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Yıl:2005; Cilt: 16; Sayı: 4>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2005;16(4):276-283
Duygudurum Bozuklukları İle Huy, Karakter ve Kişilik İlişkisi
A Sayın, S Aslan
Gazi Ü Tıp Fak, Psikiyatri AD, Ankara
Huy (tem­pe­ra­ment), ka­rak­ter ve ki­şi­lik kav­ram­la­rı ço­ğu za­man yan­lış ola­rak eş an­lam­da kul­la­nıl­mak­la bir­lik­te fark­lı an­lam­lar ta­şı­mak­ta­dır. Hi­pok­rat’ın dört sıvı ku­ra­mın­dan be­ri ba­zı huy­la­rın ve ki­şi­lik özel­lik­le­ri­nin psi­ki­yat­rik bo­zuk­luk­la­ra yat­kın­lık ya­rat­tı­ğı dü­şü­nül­müş­tür. Kra­epe­lin, Schne­ider ve Kretsch­mer be­lir­gin psi­ki­yat­rik bo­zuk­luk­la­rın mi­nör çe­şit­le­ri ola­rak ta­nım­la­dık­la­rı huy özel­lik­le­ri­nin bir yel­pa­ze üze­rin­de yer al­dı­ğı­nı söy­le­yen ilk ya­zar­lar­dır. Akis­kal’ın “si­lik iki­uç­lu­luk” ve “duy­gu­la­nım­sal huy­lar” (af­fec­ti­ve tem­pe­ra­ments) kav­ram­la­rı, ta­nım­la­yı­cı psi­ki­yat­ri­de önem­li bir ge­liş­me­dir. Bu­nun ya­nı sı­ra, Clo­nin­ger’in hu­yun bi­yo­lo­jik ve ge­ne­tik yö­nü­nü vurgulayarak ge­liş­tir­di­ği dört bo­yu­tu huy ve üç bo­yu­tu ka­rak­te­ri ta­nım­la­yan psi­ko­bi­yo­lo­jik yak­la­şı­mı, ki­şi­li­ği huy ve ka­rak­te­rin bi­le­şi­mi ola­rak ta­nım­la­mak­ta­dır. Ki­şi­lik bo­zuk­luk­la­rı ve duy­gu­du­rum bo­zuk­luk­la­rı ara­sın­da­ki iliş­ki üze­ri­ne fark­lı var­sa­yım­lar öne sü­rül­müş­tür an­cak he­nüz hiç bi­ri tek ba­şı­na ye­ter­li açık­la­ma­yı sağ­la­ya­ma­mak­ta­dır. DSM-III ile çok ek­sen­li sı­nıf­la­ma ge­ti­ri­le­rek, ki­şi­lik bo­zuk­luk­la­rı, Ek­sen II bo­zuk­luk­lar al­tın­da in­ce­len­miş­tir. Bu ya­zı­da, duy­gu­du­rum bo­zuk­luk­la­rı­na ge­ti­ri­len sı­nıf­lan­dır­ma­cı ve bo­yut­sal yak­la­şım­lar in­ce­len­mek­te, eş­lik eden huy, ka­rak­ter ve ki­şi­lik bo­zuk­luk­la­rı tar­tı­şıl­mak­ta­dır. Bu amaç­la aşa­ğı­da­ki anah­tar söz­cük­ler kul­la­nı­la­rak, 1980-2004 yıl­la­rı ara­sın­da ya­pı­lan ya­yın­lar med­li­ne (Pub/med) ile ta­ran­mış­tır. Ula­şı­lan kay­nak­lar ışı­ğın­da huy, ki­şi­lik ve ka­rak­ter özel­lik­le­ri­nin duy­gu­du­rum bo­zuk­luk­la­rıy­la bir­lik­te­li­ği­nin kli­nik öne­mi tar­tı­şıl­mak­ta­dır
The Relationship Between Mood Disorders and Temperament, Character and Personality
The terms temperament, character and personality have been used almost synonymously despite their different meanings. Hippocratic physicians conceptualized illness, including melancholia, in dimensional terms as an out-growth of premorbid characteristics. In modern times, full-scale application of this dimensional concept to psychiatric disorders led Kraepelin, Schneider and Kretschmer to hypothesize that the ‘endogenous psychoses are nothing other than marked accentuation of normal types of temperament’. Akiskal’s ‘soft-bipolarity’ and ‘affective temperaments’ concepts and Cloninger’s psychobiological model of temperament and character, which includes four temperament and three character dimensions, are examples of this dimensional approach from the last two decades. Hypotheses concerning the relationship between personality disorders and mood disorders have been described, but it is likely that a single unitary model would not adequately capture the complexity inherent in the relationship between mood and personality disorders. The DSM multiaxial approach to diagnosis encourages the clinician to distinguish state (Axis I) from trait (Axis II) features of mental disorders. Categorical systems like DSM have been criticised because of their inability to mention temperament, character and personality features. In this review, examples of dimensional approaches to mood disorders are given and discussed under the influence of temperament, character and personality disorders. For this purpose, literature from 1980 to 2004 has been reviewed through Pub/med, using the following key words.

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