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Yıl:1999; Cilt: 36; Sayı: 1>> Özet
Nöropsikiyatri Arşivi; 1999;36(1):27-32
Fibromiyalji hastalarında umutsuzluk ve depresyon
K Sayar, B Acar, T Aydın
Vakıf Gureba Eğitim Hastanesi Psikiyatri Kliniği
Gerekçe: Fibronıiyaljide psikolojik etkenlerin rolü tar­tışılmaktadır. Etiyolojisi henüz tam olarak aydınlatıl­mayan fibromiyaljide artmış depresyon yaygınlığını gösteren araştırmaların yanı sıra diğer romatolojik du­rumlarla depresyon açısından fark bildirmeyen çalış­malar da vardır. Psikolojik etkenlerin hastalık etiyoloji-sinde oynadığı rol sık tartışılsa da fibromiyalji hastala­rında umutsuzluğun araştırıldığı yalnızca bir çalışma vardır. Umutsuzluk ve depresyon düzeylerinin birlikte değerlendirilmesi fibromiyalji hastalığında psikolojik etkenlerin oynadığı rolü daha iyi aydınlatabilir. Yöntem: Vakıf Gureba Eğitim Hastanesi Fizik Tedavi ve Rehabilitasyon polikliniğinde fibromiyalji tanısı kon­muş 31 hasta ve 20 sağlıklı kontrol çalışmaya alınmış­tır. Fibromiyalji tanılan Yunus ölçütlerine göre kon­muş, denekler sosyodemograflk bilgi formu, Hamilton depresyon ölçeği ve Beck umutsuzluk ölçeğiyle değer­lendirilmişlerdir.
Bulgular: Fibromiyalji hastalarında depresyon ve umutsuzluk düzeyi kontrollere göre anlamlı ölçüde yüksek bulunmuştur. Umutsuzluk puanlanyla depres­yon puanları arasında bağıntı vardır. Yaş ve hastalık süresiyle her iki psikometrik ölçüm arasında bir ba­ğıntı bulunmamıştır.
Değerlendirme: Bu bulgular fibromiyalji hastalarının geleceğe yönelik olumsuz beklentilerinin yaygın oldu­ğunu göstermektedir. Umutsuzluk depresyonun hem bir nedeni hem de bir sonucu olarak değerlendirilebi­lir. Olumsuz bilişsel şemalar, depresyon gelişiminde rol oynadıkları gibi, depresif bozuklukla yaygın biçimde bir arada görülen ve kimi semptomları örtüşen fibro­miyalji sendromunun etiyopatogenezinde de önemli olabilirler.
Hopelessness And Depression In Fibromyalgia Patients
Objective: The role of psychological factors in fibrom­yalgia is controversial. The etiology of fibromyalgia is not completely understood but there are data repor­ting increased prevalance of depression in fibromyal­gia patients. There are also some studies indicating no difference in terms of depression prevalence between fibromyalgia patients and patients suffering from ot­her rheumatological conditions. There is only one study searching for the degree of hopelessness in fib­romyalgia patients. Assessing hopelessness together with depression may highlight the role of psychologi­cal factors in the genesis of fibromyalgia. Method: 31 fibromyalgia patients, diagnosed accor­ding to Yunus criteria in Physical Therapy and rehabi-litation outpatient clinic of Vakif Greba Training Hos­pital and 20 healthy controls were included in the study. Subjects were assessed with sociodemographic information form, Hamilton rating scale for Depressi­on and Beck hopelessness Scale.
Results: Depression and hopelessness levels of fibrom­yalgia patients were higher than controls and the diffe­rence was statistically significant. There was a correla­tion between hopelessness and depression scores. No correlation was found between psychometric measures and age and also with the duration of the illness. Discussion: These findings suggest that negative ex­pectations of future are prevalent in fibromyalgia pati­ents. Hopelessness may both be a cause and a result of depression. Negative cognitive schemas which are operant in the pathogenesis of depression may also be important for the pathogenesis of fibromyalgia syndro­me, which displays frequent comorbiditiy and overlap­ping symptomatology with major depression.

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