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Yıl:2000; Cilt: 7; Sayı: 1>> Özet
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2000;7(1):17-24
İlaçla Özkıyım Girişiminde Bulunan Ergenlerde Belirleyici Olarak Aleksitimi, Umutsuzluk ve Depresyon: Karşılaştırmalı Bir Çalışma
K Sayar, M Öztürk, B Acar
Vakıf Gureba Eğitim Hastanesi, Psikiyatrisi Bölümü, İstanbul.\r\n\r\n
Amaç: Özkıyım davranışı ergenler için en önemli hastaneye yatış nedenleri arasında sayılmaktadır. Özkıyım davranışını belirleyen etkenler arasında, umutsuzluk ve depresyon şiddeti ayrı bir önem taşımaktadır. Son yıllarda duyguları tanıma ve söze dökme zorluğu olarak tanımlanan aleksitimi de özkıyım davranışında araştırılmaktadır. Bu çalışmada, sağlıklı bir kontrol grubu kullanarak; aleksitimi, umutsuzluk ve depresyonunun ergenlerde özkıyım davranışını ne ölçüde belirlediği araştırıldı.

Yöntem: Özkıyım girişimi nedeniyle hastane acil servisine getirilen 33 ergen ve onlarla demografik açıdan eşleştirilmiş 33 sağlıklı ergen çalışmaya alınmıştır. Denekler demografik veri formunun yanısıra Zung Depresyon Ölçeği, Beck Umutsuzluk Ölçeği ve Toronto Aleksitimi Ölçeği ile değerlendirilmişlerdir. Özkıyım girişiminde bulunan gruba ayrıca Özkıyım Niyet Ölçeği ve Özkıyımın Ölümcüllüğü Ölçeği de uygulanmıştır. İki grup arasında psikometrik ölçümler açısından karşılaşma yapılmış özkıyım girişimi grubunda ise özkıyım girişiminin ve ölümcüllüğünün diğer değişkenlerle ilişkisi araştırılmıştır.

Sonuçlar: Özkıyım girişiminde bulunan ergenlerin çoğunluğu (%85) kızdır ve tümü aşırı dozda ilaç alımıyla girişimde bulunmuşlardır. Özkıyım davranışı gösteren ergenler kontrol grubuna göre anlamlı ölçüde yüksek umutsuzluk ve özkıyım düşüncesi puanları almışlardır. Çalışma grubunu oluşturan deneklerin depresyon puanları kontrol grubuna göre daha yüksek ve aradaki fark anlamlılığa yakındır. Aleksitimi açısından iki grup açısından anlamlı fark bulunmamıştır. Özkıyımın ölümcüllüğü diğer psikometrik değişkenlerden bağımsız bulunmuştur. Özkıyım niyetini belirleyen en önemli değişkenin özkıyım düşüncesi olduğu saptanmıştır.

Tartışma: Umutsuzluk ergenlerde özkıyım davranışına zemin hazırlayabilir. Özkıyım niyetini belirleyen en önemli etkenin, depresyon ölçeğinin özkıyım düşüncesini ölçen madde olduğu düşünülürse, ergen kişilerde özkıyım düşüncesinin sorgulanmasının önemi anlaşılmaktadır. Özkıyım düşüncesinin ölümcüllüğünün ise daha çok rastlantısal olduğu görülmektedir.
Alexithymia, Hopelessness and Depression in Adolescents Who Attempt Suicide by Drug Overingestion: A Controlled Study
Objective: Suicidal behavior is one of the most important reasons for hospitalization in adolescents. Hoplessness and severity of depression emerge as the most important predictors of suicidal behavior both in adult and adolescent poupulations. Method: Thirty-three adolescents who have attempted suicide and 33 demographically matched healthy controls were recruited in the study. Subjects were assessed with demographic data form. Zung Scale for Depression, Beck Hopelessness Scale and Toronto Alexithymia Scale. Suicide attempter group was also assessed bu Suicide Intent Scale and Suicide Lethality Scale. Both groups were compared on the grounds of psychometrics measures, whereas the correlation of suicide intent and lethality was investigated in the suicide attempters group. Results: Suicide attempters were predominantly girls (85%) and all of them attempted suicide by overingestion of drugs. Adolescents with suicidal behavior scored significantly higher on the measures of depression and the difference was close to significance. No siginificant difference was found between the two groups on the measure of alexithymia. Lethality of the suicide attempt was found to be independent of other psychological variables. The strongest predictor of suicidal intent in adolescents was found to be suicidal ideation. Discussion: Hopelessness may pave the way for suicidal behavior in adolescents. Suicidal ideation as measured by depression scale emerges as the strongest predictor of intent, which is a finding that should promote careful screening of suicidal thoughts in adolescent patients. The lethality of the suicide attempt seems rather to be matter of chance.

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