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Yıl:2014; Cilt: 17; Sayı: 1>> Özet
Klinik Psikiyatri Dergisi; 2014;17(1):41-48
Dissosiyatif Bozuklukta Tanı ve Ayırıcı Tanı: Olgu Sunumu
MÇ Uytun, R Durmuş, DB Öztop
Yaşam Özel Danışma Merkezi, İzmir
Çocukluk çağı travma öyküsünün, bir çok psikiyatrik hastalık ile ilişkisi olduğu bilinmektedir. Dissosiyatif bozukluklar, en çok üzerinde durulan bozukluklardandır. Dissosiyatif bozukluklarda paylaşılan ortak tema geçmişe ait belleğin, kimliğin farkında oluşun ve bedenden gelen duyumlarla bedensel hareketlerin kontrolü arasındaki normal entegrasyonun kısmi veya tam kaybıdır. Bu hastalık grubunda bir organik hastalık ya da patofizyolojik bozukluğa ait kanıtlar da yoktur ve belirtiler beden veya akıl işlevinin nasıl bozulacağı veya işlev görmeyeceğine ilişkin hastanın düşüncelerine karşılık gelir. Dissosiyatif Bozuklukların en önemli özelliği neredeyse her ruh fonksiyonunu etkileyebilmesidir. Dissosiyatif amnezi, depersonalizasyon, derealizasyon, kimlik bocalaması ve kimlik değişikliği dissosiyatif psikopatolojinin temel özellikleridir Dissosiyatif bozukluklar kişilik bozuklukları dâhil birçok psikiyatrik bozukluğa eşlik edebilir veya psikiyatrik bozuklukların belirtileri içinde bulunabilir. Bu nedenle doğru tanının konulması ve ayırıcı tanının dikkatle yapılması önemli bir konudur. Dissosiyatif bozukluklara tanı koymakta ise Uluslararası Hastalık Sınıflandırması (ICD-10) ve Psikiyatride Hastalıkların Tanısal ve İstatistiksel Sınıflandırması El Kitabı (DSM-lV-TR) kullanılmaktadır. ICD-10 ve DSM-lV-TR' de nozolojik durum açısından farklılıklar olmakla birlikte temel temalar değişmemiştir. Bu çerçevede çocukluk çağında yaşadığı bir travma sonrası dissosiasyon semptomları olan hasta üzerinden dissosiyatif bozuklukta ayırıcı tanı anlatılacaktır.
Diagnosis and Differential Diagnosis of Dissociative Disorder
It is known that there is a relationship between many psychiatric disorder and childhood trauma history. Dissociative disorders are most often investigated disorders. The common theme shared by dissociative disorders is a partial or complete loss of normal integration between memories of the past, awareness of identity, and immediate sensations and control of bodily movements. This group of illnesses also lacks the evidence of proximate organic illness or pathophysiological disturbance, and the symptoms correspond to the ideas of the patient about how parts of body or mind malfunction or fail to function. The most important feature of disscociative disorders that these disorders can affect almost every psychological function. The main features of this psychopathology includes that dissociative amnesia, depersonalization, derealization, confusion of identity and changing of identity. A number of psychiatric disorders, including personality disorders, either have dissociative disorder comorbidity or contain dissociative symptoms in their diagnostic criteria. Therefore, It is important that diagnose and diffreantial diagnose with dissociative disorders should make carefully. International Classification of Diseases (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) can be use for diagnose of dissociative disorders. In spite of the differences between nosological status, the basic themes remain unchanged. In this context, our patient who after a trauma experienced in childhood and we confused about this patient's current diagnosis are explained.

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