Öz
Amaç: Çalışmada Bipolar Bozukluk (BB) tanılı hastalardaki travmatik yaşantı, psikolojik acı ve ilişkili olduğu düşünülen intihar düşüncesi sıklığının tespitiyle, aralarındaki olası ilişkinin incelenmesi ve ön görücülerin saptanması amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya 60 BB tip I tanılı hasta ve 60 sağlıklı kontrol dahil edildi. Sosyodemografik Veri Formu, Travmatik Yaşantılar Ölçeği (TEC), İntihar Düşüncesi İçin Beck Ölçeği (BSIS), Vizuel Analog Skala (VAS), Psikolojik Acı Ölçeği (PS), Beck Depresyon Ölçeği (BDI) ve Young Mania Rating Scale (YMRS) uygulandı.
Bulgular: Hasta grubunun tüm ölçek puanları kontrol grubunun puanlarından anlamlı şekilde yüksek bulunmuştur (p<0,05). PS ile BSIS, TEC birleşik travma puanı, TEC toplam travma puanı, BDI, YMRS, VAS pozitif yönde anlamlı korelasyon görülmüştür (p=0.000). PS puanını duygusal ihmal (β=-4,289, p=0,001), duygusal istismar (β=-3,798, p=0,002), bedensel istismar (β=-4,008, p=0,001), cinsel taciz (β=-4,175, p=0,002), cinsel istismar (β=-2,941, p=0,017), birleşik travma puanı TEC (β=4,063, p=0,001) ve VAS skoru (β=2,094, p<0,001) yordamaktadır. BSIS puanını ise toplam travma puanı TEC (β=0,191, p=0,013) yordamaktadır.
Sonuç: BB hastaları sağlıklı kontrollerden daha fazla travmatik yaşantıya sahiplerdir, remisyon döneminde dahi psikolojik acıyı daha fazla hissetmekte ve intihar düşüncesinin şiddetini daha fazla yaşamaktadır. Travmanın tipi ve ciddiyeti psikolojik acıyı, sayısı intihar düşüncesi şiddetini yordamaktadır. Intihar açısından riskli bir grup olan BB hastalarının zihinsel acı çekme süreçlerinin ve nedenlerinin sorgulanması remisyon döneminde de dikkat edilmesi gereken bir husustur.
Anahtar Kelimeler
bipolar bozukluk psikolojik acı intihar travma travma yaşantıları
Kaynakça
- Dong M, Lu L, Zhang L, Zhang Q, Ungvari GS, Ng CH, et al. Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies. Epidemiol Psychiatr Sci. 2020;29:e63.
- Carballo JJ, Harkavy-Friedman J, Burke AK, Sher L, Baca-Garcia E, Sullivan GM, et al. Family history of suicidal behavior and early traumatic experiences: additive effect on suicidality and course of bipolar illness? J Affect Disord. 2008;109:57–63.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 2013;280.
- Sar V, Taycan O, Bolat N, Ozmen M, Duran A, Ozturk E et al. Childhood trauma and dissociation in schizophrenia. Psychopathology. 2010;43:33-40.
- Aas M, Henry C, Andreassen OA, Bellivier F, Melle I, Etain B. The role of childhood trauma in bipolar disorders. Int J Bipolar Disord. 2016;4:1-10. Agnew-Blais J, Danese A. Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3(4):342–9.
- Ducasse D, Holden RR, Boyer L, Artero S, Calati R, Guillaume S, et al. Psychological pain in suicidality: a meta-analysis. J Clin Psychiatry. 2017; 78(3):16108.
- Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–60.
- Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol. 1979;47(2):343.
- Ozcelik HS,Ozdel K, Bulut SD, Orsel S. The reliability and validity of the Turkish version of the Beck Scale for Suicide Ideation (Turkish BSSI). Bull Clin Psychopharmacol. 2015;25(2):141–50.
- Hisli N. Beck depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi. 1989; 7(23):3-13.
- Holden RR, Mehta K, Cunningham EJ, Mcleod LD. Development and preliminary validation of a scale of psychache. Can J Behav Sci 2001; 33(4):224-32.
- Demirkol ME, Güleç H, Çakmak S, Namli Z, Güleç M, Güçlü N, et al. Psikolojik Acı Ölçeği Türkçe formunun güvenilirliği ve geçerliliği. Anadolu Psikiyatri Dergisi. 2018;19: 14-20.
- Nijenhuis ERS, Van der Hart O, Kruger K. The psychometric characteristics of the Traumatic Experiences Checklist (TEC): First findings among psychiatric outpatients. Clinical psychology and psychotherapy clin. Psychol Psychother. 2002;9:200-10.
- Şar V. Travmatik Yaşantılar Ölçeği (TEC)-Türkçe Versiyonu. 2000. Erişim Tarihi: 15.02.2018 http://www.vedatsar.com/psikiyatrik-olcekler/.
- Karadağ F, Oral ET, Yalçın FA, Erten E. Young Mani Derecelendirme Ölçeğinin Türkiye’de Geçerlik ve Güvenilirliği. Türk Psikiyatri Derg. 2002;13:107-14.
- McKay MT, Cannon M, Chambers D, Conroy RM, Coughlan H, Dodd P, et al. Childhood trauma and adult mental disorder: A systematic review and meta‐analysis of longitudinal cohort studies. Acta Psychiatr Scand. 2021;143(3):189-205.
- Misiak B, Stramecki F, Gawęd, Ł, Prochwicz K, Sąsiadek MM, Moustafa AA, et al. Interactions between variation in candidate genes and environmental factors in the etiology of schizophrenia and bipolar disorder: a systematic review. Mol Neurobiol. 2018;55(6):5075–100.
- Örsel S, Karadağ H, Kahiloğullari AK, Kahiroğulları EK, Aktaş EA. The frequency of childhood trauma and relationship with psychopathology in psychiatric patients. Anadolu Psikiyatri Derg. 2011;12(2):130.
- Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry. 2005;186:121-5.
- Erten E, Uney Kalkay AF, Saatçioğlu O, Ozdemir A, Fıstıkçı N, Çakmak D. Effects of childhood trauma and clinical features on determining quality of life in patients with bipolar I disorder. J Affect Disord. 2014;162:107 13.
- Maslow AH. A theory of human motivation. Psychol Rev. 1943;50(4): 370-96.
- Kim J, Cicchetti D. Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. J Child Psychol Psychiatry. 2010;51(6):706-16.
- Demirkol ME, Güleç H, Tamam L, Öztürk SA, Uğur K, Karaytuğ MO, et al. Reliability and validity of Mee bunney psychological pain assessment scale turkish version. Curr Psychol. 2020;39(4):1181-8.
- Karanovic J, Ivkovic M, Jovanovic V, Svikovic S, Stefanovic M, Brkusanin M, et al. Effect of childhood general traumas on suicide attempt depends on TPH2 and ADARB1 variants in psychiatric patients. J Neural Transm. 2017:124(5):621-9.
- Agnew-Blais J, Danese A. Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3(4):342–9.
- Benarous X, M Raffin, N Bodeau, Dhossche D, Cohen D, Consoli A. Adverse childhood experiences among inpatient youths with severe and early-onset psychiatric disorders: prevalence and clinical correlates. Child Psychiatry Hum Dev. 2017;48(2):248–59.
- Duarte D, Belzeaux R, Etain B, Greenway KT, Rancourt E, Correa H, et al. Childhood-maltreatment subtypes in bipolar patients with suicidal behavior: systematic review and meta-analysis. Braz J Psychiatry. 2020;42:558–67.
- Conejero I, Olié E, Calati R, Ducasse D, Courtet P. Psychological pain, depression, and suicide: recent evidences and future directions. Curr Psychiatry Rep. 2018;20(5):1-9.
- Verrocchio MC, Carrozzino D, Marchetti D, Andreasson K, Fulcheri M, Bech P. Mental pain and suicide: a systematic review of the literature. Front Psychiatry. 2016;7:108.
- Tossani E. The concept of mental pain. Psychother Psychosom. 2013; 82(2):67-73.
Öz
Aim: The present study attempted to explore the traumatic experiences of patients with bipolar disorder (BD), uncover the prevalence frequency of psychological pain and associated suicidal ideation among them, and investigate the relationships between these variables.
Materials and Methods: Sixty BD type I patients and 60 healthy controls were included in the study. We collected the data using The Sociodemographic Information Form, The Traumatic Experience Checklist (TEC), The Beck Scale for Suicidal Ideation (BSSI), The Visual Analogue Scale (VAS), The Psychache Scale (PS), The Beck Depression Inventory (BDI), and The Young Mania Rating Scale (YMRS).
Results: The findings showed that the patient group scored significantly higher on the scales than the control group (p < 0.05). Their PS total score was significantly predicted by the TEC composite scores of emotional neglect (β = -4.289, p = 0.001), emotional abuse (β = -3.798, p = 0.002), physical abuse (β = -4,000, p = 0.001), sexual abuse (β = -4.175, p = 0.002), sexual harassment (β = -2.941, p = 0.017), and trauma (β = 4.063, p = 0.001) score. And the patients’ TEC total score significantly predicted their BSSI score (β = 0.191, p = 0.013).
Conclusion: Overall, compared to the healthy controls, the BD patients had more traumatic experiences, felt greater psychological pain even in the remission period, and experienced more severe suicidal ideation. In addition, while the number of trauma significantly predicted the severity of suicidal ideation, its type and severity significantly predicted psychological pain. Ultimately, the processes and causes of mental suffering among BD patients, a risk group for suicide, should always be under the spotlight even during the remission period.
Anahtar Kelimeler
bipolar disorder psychache psychological pain suicide trauma trauma experiences
Kaynakça
- Dong M, Lu L, Zhang L, Zhang Q, Ungvari GS, Ng CH, et al. Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies. Epidemiol Psychiatr Sci. 2020;29:e63.
- Carballo JJ, Harkavy-Friedman J, Burke AK, Sher L, Baca-Garcia E, Sullivan GM, et al. Family history of suicidal behavior and early traumatic experiences: additive effect on suicidality and course of bipolar illness? J Affect Disord. 2008;109:57–63.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 2013;280.
- Sar V, Taycan O, Bolat N, Ozmen M, Duran A, Ozturk E et al. Childhood trauma and dissociation in schizophrenia. Psychopathology. 2010;43:33-40.
- Aas M, Henry C, Andreassen OA, Bellivier F, Melle I, Etain B. The role of childhood trauma in bipolar disorders. Int J Bipolar Disord. 2016;4:1-10. Agnew-Blais J, Danese A. Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3(4):342–9.
- Ducasse D, Holden RR, Boyer L, Artero S, Calati R, Guillaume S, et al. Psychological pain in suicidality: a meta-analysis. J Clin Psychiatry. 2017; 78(3):16108.
- Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–60.
- Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol. 1979;47(2):343.
- Ozcelik HS,Ozdel K, Bulut SD, Orsel S. The reliability and validity of the Turkish version of the Beck Scale for Suicide Ideation (Turkish BSSI). Bull Clin Psychopharmacol. 2015;25(2):141–50.
- Hisli N. Beck depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi. 1989; 7(23):3-13.
- Holden RR, Mehta K, Cunningham EJ, Mcleod LD. Development and preliminary validation of a scale of psychache. Can J Behav Sci 2001; 33(4):224-32.
- Demirkol ME, Güleç H, Çakmak S, Namli Z, Güleç M, Güçlü N, et al. Psikolojik Acı Ölçeği Türkçe formunun güvenilirliği ve geçerliliği. Anadolu Psikiyatri Dergisi. 2018;19: 14-20.
- Nijenhuis ERS, Van der Hart O, Kruger K. The psychometric characteristics of the Traumatic Experiences Checklist (TEC): First findings among psychiatric outpatients. Clinical psychology and psychotherapy clin. Psychol Psychother. 2002;9:200-10.
- Şar V. Travmatik Yaşantılar Ölçeği (TEC)-Türkçe Versiyonu. 2000. Erişim Tarihi: 15.02.2018 http://www.vedatsar.com/psikiyatrik-olcekler/.
- Karadağ F, Oral ET, Yalçın FA, Erten E. Young Mani Derecelendirme Ölçeğinin Türkiye’de Geçerlik ve Güvenilirliği. Türk Psikiyatri Derg. 2002;13:107-14.
- McKay MT, Cannon M, Chambers D, Conroy RM, Coughlan H, Dodd P, et al. Childhood trauma and adult mental disorder: A systematic review and meta‐analysis of longitudinal cohort studies. Acta Psychiatr Scand. 2021;143(3):189-205.
- Misiak B, Stramecki F, Gawęd, Ł, Prochwicz K, Sąsiadek MM, Moustafa AA, et al. Interactions between variation in candidate genes and environmental factors in the etiology of schizophrenia and bipolar disorder: a systematic review. Mol Neurobiol. 2018;55(6):5075–100.
- Örsel S, Karadağ H, Kahiloğullari AK, Kahiroğulları EK, Aktaş EA. The frequency of childhood trauma and relationship with psychopathology in psychiatric patients. Anadolu Psikiyatri Derg. 2011;12(2):130.
- Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry. 2005;186:121-5.
- Erten E, Uney Kalkay AF, Saatçioğlu O, Ozdemir A, Fıstıkçı N, Çakmak D. Effects of childhood trauma and clinical features on determining quality of life in patients with bipolar I disorder. J Affect Disord. 2014;162:107 13.
- Maslow AH. A theory of human motivation. Psychol Rev. 1943;50(4): 370-96.
- Kim J, Cicchetti D. Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. J Child Psychol Psychiatry. 2010;51(6):706-16.
- Demirkol ME, Güleç H, Tamam L, Öztürk SA, Uğur K, Karaytuğ MO, et al. Reliability and validity of Mee bunney psychological pain assessment scale turkish version. Curr Psychol. 2020;39(4):1181-8.
- Karanovic J, Ivkovic M, Jovanovic V, Svikovic S, Stefanovic M, Brkusanin M, et al. Effect of childhood general traumas on suicide attempt depends on TPH2 and ADARB1 variants in psychiatric patients. J Neural Transm. 2017:124(5):621-9.
- Agnew-Blais J, Danese A. Childhood maltreatment and unfavourable clinical outcomes in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3(4):342–9.
- Benarous X, M Raffin, N Bodeau, Dhossche D, Cohen D, Consoli A. Adverse childhood experiences among inpatient youths with severe and early-onset psychiatric disorders: prevalence and clinical correlates. Child Psychiatry Hum Dev. 2017;48(2):248–59.
- Duarte D, Belzeaux R, Etain B, Greenway KT, Rancourt E, Correa H, et al. Childhood-maltreatment subtypes in bipolar patients with suicidal behavior: systematic review and meta-analysis. Braz J Psychiatry. 2020;42:558–67.
- Conejero I, Olié E, Calati R, Ducasse D, Courtet P. Psychological pain, depression, and suicide: recent evidences and future directions. Curr Psychiatry Rep. 2018;20(5):1-9.
- Verrocchio MC, Carrozzino D, Marchetti D, Andreasson K, Fulcheri M, Bech P. Mental pain and suicide: a systematic review of the literature. Front Psychiatry. 2016;7:108.
- Tossani E. The concept of mental pain. Psychother Psychosom. 2013; 82(2):67-73.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Psikiyatri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 10 Haziran 2024 |
| Gönderilme Tarihi | 2 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2024 |