Dergi Ara >>
Yıl:2005; Cilt: 6; Sayı: 2>> Özet
Anadolu Psikiyatri Dergisi; 2005;6(2):69-74
Fibromyalji hastalarında ağrı şiddeti ile psikiyatrik belirtiler arasındaki ilişki
B Evren, C Evren, A Yapıcı, MH Güler
Amaç: Bu çalışmanın amacı ayaktan tedavi gören kadın fibromyalji hastalarında ağrı şiddeti ile psikiyatrik belirtiler,
depresyon ve anksiyete belirtilerinin şiddeti arasındaki ilişkiyi saptamaktır. Yöntem: Çalışma Ekim 2003 ve Mart 2004
tarihleri arasında Baltalimanı Kemik Hastalıkları Eğitim ve Araştırma Hastanesi’nde yapılmıştır. American College of
Rheumatology tarafından önerilen operasyonel ölçütlere göre fibromyalji tanısı konmuş 51 kadın hasta çalışmaya
alınmıştır. Sosyodemografik form dışında hastalara SCL–90, Beck Depresyon Envanteri (BDE), Beck Anksiyete Envanteri
(BAE), Hamilton Anksiyete Ölçeği (HAÖ) ve Hamilton Depresyon Ölçeği (Ham-D) uygulanmıştır. Ağrı şiddeti Görsel Analog
Skala (GAS) ve Sözel Değerlendirme Skalası (SDS) ile değerlendirilmiştir. Bulgular: GAS, SCL–90 ile değerlendirilen
somatik, anksiyete ve fobi belirtileri ve genel belirti indeksi ile korelasyon gösterirken, SDS salt anksiyete belirtileri ile
korelasyon göstermiştir. Hem GAS hem de SDS, BAE ile doğrusal korelasyon göstermiş, SDS ise BDE ile de korelasyon
göstermiştir. GAS ve SDS ile Ham-D arasında korelasyon saptanmazken, her iki ölçek ile HAÖ arasında doğrusal
korelasyon saptanmıştır. HAÖ somatik ve psişik alt ölçekleri değerlendirildiğinde, GAS her iki alt ölçekle korelasyon
göstermiş, SDS ise sadece psişik alt ölçeği ile doğrusal korelasyon göstermiştir. GAS’ın sabit değişken olarak alındığı
doğrusal regresyon analizinde BAE belirleyici olarak saptanırken, SDS’nın sabit değişken olarak alındığı doğrusal
regresyon analizinde HAÖ’nn psişik alt ölçeği belirleyici olarak bulunmuştur. Sonuç: GAS daha çok somatik belirtiler ve
anksiyete ile ilişkili olarak görünürken, SDS psişik anksiyete ile ilişkili gibi görünmektedir. Ayrıca sonuçlar aralarındaki
nedensel ilişki nasıl olursa olsun fibromyaljili hastalarda depresyondan çok anksiyete şiddetinin ağrı şiddeti ile ilişkili
olduğunu göstermektedir.
Severity of pain and relationship with psychiatric symptoms in patients with fibromyalgia
Objective: Aim of this study was to evaluate the severity of pain and relationship with psychiatric symptoms, alexithymia,
depression and anxiety in female outpatients with fibromyalgia. Methods: The study was conducted between October
2003 and March 2004 in Baltalimani State Hospital for Musculoskeletal Disorders in Istanbul. Fifty one patients with fibromyalgia according to the operational criteria proposed by the American College of Rheumatology were included
in the study. Other than sociodemographic form, for psychiatric symptoms we used SCL-90. Pain was measured by Visual
Analog Scale (VAS) and Verbal Rating Scale (VRS) and the anxiety and depression levels were measured by self-rating
scales the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI), and clinician rating scales the
Hamilton Anxiety Rating Scale (HARS) and the Hamilton Depression Rating Scale (Ham-D). Results: VAS showed positive
correlation with somatic, anxiety and phobia symptoms of SCL-90, whereas VRS only showed positive correlation with
anxiety symptoms. Both VAS and VRS showed positive correlations with BAI and HARS and VRS also showed positive
correlation with BDI. There was no correlation with Ham-D. When considering subscales of HARS, VAS showed positive
correlation with both subscales of HARS and VRS showed positive correlation with only psychic subscale of HARS.
Determinant was BAI score when taking VAS score as a dependent variable in linear regression. VRS score was taken as
a dependent variable in other linear regression and determinant was score of psychic subscale of HARS. Conclusion: VAS
was associated with somatic symptoms and anxiety, while VRS was associated with psychic anxiety. Nevertheless, results
of this study suggest that whatever the causal relationship is anxiety severity rather than depression is related with
severity of pain in patients with FM.

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