini düşündürmektedir. Psikosomatik hastalıklarda mizaç ve karakter özelliklerinin ayrıntılı değerlendirilmesi etiyolojik açıdan bu hastalıkların daha iyi anlaşılmasına katkıda bulunacaktır

Anahtar Kelimeler:

Psikosomatik hastalık, somatizasyon, mizaç ve karakter

Temperament and Character in Psychosomatic Disorders

Personality plays an important role in the etiology of psychosomatic disorders. The studies investigating personality features with Temperament and Character Inventory according to psychobiological model is considered to have a major role in understanding the relationship between personality and psychosomatic disorders. We have done a database search in Pubmed and Turk Psikiyatri Dizini (Turkish Psychiatry Directory) for the time period between 1991 and 2009 to determine and evaluate the articles conducted among somatization, dermatologic illness, headache, physical medicine, angina, irritable bowel syndrome and asthma patients using Temperament and Character Inventory. The most significant consistent result of these studies was elevated harm avoidance scores. Harm avoidance scores still remain high even after controlling for the effect of depression and anxiety. Thus this temperament dimension is possibly an important state and trait feature for development of psychosomatic illnesses. These findings also confirmed that serotonergic systems get involved in the process of psychosomatic organization. In many studies, the mean scores of self direction sub-dimension of Temperament and Character Inventory which has been considered as fundamental dimension to achieve mature personality, was found to be lower in psychosomatic patient groups than normal healthy control. Overall the research studies support the notion that course of the diseases clearly affect the personality features among these patients. Detailed evaluation of temperament and character profiles of psychosomatic patients would contribute much into understanding the etiology of these disorders.

Keywords:

Psychosomatic disorders, somatization, temperament and character,

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