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Yıl:2010; Cilt: 11; Sayı: 2>> Özet
Anadolu Psikiyatri Dergisi; 2010;11(2):120-126
İrritabl barsak sendromu hastalarında cinsel-fiziksel istismar sıklığı ve majör depresif bozukluk öyküsü tanı ilişkisi
MÇ Eker, E Kasap, H Elbi, S Bor
Ege Üniversitesi Tıp Fakültesi, İzmir
Amaç: İşlevsel bir barsak hastalığı olan irritabl barsak sendromu (İBS) gastroenterologlara en sık başvuru nedenlerindendir. İBS'nin etiyolojisine ilişkin birçok açıklamanın yanı sıra, başta majör depresif bozukluk (MDB) olmak üzere birçok psikiyatrik bozuklukla olan birlikteliğine dikkat çekilmektedir. Cinsel ve fiziksel istismara uğramış olmanın da İBS riskini artırdığı öne sürülmektedir. Yöntem: Bu çalışmada İBS hastaları ile İBS olmayan kontrol olguları arasında cinsel ve fiziksel istismar öyküsü veya MDB öyküsünün sıklığı açısından fark olup olma-dığı araştırılmıştır. Çalışmaya 54 İBS hastası ile 30 kişilik kontrol grubu alınmıştır (Ortalama yaş İBS grubunda 41±11, kontrol grubunda 34±12 yıl; p<0.05). Bulgular: İBS hastalarında (%69, s=37) İBS olmayan kontrol grubu-na (%30, s=9) göre daha sık MDB öyküsü (p=0.001) saptanmış olmakla birlikte; cinsel istismar (İBS grubun-da %20, s=11; kontrol grubunda %13, s=4; p>0.05) veya fiziksel istismar (İBS grubunda %19, s=10; kontrol grubun-da %13, s=4); p>0.05) öyküsü bakımından iki grup arasında fark saptanmamıştır. Tartışma: İBS�na MDB sıklıkla eşlik etmektedir, bu birliktelik iki bozukluğun etiyopatogenezlerinde ortak noktalar olabileceğini düşündürmektedir. Cinsel ve fiziksel istismar öyküsünün ise bu birlikteliğe katkısı tartışmalıdır. Çalışmamızda cinsel ve fiziksel istis-mara uğrama öyküsünün İBS hastalarında daha sık saptanmamış olması, istismarın İBS gelişiminde bizim hasta larımız için birincil önem taşımadığını düşündürmüştür.
The frequency of sexual-physical abuse history in irritabl bowel syndrome patients and diagnostic relation with major depressive disorder history
Objective: IBS is a functional disorder which is one of the most common causes of gastroentrology doctor visits. Besides multiple factors suggested for the etiology of IBS, the co-morbidity of psychiatric illnesses, of which MDD is most the frequent, is also noted. Being exposed to sexual or physical abuse is also considered as a risk factor for the development of IBS. Methods: In this study the differences between IBS patients and non-IBS control cases are evaluated regarding the history of major depressive disorder and sexual or physical abuse. Fiftyfour IBS and thirty control cases (mean age for IBS patients 41±11; for control group 34±12 [year]s; p<0.05) were recruited for the study. Results: IBS patients had a history of MDD more frequently than the control cases (69% for the IBS group, n=37; 30% for the control group, n=9; p<0.001]. However, two groups did not differ regarding the history of sexual abuse (20% for the IBS group, n=11; (13% for the control group, n=4; p>0.05) or physical abuse (19% for the IBS group, n=10; 13% for the control group, n=4; p>0.05). Discussion: IBS and MDD are frequently co-morbid and this co-morbidity suggests a possible common point for the etiopathogenesis for both disorders. Nevertheless, the contribution of sexual or physical abuse to the co-morbidity of these disorders seems to be inconclusive. It can be suggested that sexual and physical abuse history do not have fundemental importance for the development of IBS in our patients.

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