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Yıl:2003; Cilt: 13; Sayı: 4>> Özet
TAM METİN
Klinik Psikofarmakoloji Bülteni; 2003;13(4):191-196
Hafirgan: kültüre bağlı bir sendrom mu, yoksa anksiyetenin kültüre özgü bedensel ifadesi mi?
M Yanık
Harran Ü. Tıp Fak. Psikiyatri ABD, Şanlıurfa
Psikiyatrik hastalıkların ve tanı sistemlerinin kültür ile ilişkili olduğu yaygın kabul görmektedir. DSM-IV’de 25 farklı kültüre özgü sendrom tanımlanmıştır. Şanlıurfa’da hastalar halkın “hafirgan” adını verdiği bir klinik tablo ile yerel iyile.tiricilere ya da hekimlere başvurmaktadırlar. Bu yazıda “hafirgan” belirtileri tanımlayan üç olgu sunulmuştur. Ayrıca psikiyatri polikliniğine başvuran 100 hastaya hafirganla ilgili anket uygulanmı.tır. Hafirganın ne demek olduğunu bilme oranı %35, hafirgan ya.adıklarını bildirenlerin oranı %15, yakınlarından birinin hafirgan ya.adığını bildirme oranı %23 bulunmu.tur. Hafirgan ya.adıklarını bildiren 15 hastanın tanımladıkları şikayetlerin incelendiğinde tamamında (n= 15) karında çarpıntı/atma hissi, halsizlik, %33.3 (n=5)’ünde aşırı uyuma isteği, %26.7 (n=4)’sinde iştahsızlık, %20 (n=3)’sinde dizlerin tutmama hissi, %20 (n=3)’sinde sıkıntı hissi, %13,3 (n=2)’ünde kalp çarpıntısı, %6.7 (n=1)’sinde nefes almada zorluk belirtileri saptanmıştır. On hasta hafirganın kendilerini korkutan bir ya.am olayından sonra başladığını bildirmiş, sekizi ise hafirganın yerel tedavisini uygulatmıştır. Hafirganın yerel tedavisi; aç iken üç gün üst üste her seferinde üç kez karın ortasına şiddetli bir .ekilde basmak şeklindedir. Hafirgan DSM-IV tanı kategorilerinden biriyle tam olarak izah edilememektedir ve kültüre bağlı psikiyatrik bir tanı olmaya adaydır. Bu yazıda kültüre bağlı bir psikiyatrik sendrom özelliklerine sahip olan ve “hafirgan” olarak bilinen bu klinik tablo tanımlanmaya çalışılmıştır.
Hafirgan: is it a culture bound syndrome or a somatic manifest of anxiety?
It was accepted that psychiatric illnesses and their diagnostic categories have been found to be related to a particular culture. DSM-IV contains symptomatic description of 25 culture bound syndromes. In Sanliurfa, people seeking help for a clinical condition called “hafirgan” from traditional healers or medical doctors. In this paper, three cases with the hafirgan were reported. Additionally, one hundred patients who attended a psychiatric outpatients clinic were administered an inventory about hafirgan. It was found that 35% of the patients knew what the hafirgan is, 15% of them reported that they had experienced hafirgan, and 23% of them reported that their relatives had experienced hafirgan. According to 15 patients who had experienced hafirgan, the most common symptoms are palpitations in abdominal area (15 patients), fatigue (10 patients), hypersomnia (5 patients), loss of appetite (4 patients) feeling of weakness on knee (3 patients), palpitations of heart (2 patients), difficulty in taking breath (1 patient). 10 of 15 patients having hafirgan reported that they had experienced hafirgan after a fearful event. Moreover, 8 of 15 patients received treatment by local traditional healers. In local traditional treatment of hafirgan, patients are pressed strongly on the center of their abdomen when they are hungry for three consecutive days, three times for each trial. Hafirgan can not be fully explained within the diagnostic classification system of DSM-IV and should be regarded as a culture-bound syndrome. In the paper, we define a clinical condition called “hafirgan” which is regarded as having the features of a culture bound psychiatric syndrome

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