Dergi Ara >>
Yıl:2009; Cilt: 2; Sayı: 4>> Özet
TAM METİN
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2009;2(4):1-5
Cinselliği Konuşmak ve Cinsel Öykü
EA Yıldırım
Bakırköy Ruh ve Sinir Hastalıkları Hastanesi
Cinsellik, doğası gereği yaşamın zor ifade edilen ve paylaşılan bir alanıdır. Bu zorluk tıbbi başvurularda da yaşanmakta ve ciddi sorunlara yol açmaktadır. Cinselliğin konuşulmasındaki zorluk yalnızca başvurana değil aynı zamanda klinisyen için de bir sorundur. Cinselliğin sorgulanmaması ile mevcut sorunlar sürgitleşmekte ve tedavisi güçleşmektedir. Konuşma becerisini klinisyenin cinsellik ile ilgili kaygıları, kendi cinselliğini ifade edebilme becerisi, anksiyetesi, bu konuda eğitimli olması gibi bir çok faktör belirlemektedir. Cinsel öykü genel psikiyatrik değerlendirmeye benzemekle birlikte bazı özel başlıklar içerir. Çift başvurularında yaklaşım ve izlenecek adımlar ile ilgili klinisyenin eğitim almış olması gerekir. Özelikle görüşme ortamının koşulları, çift ilişkisinin dinamikleri, hasta sırrı ve diğer etik kurallar çift başvurularında önemli ve zorluk yaşanabilecek alanlardır. Cinsel öyküde ana başlıklar başvuru yakınması, yakınmanın öyküsü, cinsel gelişim öyküsü, cinsel durum değerlendirmesi, psikiyatrik değerlendirme, organik etiyoloji sorgulanması, travma ve partner ilişkisinin sorgulanması ve durum değerlendirmesi şeklindedir. Çift başvurularında başvuru yakınması, yakınma öyküsü ve durum değerlendirmesi dışındaki alanlar bireysel sorgulanır.
Talking About Sex and Sexual History
By definition, sexuality is a part of life which is difficult to express and share.This is the case in seeking medical help and might lead to serious problems. Difficulty in talking about sex is a problem not only for applicant but also for clinician. Current problems could become chronic and hard to treat if they remain unquestioned. Ability to talk is affected by multiple factors including clinician's concerns on sexuality, his/her ability to express his/her sexuality, anxiety level and adequate training. Sexual history is somewhat similar to psychiatric evaluation, yet contains several special issues. Clinician should be trained in specific approach and steps to be followed in couple interviews. Challenging and important areas for couple applicants include conditions of interview room, dynamics of couple relationship, patient confidentiality and other ethical issues. Main topics of sexual history are as follows: complaint at presentation, history of the complaint, sexual development history, assessment of sexual status, psychiatric evaluation, questioning organic etiology, questioning trauma history and partner relationships and assessment of current status. All topics except complaint at presentation, history of the complaint and assessment of current status are interviewed individually.

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