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Yıl:2017; Cilt: 54; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2017;54(2):99-104
Depresyon Hastalarında Aleksitimi ve Bedenselleştirme: Belirtileri Bedensel Nedenlere Bağlama Biçiminin Rolü
O Taycan, A Özdemir, SE Taycan
Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Bu çalışmada, depresyon hastalarında aleksitimi ile başta bedenselleştirme olmak üzere çeşitli faktörler arasındaki ilişkinin incelenmesi ve aleksitiminin yordayıcılarının saptanması amaçlanmıştır. Yöntem: Major depresif bozukluk tanısı konan 90 hastaya Toronto Aleksitimi Ölçeği (TAÖ), Beck Depresyon Ölçeği, Belirti Tarama Listesi–90, Bedensel Duyumları Büyütme Ölçeği ve Belirti Yorumlama Ölçeği uygulanmıştır. Hastalar TAÖ kesme puanına göre (≥59= aleksitimik) aleksitimik olan ve olmayan şeklinde iki gruba ayrılarak karşılaştırılmıştır. Aleksitiminin yordayıcıları ise çoklu doğrusal regresyon analizi ile test edilmiştir. Bulgular: Hastaların 36’sı (%40) aleksitimik grupta yer aldı. Aleksitimik grupta kadınların oranının, depresyon seviyesinin, genel psikopatoloji ve psikolojik zorlanma düzeyinin, bedensel belirti bildiriminin, bedensel duyumları büyütme eğiliminin, bedensel belirtileri gerek bedene ait, gerek ruhsal, gerekse normal nedenlere bağlama eğilimlerinin, aleksitimik olmayan gruba oranla anlamlı olarak daha yüksek olduğu tespit edildi. Ayrıca yaşın, depresyon seviyesinin, bedensel belirti düzeyinin ve bedensel belirtileri bedene ait nedenlere bağlama eğiliminin aleksitiminin yordayıcıları olduğu saptandı. Sonuç: Bulgularımız depresyon hastalarında aleksitimi ile bedenselleştirme arasında yakın bir ilişkinin varlığına işaret etmektedir. Depresif hastalarda aleksitimi ve bedenselleştirmeye olan eğilimin altta yatan depresif tabloyu maskeleyebileceği ihtimali göz önüne alınarak klinik açıdan dikkatli değerlendirilmesi önerilmektedir.
Alexithymia and Somatization in Depressed Patients: The Role of the Type of Somatic Symptom Attribution
Introduction: This study aimed to establish the association between alexithymia and various factors, mainly somatization, and to determine the predictors of alexithymia in depressed patients. Methods: A total of 90 patients with major depressive disorder who met The Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (DSM-IV) diagnostic criteria were administered the Toronto Alexithymia Scale (TAS), Beck Depression Inventory, Symptom Checklist-90 (SCL-90), Somatosensory Amplification Scale, and Symptom Interpretation Questionnaire. The patients were classified into two groups as alexithymic and non-alexithymic with respect to the TAS cut-off points (=59=alexithymic). Predictors of alexithymia were tested by multiple linear regression analysis. Results: Of all patients, 36 (40%) were in the alexithymic group. The percentage of women, depression severity, level of general psychopathology and distress, and somatic symptom reporting (SCL- 90), as well as the tendency to somatosensory amplification and three forms of somatic symptom attributions, were significantly higher in alexithymic patients than in non-alexithymic patients. Furthermore, age, depression severity, somatic symptom reporting, and the tendency to attribute physical symptoms to somatic causes were predictors of alexithymia. Conclusion: The results indicated an intimate association between alexithymia and somatization in depressed patients. Therefore, when evaluating depressed patients with alexithymia, their tendency for somatization should be considered, and alexithymic individuals should be assessed with particular attention, considering that somatization can mask the underlying depressive condition.

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