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Yıl:2002; Cilt: 10; Sayı: 3>> Özet
Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi; 2002;10(3):255-266
Üniversite öğrencilerinde yeme bozukluklarının yaygınlığı ve yeme bozukluğu olanlarda benlik saygısı, aile işlevleri, çocukluk çağı istismarı ve ihmalinin araştırılması
N Kuğu, G Akyüz, O Doğan, E Erşan, F İzgiç
Cumhuriyet Ü. Tıp Fak. Psikiyatri ABD, Sivas
Amaç: Bu çalışmada yarı-kırsal özellikler gösteren bir bölgenin üniversite öğrencileri arasında yeme bozukluklarının yaygınlığının belirlenmesi; yeme bozukluğu olan gruptaki sosyodemografik verilerin, çocukluk çağı kötüye kullanımı ve ihmali öyküsünün ve aile işlevlerinin normal kontrol grubuyla karşılaştırılması amaçlanmıştır. Gereç ve yöntem: Basit rasgele örneklem yöntemiyle seçilen ve Cumhuriyet Üniversitesinde öğrenim gören 1003 öğrenciden çalışmayı katılmayı kabul eden 980’ nine bölümümüzce oluşturulan sosyodemografik bilgi formu ve yeme tutum testi verilmiş; yeme tutum testinde kesme puanının üzerinde puan alan öğrencilerle DSM-IV Yapılandırılmış Klinik Görüşme Formu (SCID-I) kullanılarak tanı koymaya yönelik görüşme yapılmıştır. Olgu ve kontrol grubuna Rosenberg Benlik Saygısı Ölçeği, Aile Yapısını Değerlendirme Aracı (AYDA) ve Çocukluk Çağı Kötüye Kullanımı ve İhmali Soru Listesi Formu verilmiştir. Bulgular: Yeme Tutum Testini doğru olarak dolduran 951 Öğrenciden (492 kız, 459 erkek) 71’inin test puanı, kesme puanı olan 30 veya üzerinde olarak bulundu. 71 öğrencinin 21’ inde (% 2.20) SCID-I ile yeme bozukluğu belirlendi. 21 olgunun 15’ inde Bulimiya Nervoza (1.57) ve 6’ sında Tıkınırcasına Yeme Bozukluğu (TYB) (% 0.63) tespit edildi. Anoreksiya Nervoza tanısı alan olgu yoktu. Olgu grubundaki 21 öğrencinin 18’ i (% 85.7) kız, 3’ü (% 14.3) erkekti. Tanı alan 3 erkek öğrencinin tümünde tanı TYB idi. Olgu ve kontrol grubundaki öğrencilerin yaşları 18-24 yaş arasında olup yaş ortalamalrı olgu grubunda 20.0 ± 1.60, kontrol grubunda 21.1 ± 1.72 idi. Olgu grubunda adet düzensizliği kontrol grubuna göre anlamlı şekilde daha sıktı (x²= 4.50 p= 0.03). Olgu grubunda benlik sayısı, kontrol grubuna göre daha düşük bulundu. (x²= 33.4 p<0.00). Sırasıyla çocukluk çağı cinsel ve emosyonel kötüye kullanımı öyküsü, olgu grubunda kontrol grubuna göre anlamlı ölçüde daha fazlaydı (x²= 4.28 p=0.03, x²=6.92 p=0.00). Yine olgu grubunda AYDA ailede iletişim (İG), birlik (BG) ve duygusal bağlam (DuyB) göstergeleri puanları kontrol grubundan anlamlı şekilde düşük bulundu (z= -3.91 p‹0.00, z= -2.72 p‹0.00, z=5.59 p‹0.00). Tartışma: Bu çalışmada yarı-kırsal özellikler gösteren bir bölgenin üniversite öğrencileri arasında yeme bozukluğu en sık kızlarda bulunmuş, anoreksiya nervoza saptanmamış, tanı alan olguların kontrol grubuna göre benlik saygılarının daha düşük olduğu, daha sık cinsel ve emosyonel çocukluk çağı kötüye kullanımına maruz kaldıkları, aile işlevlerini bazı alanlarını (aile içi iletişim, birlik ve duygusal bağlam) daha problemli olarak algıladıkları belirlenmiştir. Sonuç olarak yeme bozukluklarının kültüre özgü olduğu düşüncesinin ülkemizde yeme bozukluğunun bölgelere göre ve farklı örneklem gruplarında yaygınlığının araştırılması ile yeniden gözden geçirilmeli, yeme bozukluğu olanlarda risk faktörleri olarak çocukluk çağı kötüye kullanımı ve aile işlevlerinin incelenmesi gerektiği anlaşılmaktadır.

Prevalence of eating disorders in a university students population and the investigation of its relation with self-esteem, family functions, childhood abuse and neglect
Objective: In this study it has been aimed to determine the prevalence of eating disorders among university students of a semi-urban region and to compare the sociodemographic data, history of childhood abuse and neglect and family functions of the group having eating disorder with normal control group. Method: Sociodemographic information form which were developed in our development and eating attitude test have been given to 980 students who accepted to join to the study among 1003 students having education in Cumhuriyet University and chosen by stratified simple random sampling method. Interviews have been done to make diagnosis using DSM-IV SCID-I with the students who had points above the cut values in the eating attitude test. Rosenberg Self Esteem Scale, Family Functioning Assessment Device (FFAD) and Childhood Abuse and Neglect Questionnaire Form were given to case and control groups. Results: Among the 951 students (492 female, 459 male) who filled the eating attitude, test, test point of the 71 students were 30 or above 30 which the cut point. 21 (2.20%) of the 71 students had identified as having eating disorder with SCID-I. In 15 of 21 cases (1.57%) Bulimia Nervosa and in 6 of the 21 cases (0.63%) Binge eating Disorder (BED) were detected. There was no case diagnosed as Anorexia Nervosa. 18 of the case group were females and 3 were males. In all of the males the diagnosis was BED. The ages in both control and case groups were distributed between 18-24 [year]s old and in control group mean age was 21.1 ± 1.72 [year]s old whereas mean age in case group was 20.0 ± 1.60 [year]s old. In the case group irreguacity in menstrual cycle irregulacity was more prominent when compared with control group (x²= 4.50 p=0.03). In case group self-esteem was much lower than the control group (x²=33.4 p<0.00). History of childhood sexual and emotional abuse was significantly prominent in case group than in control group (x²= 4.28 p=0.03, x²= 6.92 p=0.00). Also the points of FFAD of family communication, association and emotional context was found to be significantly lower in case group than in normal control group (z= -3.91 p<0.00, z=2.72 p<0.00, z= -5.59 p<0.00). Conclusion: In this study among the university students of semi-urban area, eating disorder has been found frequently in females, no anorexia nervosa has been detected. In the case group when compared with control group it has been determined that self-esteem was lower, exposure to sexual and emotional childhood abuse was much higher and their perception of some family function topics (intrafamiliar communication, association and emotional context) were much more doubtful. In conclusion, it seems to be necessary to review the opinion that the eating disorder is specific to the culture by reviewing and investigating the regional distribution and prevalence of eating disorder on different sampling groups and also evaluation of childhood abuse and family functions as risk factors on eating disorder.

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