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Yıl:2020; Cilt: 31; Sayı: 4>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2020;31(4):252-258
Aleksitimi, Ruminasyon ve Stresle Başa Çıkmanın Psöriyazis ile İlişkisi ve Psöriyazis Kliniğine Etkisi
S Baysak, FA Kılıç, E Karagün, E Baysak
İstanbul Sultan 2. Abdülhamid Han Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Psöriyazis hastalığında, psöriyatik plaklarda artış ile stres arasında ilişki olduğu gösterilmiştir. Psöriyazis, ayrıca yüksek aleksitimi düzeyleri ve stres ile de ilişkilidir. Depresyon ve çeşitli psikiyatrik hastalıklarda, ruminasyon ile hem hastalığın başlaması hem de süreğenleşmesi arasında ilişki olduğu bildirilmiştir. Bu çalışmada stresle ilişkili diğer bir faktör olan ruminasyon incelenmiştir. Yöntem: 96 psöriyazis hastası ve 93 sağlıklı kontrol çalışmaya alınmıştır. Katılımcıların tamamına Sosyodemografik Veri Formu, Toronto Aleksitimi Ölçeği, Stresle Başa Çıkma Tarzları Ölçeği, Ruminatif Düşünme Biçimi Ölçeği ve Hastane Anksiyete Depresyon Ölçeği uygulanmıştır. Hasta grubunda, psöriyatik plaklarda son 1 ayda artış olup olmadığı klinisyen tarafından kayıt altına alınmıştır. Bulgular: Hem hasta hem de kontrol grubunda ruminasyon puanları ile aleksitimi puanları (hasta grubu, r=0,47; p<0,01; kontrol grubu, r=0,38; p<0,01) ve çaresiz stresle başa çıkma tarzı puanları (hasta grubu, r=0,56; p<0,01; kontrol grubu, r=0,57; p<0,01) arasında anlamlı ilişki saptanmıştır. Depresyon ve anksiyete puanları kontrol edildiğinde hasta grubunda, ruminasyon puanları ile duyguları tanıma güçlüğü puanları (r=0,42; p<0,01), duyguları ifade güçlüğü puanları (r=0,25; p<0,05) ve çaresiz stresle başa çıkma becerileri puanları (r=0,41; p<0,01) arasında pozitif yönde anlamlı ilişki olduğu görülmüştür. Depresyon ve anksiyete puanları kontrol edildiğinde kontrol grubunda ise ruminasyon düzeyi ile duyguları tanıma güçlüğü puanları (r=0,27; p<0,05) ve çaresiz stresle başa çıkma becerileri puanları (r=0,42; p<0,01) arasında pozitif yönde anlamlı ilişki olduğu görülmüştür. Psöriyatik plaklarda son 1 ayda artış olan ve olmayan hastalar karşılaştırıldığında, ruminasyon puanları (p<0,01), duyguları ifade etmede güçlük puanları (p<0,05) ve toplam aleksitimi puanları (p<0,05) arasında anlamlı fark olduğu saptanmıştır. Sonuç: Psöriyaziste aleksitimi ve pasif stresle başa çıkma tarzlarının ruminasyon ile ilişkisi hastalık seyrini etkiliyor olabilir.
Relationship of Alexithymia, Rumination and Coping Style with Psoriasis and Their Effects on The Clinical Features
Objective: A relationship has been demonstrated between stress and the increase in the skin plaques in psoriasis. In addition, psoriasis is observed in cases of severe alexithymia and stress. In depression and various psychiatric disorders, there is a relationship between rumination and both the onset and persistence of the disease. The role of rumination, being a stress related factor, was investigated in this study. Method: The study included 91 patients with psoriasis and 93 healthy controls. All participants were evaluated with the Toronto Alexithymia Scale, Coping Style Scale, the Ruminative Thought Style Questionnaire and the Hospital Anxiety and Depression Scale. Any increase in the plaque formation after the duration of 1 month was recorded by the clinician. Results: In both the patient and the control groups, rumination scores were significantly correlated with the alexithymia severity scores (psoriasis group r=0.46, p<0.01; control group r=0.38, p<0.01) and the helpless coping styles scores (psoriasis group r=0.56, p<0.01; healthy r=0.57, p<0.01). When depression and anxiety scores were controlled, significant positive correlations were observed in the patient group between rumination scores and the scores on the difficulty of identifying feelings (r=0.42, p<0.01), the difficulty of describing feelings (r=0.25, p<0.05) and the scores on helpless coping styles (r=0.41, p<0.01); and also significant positive correlations were observed in the control group between the rumination scores and the scores on the difficulty of identifying feelings (r=0.27, p<0.05) and on helpless coping styles (r=0.42, p<0.01). Comparing the patients with and without increase in the plaques showed significant differences in the scores on rumination (p<0.01), difficulty of describing feelings (p <0.05) and total alexithymia scores (p<0.05). Conclusion: The relationship of alexithymia and of passive stress coping styles with rumination may have an effect on the course of psoriasis.

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