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Yıl:2000; Cilt: 1; Sayı: 4>> Özet
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Anadolu Psikiyatri Dergisi; 2000;1(4):197-206
Çocuk ve ergenlerde dissosiyatif bozukluk: 36 olgunun gözden geçirilmesi
SS Zoroğlu, Ü Tüzün, M Öztürk, V Şar
Gaziantep Ü.T.F. Çocuk ve Ergen Psikiyatrisi Bilim Dalı, Gaziantep
Amaç: Bu çalışmanın amacı, 36 çocuk ve ergenden oluşan dissosiyatif bozukluk olgularının klinik görünüm ve
travmatik özgeçmişleriyle ilgili özellikleri ortaya koymak ve hastalığın çocukluk travmaları ile oluşan, kültürler
üstü bir bozukluk olduğunu gösterebilmektir. Yöntem: Dissosiyatif Kimlik Bozukluğu (DKB) ve Başka Türlü
Adlandırılmayan Dissosiyatif Bozukluk (BTADB) tanısı konulan ve en az 3 görüşme yapılan 36 olgunun klinik
özellikleri, daha önce aldıkları tanılar ve çocukluk çağı travmaları gözden geçirilmiştir. Hastalara Çocuk
Dissosiyasyon Değerlendirme Ölçeği (ÇDDÖ) ve Ergen Dissosiyatif Yaşantılar Ölçeği (E-DYÖ) uygulanmıştır.
Bulgular: Ergen hastalar çocuk hastalara göre ve DKB olguları da BTADB olgularına göre daha zengin klinik
belirtiler ortaya koymaktadır. En sık gözlenen belirtiler; dalgınlık, kafa içinden ses duyma, içindeki bir güç
tarafından yönetilme, kişilik değişikliği ve amnezi gibi dissosiyatif belirtilerdir. Bunun yanında diğer psikiyatrik
bozukluklara özgü belirtilere de sık olarak rastlanmıştır. En sık konulan yanlış tanılar epilepsi, psikoz,
depresyon ve konversiyon bozukluğu olmuştur. Hastalarımızın özgeçmişlerinde en sık gözlenen travma türünün
duygusal istismar olduğu ortaya çıkmaktadır. Tartışma: Dissosiyatif bozukluk, Batı toplumuna ve özelde Kuzey
Amerika'ya ait bir bozukluk olmadığı gibi, klinisyenlerin aşırı abarttığı bir durum da değildir. Tersine, çocuk
istismarı ve ihmalinin oluştuğu her durumda, coğrafya ve kültürden bağımsız olarak gelişebilen ve her yaş
grubunu etkileyen, kronik, ağır ve yıkıcı bir ruh sağlığı sorunudur.
Dissociative disorders in childhood and adolescents: review of the 36 Turkish cases
Objective: This study aims to bring out the characteristics of clinical presentations and histories of traumatic
experiences of 36 dissociative disorder cases consisted of both children and adolescents and to demonstrate that
as an overcultural disorder, it is resulted from traumas in childhood. Methods: Clinical features of 36 patients
interviewed at least for 3 times and diagnosed with DID and DDNOS, their previous diagnoses and childhood
traumas were examined and the CDC and ADES were performed. Results: Adolescents are much more
symptomatic than child patients, so are DID cases than DDNOS patients. Most frequent symptoms are dissociative ones such as hearing many simultaneous voices in their heads, translike behaviour, passive
interference experiences, passive alterations in identity and amnesia. Additionally, spesific symptoms of other
psychiatric disorders are often available. Many patients had been misdiagnosed with epilepsia, psychosis,
depression or conversion. This demonstrated that emotional abuse is the most often trauma kind in the histories
of our patients. Conclusion: Dissociative disorder is neither a case much exaggerated by the clinicians nor a
disorder belonging to the societies in the West, especially to the North America. On the contrary, it has been a
chronic, severe and destructive mental problem seemed in different age brackets and independently from the
culture and geography, come out where child abuse and neglect formed.

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