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Yıl:2007; Cilt: 8; Sayı: 4>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2007;8(4):248-255
Fizik tedavi ve rehabilitasyon polikliniğine ilk kez başvuran ve fibromiyalji tanısı konan hastalarda depresif bozuklukların görülme sıklığı ve aleksitimi ile ilişkisi
EO Taşkın, C Tıkız, EG Yüksel, A Fırat, Ç Tüzün, Ö Aydemir
Celal Bayar Üniv. Tıp Fak. Psikiyatri ABD, MANİSA
Amaç: Bu çalışmada, fizik tedavi ve rehabilitasyon (FTR) polikliniğine ilk kez başvuran ve fibromiyalji (FM) tanısı konan hastalarda depresif bozuklukların görülme sıklığı ve aleksitimi ile ilişkisinin araştırılması amaçlanmıştır. Yöntem: Çalışmanın örneklemini, FTR polikliniğine ilk kez başvuran, Amerikan Romatoloji Birliği tarafından geliş-tirilen ölçütlere göre FM tanısı konan ve çalışmaya alınma ölçütlerini karşılayan ardışık 50 hasta oluşturmuştur. Hastaların değerlendirilmesinde DSM-IV Eksen I Bozuklukları için Yapılandırılmış Klinik Görüşme (SCID-I) Duygudurum modülü, Hamilton Depresyon Derecelendirme Ölçeği (HAM-D) ve 20 soruluk Toronto Aleksitimi Ölçeği (TAÖ-20) kullanılmıştır. Verilerin istatistiksel değerlendirmesinde kategorik değişkenler için ki-kare, sayısal değişkenler için t testi kullanılmıştır. HAM-D ve TAÖ-20 ölçek puanlarının korelasyonun test edilmesinde Pearson korelasyon testi yapılmıştır. Sonuçlar: Deneklerde majör depresif bozukluk %44, başka türlü adlandırılamayan depresif bozukluk %14 ve distimik bozukluk %10 oranında bulunmuştur. Hastaların hiçbiri depresyon için bir çare arama davranışında bulunmamıştır ve antidepresan ilaç kullanmamaktadır. Herhangi bir depresif bozukluk tanısı konan deneklerin TAÖ-20 puanları daha yüksektir (p=0.022). Aleksitimik deneklerin HAM-D puan ortalaması daha yüksektir (p=0.035) ve TAÖ-20 puanları ile HAM-D puanları arasında pozitif bir korelasyon saptanmıştır (p= 0.014). Tartışma: FM hastalarında depresyon önemli oranda tabloya eşlik etmektedir. Aleksitimi puanları yüksek olan hastalarda depresyon yaygınlığı daha fazladır. FM’li hastalar depresyonlarını yaşayamayan ve depresyon sağaltımı açısından çare aramayan kişiler olarak değerlendirilebilir. Bu nedenle, FM hastalarının sağaltım sürecinde depresyon tanısının ayrıca değerlendirilmesi gereklidir.
Prevalence of depressive disorders among patients with fibromyalgia seeking help for the first time
Objective: In this study, it was aimed to determine the prevalence of depression and its relationship with alexi-thymia among patients with fibromyalgia who apply to the Physical Therapy and Rehabilitation outpatient clinic for the first time. Methods: The research included 50 patients who applied to the Physical Therapy and Rehabilitation outpatient clinic for the first time and diagnosed as FM according to the American College of Rheumatology Scale. The subjects were evaluated with the SCID-I affective disorders module, 20-item Toronto Alexithymia Scale (TAS-20), 17-item Hamilton Depression Scale (HAM-D) and a demographic data form. Data were analyzed using t-test for continuous numerical parameters and chi-square test for categorized parameters. Pearson correlation test was used for determination of correlation between HAM-D and TAS-20 scores. Results: The prevalence of major depressive episode, depressive disorder NOS and dysthymia were found to be 44%, 10% and 14% respectively. None of the patients were seeking help for their depressive disorder and were using antidepressant treatment. TAS-20 scores of the patients with depression were higher (p=0.022) than scores of the non-depressive patients. Alexithymic patients had higher HAM-D mean values (p=0.035) and there was a positive correlation between TAS-20 and HAM-D scores (p=0.014). Conclusion: In fibromyalgia, the prevalence rate of depression is found to be significant. The prevalence rate of depression was even higher in alexithymic patients. Patients with fibromyalgia seem to have difficulty in experiencing their depression, and thus they do not seek psychiatric help. Therefore, these patients must be evaluated additionally for depression during the management of fibromyalgia.

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