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Yıl:2013; Cilt: 3; Sayı: 1>> Özet
TAM METİN
Journal of Mood Disorders; 2013;3(1):11-16
İki uçlu bozukluğu olan kadınların sosyal ve üreme yaşamları: Türkiye’den tanımlayıcı bir çalışma
BB Annagür, SB Zincir, Y Bez, İ İnanlı, M Şahingöz, N Ateş, G Alpak
Selçuk Üniversitesi, Konya
Amaç: İki uçlu bozukluk (İUB) cinsiyetler arasında bazı farklılıklar göstermektedir. Kadın hastaların tedavileri hamilelik, doğum ve emzirme gibi nedenlerle sıklıkla aksamaktadır. Ülkemizde İUB tanısı olan kadınların durumu henüz yeterince incelenmemiştir. Bu çalışmanın amacı, İUB tanısı olan kadınların evlilik yaşamı, fertilite durumu ve sosyal yaşamı ile ilgili özelliklerini ortaya koymaktır. Yöntem: Çalışma Türkiye’nin üç bölgesinden beş farklı merkezde Ocak –Haziran 2011 ayları arasında gerçekleştirildi. İUB tanısı olan toplam 231 kadın çalışmaya dâhil edildi. İUB tanısı DSM-IV Eksen I bozuklukları için yapılandırılmış klinik görüşme ile doğrulandı. Sosyodemografik ve klinik özellikler önceden yazarlarca hazırlanmış yarı yapılandırılmış bir form kullanılarak kaydedildi. Bulgular: Yaşları 18-73 arasında olan hastaların yaş ortalaması 39.19±11.2 yıldı. Hastalık başlangıç yaşı ortalama 24.22±7.5 yıl idi. Hastaların 220’si İUB Tip-I (%95.2), 11’i ise İUB Tip-II (%4.8) olarak saptandı. Depresyon atak sayısı ortalama 3.36±3.4, manik atak sayısı ortalama 3.75±3.6, hipomanik atak sayısı ortalama 1.68±2.0 olarak saptandı. Hastaneye yatış sayısı ortalama 3.43±3.8 idi ve hastaların %92.3’ü (n= 213) en az bir kez hastaneye yatmıştı. Hastaların %32.5’i (n= 75) en az bir kez özkıyım girişiminde bulunmuştu. Hastaların %18.2’si (n=42) gebelik döneminde en az bir kez atak geçirmişti, %20.7’sinde (n=48) ise geçirilmiş puerperal atak öyküsü mevcuttu. Hastaların neredeyse beşte biri (%18.6) hastalığı nedeniyle eğitimine ara vermek zorunda kalmışken, %12.1’si eğitimini hiç sürdüremediği tespit edildi. Hastaların %19.5’i düzenli bir işte çalışmayı halen sürdürüyordu. Tüm hastaların %23.8’i bekâr, %51.1’i evli, %2.2’si nikahsız olarak birlikte yaşıyor, %20.3’ü boşanmış ve %2.6’sı ise dul idi. Kadınların %11.3’i hastalık etiketi nedeni ile evlenemediklerini, %16’sı hastalık nedeniyle boşandıklarını belirttiler. Ortalama gebelik sayısının 3.02±2.0 olduğu, sahip olunan çocuk sayısının ortalama 2.18±1.4 olduğu saptandı. Hastaların %51.5’i ilaca bağlı menstrüel düzensizlikleri olduğunu belirtti. Hastalık sürecinin bir döneminde kullandıkları ilaca bağlı amenorenin %13.9, galaktorenin ise %22.5 oranında olduğu saptandı. Hastaların yalnızca %28.6’sı doktoru tarafından kontrasepsiyon hakkında bilgilendirildiğini belirtti. Sonuçlar: Sosyal yaşama etkileri ve üreme yaşamı ile ilişkisi göz önüne alındığında İUB kadın hastalar açısından incelenmesi ve akılda tutulması gereken birçok özel durumu içerisinde barındırmaktadır. Bu çalışma, Türkiye’de yaşayan ve İUB tanısı olan kadınların sosyal ve üreme yaşam özelliklerini kesitsel olarak ortaya koymuştur. Bu konuda ülkemizde yapılmış ilk geniş ölçekli çalışma olması açısından bulguları itibariyle önemlidir.
Social and reproductive lives of women with bipolar disorder: A descriptive study from Turkey
Aims: Bipolar disorder (BD) shows some differences across genders. Pregnancy, delivery, and lactation periods of women with BD may sometimes interfere with their treatment. In terms of social and reproductive lives, the characteristics of women with bipolar disorder living in our country have not been thoroughly studied yet. The aims of this study were to investigate the characteristics of marital life, fertility, and social life of the women with BD. Methods: The study was conducted in 5 different centers from 3 parts of the Turkey between January–June 2011. A total of 231 women with the diagnosis of BD have been included in the study. The diagnosis was confirmed by using Structured Clinical Interview for the DSM-IV Axis-I Disorders (SCID-I). Sociodemographical and clinical features of the patients were recorded by using a semi-structured form prepared by the authors. Results: The mean age of the patients was 39.19±11.2 years ranging from 18 to 73. Mean age at onset of BD was 24.22±7.5 years of age. The type of diagnosis was BD Type-I in 220 (95.2%) patients, whereas, BD Type-II in 11 (4.8%) patients. Mean numbers of depressive, manic, and hypomanic episodes were 3.36±3.4, 3.75±3.6, and 1.68±2.0, respectively. Mean number of hospitalizations was 3.43±3.8 where 92.3% (n=213) of the participants were hospitalized at least once. History of at least one suicide attempt was proclaimed by 32.5% (n=75) of the patients. Fourty-two (18.2%) patients reported at least one mood episode during their pregnancy. Additionally, a puerperal episode was defined by 20.77% (n=48) of the patients. Almost one fifth of the patients (18.6%) had to suspend their education due to their disorder, whereas 12.1% were not able to pursue it anymore. Frequency of the patients who worked in a regular job was 19.1%. Marital status of the patients were as follows; unmarried 23.3%, married 51.1%, living with a partner 2.2%, divorced 20.3%, and widowed 2.6%. Among the participants 11.3% reported that they could not marry due to stigma of their disorder, whereas, 16% reported a divorce history due to BD. Mean numbers of pregnancy and children were 3.02±2.0 and 2.18±1.4, respectively. Menstrual abnormalities were reported by 51.5% of the patients. Amenorrhea and galactorrhea secondary to the medications were identified in 13.9% and 22.5% of the patients at sometime during their disease course, respectively. Only 28.6% of the participants acknowledged that their psychiatrists have provided information about contraception. Conclusions: When its effects on social life and reproductive life were taken into account, BD harbors many specific conditions for female patients that should be investigated further and kept in mind. This study cross-sectionally investigated characteristics of social and reproductive lives of the patients with BD who were living in Turkey. Its results are important given the fact that it is the first large-scale study conducted in our country on this topic.

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