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Yıl:2011; Cilt: 48; Sayı: 1>> Özet
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Nöropsikiyatri Arşivi; 2011;48(1):31-38
Fibromiyalji Sendromlu Kadınların Depresyon ve Mizaç Karakter Özellikleri Açısından Değerlendirilmesi
Ö Altunören, FÖ Orhan, V Nacitarhan, A Özer, MF Karaaslan, O Altunören
Kahramanmaraş Devlet Hastanesi, Psikiyatri Kliniği, Kahramanmaraş
maç: Fibromiyalji Sendromu (FMS); yaygın vücut ağrılarıyla seyreden, psikosomatik hastalık olarak da değerlendirilen kas-iskelet sistemi hastalığıdır ve en sık depresyon olmak üzere çeşitli ruhsal bozukluklara eşlik ettiği bilinmektedir. Psikosomatik hastalıkların etiyolojisinde kişiliğin de önemli rol oynadığı düşünülmektedir. Bu çalışmada FMS hastaları ile sağlıklı kontrol grubunun, mizaç karakter özelliklerinin incelenmesi ve elde edilen verilerin hastaların klinik özelllikleri ve depresif durumu ile ilişkili olup olmadığı araştırıldı. Yöntemler: Çalışmamıza 51 FMS hastası, 51 sağlıklı kadın alındı. FMS'lu hastalar ve sağlıklı kontroller DSM-IV TR (Mental Bozuklukların Tanısal ve Sayımsal Elkitabı) tanı ve değerlendirme sistemine göre psikiyatrik yönden değerlendirildi. Mizaç ve Karakter Envanteri (Temperament and Character Inventory-TCI), Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Fibromiyalji Etkilenme Anketi (FEA), Görsel Ağrı Skala (GAS) uygulandı. Bulgular: FMS hastalarının %76.5'i DSM-IV TR'ye göre psikiyatrik tanı aldı. FMS'lu hastalarda, sağlıklı kontroller ile karşılaştırıldığında yüksek zarardan kaçınma (HA), düşük kendini yönetme (S), düşük sebat etme (P) puanları bulundu. Düzeltilmiş TCI puanları kullanıldığında (HAM-D puanlarının etkisi ortadan kaldırıldıktan sonra) hastalarda kontrol grubuna göre benzer şekilde yüksek zarardan kaçınma, düşük kendini yönetme puanları ile işbirliği yapma (C) puanında artış bulundu. HAM-D puanları ile zarardan kaçınma skorları arasında pozitif korelasyon saptanırken, HAM-D puanları ile kendini yönetme ve işbirliği yapma puanları arasında negatif korelasyon saptandı. Sonuç: Fibromiyalji sendromunun süresi ve şiddetinin depresif belirtiler ve kişilik özellikleriyle ilişkisi olduğundan, FMS hastalarının takibi ve tedavisi planlanırken bu hastaların, kişilik özellikleri ve depresif durumlarının da ayrıca değerlendirilmesi gerekmektedir.
Evaluation of Depression, Temperament and Character Profiles in Female Patients with Fibromyalgia Syndrome
Objective: Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by diffuse body pain and is also regarded as a psychosomatic disorder. FMS is most commonly associated with depression among the psychological disorders. It is known that personality plays an important role in the etiology of psychosomatic disorders. In this study, we analyzed the temperament characteristics of FMS patients and healthy control group and, using data obtained from both groups, investigated whether these traits were associated with clinical features and depressive states in FMS patients. Methods: Fifty-one FMS patients and 51 healthy women were included in the study. Both groups were evaluated according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (text revision) (DSM-IV-TR). The Temperament and Character Inventory (TCI), the Hamilton Depression Rating Scale (HAM-D), the Fibromyalgia Impact Questionnaire (FIQ), and the Visual Analogue Scale (VAS) were applied to both groups. Results: According to DSM-IV-TR, 76.5% of FMS patients were diagnosed with psychiatric disorder. FMS patients had higher harm avoidance scores and lower self-directedness and persistence scores than healthy controls. Harm avoidance scores were found higher and self-directedness scores were found lower when the total corrected increment (TCI) points were used, but cooperation scores increased. HAM-D scores correlated positively with harm avoidance scores, but negatively with both self-directedness and cooperation scores. Conclusion: Depressive symptoms and personality features are related to the duration and severity of FMS, and therefore, should be further evaluated by physicians when planning the treatment and follow-up in FMS patients.

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