Araştırma Makalesi
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Alkol-madde kullanım bozukluğu olan hastalarda tedaviye yarım bırakmanın yordayıcıları olarak mizaç ve karakter profilleri ve dürtüsellik

Yıl 2019, Cilt: 44 Sayı: 1, 59 - 65, 31.03.2019
https://doi.org/10.17826/cumj.446640

Öz

Amaç: Bu çalışmada alkol madde kullanım bozukluğu gibi depreşmenin/yinelemenin sık olduğu hasta grubunda tedaviyi yarım bırakma öngörücüleri araştırılmıştır. 

Gereç ve Yöntem: Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi AMATEM (Alkol Madde Tedavi Merkezi) Kliniğine alkol ve madde kullanım bozuklukları tanıları yatarak tedavi programını tamamlamış 60 hasta ve tedavisini 1 tamamlamadan çıkmış 28 hasta çalışmaya alınmıştır. Katılmayı kabul eden hastalara klinik değişkenleri bu çalışma için hazırlanmış olan sosyodemografik veri formu ile Bağımlılık Profil İndeksi (BAPİ), Mizaç ve Karakter Envanteri (MKE) ve Barratt Dürtüsellik Ölçeği (BIS-11) ölçeği uygulanmıştır.

Bulgular: Yatışını tamamlayan grupta zarardan kaçınma, ödül bağımlılığı, sebat etme, işbirliği yapma, BAPİ toplam puanı, BAPİ tanı alt ölçeği anlamlı olarak daha yüksekti. Çok değişkenli indirgenmiş modelde yatış tamamlanan ve yatış tamamlanmayan grubun ayırmada yenilik arayışı, sebat etme, işbirliği yapma, BAPİ toplam puanının anlamlı-bağımsız etkinliği gözlenmiştir.

Sonuç: Bağımlılığa yol açtığı ileri sürülen yenilik arayışı ve ödül bağımlılığı kişilik özelliği olarak tedaviyi tamamlayan hastalarda anlamlı farklı bulunmuştur. Tedaviyi yarım bırakan hastaların sebat etme ve işbirliği yapma konusundaki yetersizlikleri tedaviyi yarım bırakmanın önemli-bağımsız belirleyicisi olarak saptandı. 


Kaynakça

  • 1. TUBİM. Türkiye Uyuşturucu Raporu. T.C. İçişleri Bakanlığı Emniyet Genel Müdürlüğü. EM-CDDA 2017 Ulusal Raporu.
  • 2. Vardar E, Karaca E. Bağımlılık Tedavisini Terk Nedenlerinin Değerlendirilmesi Fakültesi Ruh Sağlığı ve Hastalıkları Balkan. 2015;90(284):70–7.
  • 3. Petry NM, Bickel WK. Therapeutic alliance and psychiatric severity as predictors of completion of treatment for opioid dependence. Psychiatr Serv. Am Psychiatric Assoc; 1999;50(2):219–27.
  • 4. Yılmaz A, Can Y, Bozkurt M, Evren C. Alkol ve madde bağımlılığında remisyon ve depreşme. Psikiyatr Güncel Yaklaşımlar. 2014;6(3).
  • 5. Brorson HH, Arnevik EA, Rand-Hendriksen K, Duckert F. Drop-out from addiction treatment: a systematic review of risk factors. Clin Psychol Rev. Elsevier; 2013;33(8):1010–24.
  • 6. Cüneyt E, Kültegin Ö, Berna U. Alkol Madde Bağımlılığı Tanı ve Tedavi El Kitabı. Tuna Matbaacılık; 2012. 53-66 p.
  • 7. Alterman AI, Cacciola JS. The antisocial personality disorder diagnosis in substance abusers: problems and issues. J Nerv Ment Dis. Lippincott Williams & Wilkins; 1991;
  • 8. Brooner RK, Greenfield L, Schmidt CW, Bigelow GE. Antisocial personality disorder and HIV infection among intravenous drug abusers. Am J Psychiatry. American Psychiatric Assn; 1993;
  • 9. Kokkevi A, Stefanis N, Anastasopoulou E, Kostogianni C. Personality disorders in drug abusers: prevalence and their association with AXIS I disorders as predictors of treatment retention. Addict Behav. Elsevier; 1998;23(6):841–53.
  • 10. Conway KP, Kane RJ, Ball SA, Poling JC, Rounsaville BJ. Personality, substance of choice, and polysubstance involvement among substance dependent patients. Drug Alcohol Depend. Elsevier; 2003;71(1):65–75.
  • 11. Milivojevic D, Milovanovic SD, Jovanovic M, Svrakic DM, Svrakic NM, Svrakic SM, et al. Temperament and character modify risk of drug addiction and influence choice of drugs. Am J Addict. Wiley Online Library; 2012;21(5):462–7.
  • 12. Evren C, Evren B, Yancar C, Erkiran M. Temperament and Character Model of Personality Profile of Alcohol- and Drug-Dependent Inpatients. Compr Psychiatry. 2007;48(3):283–8.
  • 13. Özdemir PG, Selvi Y, Aydin A. Dürtüsellik ve Tedavisi/Impulsivity and Its Treatment. Psikiyatr Guncel Yaklasimlar. Psikiyatride Guncel Yaklasimlar: Current Approaches in Psychiatry; 2012;4(3):293.
  • 14. KISA C, YILDIRIM SG, GÖKA E. Atakl› k ve Ruhsal Bozukluklar. Turk Psikiyatr Derg. 2005;16:46–54.
  • 15. Dom G, Hulstijn W, Sabbe B. Differences in impulsivity and sensation seeking between early-and late-onset alcoholics. Addict Behav. Elsevier; 2006;31(2):298–308.
  • 16. De Wit H. Impulsivity as a determinant and consequence of drug use: a review of underlying processes. Addict Biol. Wiley Online Library; 2009;14(1):22–31.
  • 17. Evren C, Bozkurt M, Evren B, Can Y, Yiğiter S, YILMAZ A. Relationships of personality dimensions with impulsivity in heroin dependent inpatient men. Anatol J Psychiatry/Anadolu Psikiyatr Derg. 2014;15(1).
  • 18. Ögel K, Evren C, Karadağ F, Gürol T. Bağımlılık Profil İndeksi’nin (BAPİ) geliştirilmesi, geçerlik ve güvenilirliği. Türk Psikiyatr Derg. 2012;23(4):264–73.
  • 19. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Dev psychiatry its Complex. Waxmann Münster; 1998;1–16.
  • 20. Köse S, Sayar K, Ak I, Aydin N, Kalelioǧlu Ü, Kirpinar I, et al. Mizaç ve Karakter Envanteri (Türkçe TCI): Geçerlik, Güvenirliği ve Faktör Yapısı. Klin Psikofarmakol Bul. 2004;14(3).
  • 21. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. Wiley Online Library; 1995;51(6):768–74.
  • 22. Güleç H, Tamam L, Güleç MY, Turhan M, Karakuş G, Zengin M, et al. Psychometric Properties of the Turkish Version of the Barratt. Bull Clin Psychopharmacol. 2008;18(December):251–8.
  • 23. Eysenck HJ. Addiction, personality and motivation. Hum Psychopharmacol Clin Exp. Wiley Online Library; 1997;12(S2):S79–87.
  • 24. M. Pettinati H, D. Pierce J, P. Belden P, Meyers K. The relationship of Axis II personality disorders to other known predictors of addiction treatment outcome. Am J Addict. Taylor & Francis; 1999;8(2):136–47.
  • 25. Morgan TJ, Morgenstern J, Blanchard KA, Labouvie E, Bux DA. Health-related quality of life for adults participating in outpatient substance abuse treatment. Am J Addict. Taylor & Francis; 2003;12(3):198–210.
  • 26. Stark MJ. I-IIIDropping out of substance abuse treatment: A clinically oriented review. Clin Psychol Rev [Internet]. 1992;12(1):93–116. Available from: http://www.sciencedirect.com/science/article/pii/027273589290092M
  • 27. Keegan JF, Lachar D. The MMPI as a predictor of early termination from polydrug abuse treatment. J Pers Assess. Taylor & Francis; 1979;43(4):379–84.
  • 28. Arnau MM, Mondon S, Santacreu JJ. Using the temperament and character inventory (TCI) to predict outcome after inpatient detoxification during 100 days of outpatient treatment. Alcohol Alcohol. Oxford University Press; 2008;43(5):583–8.
  • 29. Cloninger CR, Svrakic DM. Personality Disorders; In: Kaplan and Sadock’s Comprehensive Textbook Psychiatry. 7th ed. 2000.
  • 30. Kosten TA, Kosten TR, Rounsaville BJ. Personality disorders in opiate addicts show prognostic specificity. J Subst Abuse Treat. Elsevier; 1989;6(3):163–8.
  • 31. Deane FP, Wootton DJ, Hsu C-I, Kelly PJ. Predicting dropout in the first 3 months of 12-step residential drug and alcohol treatment in an Australian sample. J Stud Alcohol Drugs. Rutgers University; 2012;73(2):216–25.

Temperament and character profiles and impulsivity as predictors of drop-out in patients with alcohol-substance use disorder

Yıl 2019, Cilt: 44 Sayı: 1, 59 - 65, 31.03.2019
https://doi.org/10.17826/cumj.446640

Öz

Purpose: In this study, predictors of drop-out of treatment were searched in a group of patients with alcohol substance abuse who had frequent relapse.

Materials and Methods: In Erenköy Mental and Neurological Diseases Training and Research Hospital AMATEM (Alcohol Substance Treatment Center), 60 patients who completed the inpatient treatment program for alcohol and substance use disorders diagnosed and 28 patients who had left their treatment were included in the study. The Sociodemographic and Clinical Variables that accepted the participation were applied to the data form prepared for this study, Addiction Profile Index (BAPI), Temperament and Character Inventory (MKE) and Barratt Impulsivity Scale (BIS-11) scale.

Results: In the group completing the treatment, total harm avoidance, reward dependence, persistence, cooperation scores, BAPI diagnosis subscale and BAPI total score was significantly higher. In the multivariate reduced model, the dropped-out group showed a significant difference on the novelty-seeking, persistence, cooperation and total score of BAPI.

Conclusion: The novelty-seeking and reward dependence, which are claimed to lead to addiction as personality traits, was found to be significantly different in patients who completed therapy. Inadequacies in persistence and cooperation in patients with dropping out the treatment, was determined to be an important-independent determinant of leaving the treatment half. 


Kaynakça

  • 1. TUBİM. Türkiye Uyuşturucu Raporu. T.C. İçişleri Bakanlığı Emniyet Genel Müdürlüğü. EM-CDDA 2017 Ulusal Raporu.
  • 2. Vardar E, Karaca E. Bağımlılık Tedavisini Terk Nedenlerinin Değerlendirilmesi Fakültesi Ruh Sağlığı ve Hastalıkları Balkan. 2015;90(284):70–7.
  • 3. Petry NM, Bickel WK. Therapeutic alliance and psychiatric severity as predictors of completion of treatment for opioid dependence. Psychiatr Serv. Am Psychiatric Assoc; 1999;50(2):219–27.
  • 4. Yılmaz A, Can Y, Bozkurt M, Evren C. Alkol ve madde bağımlılığında remisyon ve depreşme. Psikiyatr Güncel Yaklaşımlar. 2014;6(3).
  • 5. Brorson HH, Arnevik EA, Rand-Hendriksen K, Duckert F. Drop-out from addiction treatment: a systematic review of risk factors. Clin Psychol Rev. Elsevier; 2013;33(8):1010–24.
  • 6. Cüneyt E, Kültegin Ö, Berna U. Alkol Madde Bağımlılığı Tanı ve Tedavi El Kitabı. Tuna Matbaacılık; 2012. 53-66 p.
  • 7. Alterman AI, Cacciola JS. The antisocial personality disorder diagnosis in substance abusers: problems and issues. J Nerv Ment Dis. Lippincott Williams & Wilkins; 1991;
  • 8. Brooner RK, Greenfield L, Schmidt CW, Bigelow GE. Antisocial personality disorder and HIV infection among intravenous drug abusers. Am J Psychiatry. American Psychiatric Assn; 1993;
  • 9. Kokkevi A, Stefanis N, Anastasopoulou E, Kostogianni C. Personality disorders in drug abusers: prevalence and their association with AXIS I disorders as predictors of treatment retention. Addict Behav. Elsevier; 1998;23(6):841–53.
  • 10. Conway KP, Kane RJ, Ball SA, Poling JC, Rounsaville BJ. Personality, substance of choice, and polysubstance involvement among substance dependent patients. Drug Alcohol Depend. Elsevier; 2003;71(1):65–75.
  • 11. Milivojevic D, Milovanovic SD, Jovanovic M, Svrakic DM, Svrakic NM, Svrakic SM, et al. Temperament and character modify risk of drug addiction and influence choice of drugs. Am J Addict. Wiley Online Library; 2012;21(5):462–7.
  • 12. Evren C, Evren B, Yancar C, Erkiran M. Temperament and Character Model of Personality Profile of Alcohol- and Drug-Dependent Inpatients. Compr Psychiatry. 2007;48(3):283–8.
  • 13. Özdemir PG, Selvi Y, Aydin A. Dürtüsellik ve Tedavisi/Impulsivity and Its Treatment. Psikiyatr Guncel Yaklasimlar. Psikiyatride Guncel Yaklasimlar: Current Approaches in Psychiatry; 2012;4(3):293.
  • 14. KISA C, YILDIRIM SG, GÖKA E. Atakl› k ve Ruhsal Bozukluklar. Turk Psikiyatr Derg. 2005;16:46–54.
  • 15. Dom G, Hulstijn W, Sabbe B. Differences in impulsivity and sensation seeking between early-and late-onset alcoholics. Addict Behav. Elsevier; 2006;31(2):298–308.
  • 16. De Wit H. Impulsivity as a determinant and consequence of drug use: a review of underlying processes. Addict Biol. Wiley Online Library; 2009;14(1):22–31.
  • 17. Evren C, Bozkurt M, Evren B, Can Y, Yiğiter S, YILMAZ A. Relationships of personality dimensions with impulsivity in heroin dependent inpatient men. Anatol J Psychiatry/Anadolu Psikiyatr Derg. 2014;15(1).
  • 18. Ögel K, Evren C, Karadağ F, Gürol T. Bağımlılık Profil İndeksi’nin (BAPİ) geliştirilmesi, geçerlik ve güvenilirliği. Türk Psikiyatr Derg. 2012;23(4):264–73.
  • 19. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Dev psychiatry its Complex. Waxmann Münster; 1998;1–16.
  • 20. Köse S, Sayar K, Ak I, Aydin N, Kalelioǧlu Ü, Kirpinar I, et al. Mizaç ve Karakter Envanteri (Türkçe TCI): Geçerlik, Güvenirliği ve Faktör Yapısı. Klin Psikofarmakol Bul. 2004;14(3).
  • 21. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. Wiley Online Library; 1995;51(6):768–74.
  • 22. Güleç H, Tamam L, Güleç MY, Turhan M, Karakuş G, Zengin M, et al. Psychometric Properties of the Turkish Version of the Barratt. Bull Clin Psychopharmacol. 2008;18(December):251–8.
  • 23. Eysenck HJ. Addiction, personality and motivation. Hum Psychopharmacol Clin Exp. Wiley Online Library; 1997;12(S2):S79–87.
  • 24. M. Pettinati H, D. Pierce J, P. Belden P, Meyers K. The relationship of Axis II personality disorders to other known predictors of addiction treatment outcome. Am J Addict. Taylor & Francis; 1999;8(2):136–47.
  • 25. Morgan TJ, Morgenstern J, Blanchard KA, Labouvie E, Bux DA. Health-related quality of life for adults participating in outpatient substance abuse treatment. Am J Addict. Taylor & Francis; 2003;12(3):198–210.
  • 26. Stark MJ. I-IIIDropping out of substance abuse treatment: A clinically oriented review. Clin Psychol Rev [Internet]. 1992;12(1):93–116. Available from: http://www.sciencedirect.com/science/article/pii/027273589290092M
  • 27. Keegan JF, Lachar D. The MMPI as a predictor of early termination from polydrug abuse treatment. J Pers Assess. Taylor & Francis; 1979;43(4):379–84.
  • 28. Arnau MM, Mondon S, Santacreu JJ. Using the temperament and character inventory (TCI) to predict outcome after inpatient detoxification during 100 days of outpatient treatment. Alcohol Alcohol. Oxford University Press; 2008;43(5):583–8.
  • 29. Cloninger CR, Svrakic DM. Personality Disorders; In: Kaplan and Sadock’s Comprehensive Textbook Psychiatry. 7th ed. 2000.
  • 30. Kosten TA, Kosten TR, Rounsaville BJ. Personality disorders in opiate addicts show prognostic specificity. J Subst Abuse Treat. Elsevier; 1989;6(3):163–8.
  • 31. Deane FP, Wootton DJ, Hsu C-I, Kelly PJ. Predicting dropout in the first 3 months of 12-step residential drug and alcohol treatment in an Australian sample. J Stud Alcohol Drugs. Rutgers University; 2012;73(2):216–25.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma
Yazarlar

Fikret Ferzan Gıynaş 0000-0001-8280-2979

Özlem Kazan Kızılkurt 0000-0001-7121-9139

Nihal Taştekin Bu kişi benim

Betül Kırşavoğlu Bu kişi benim 0000-0002-3703-9035

Gamze Akçay Oruç Bu kişi benim 0000-0002-2444-6192

Rabia Bilici 0000-0001-6040-6174

Yayımlanma Tarihi 31 Mart 2019
Kabul Tarihi 15 Ağustos 2018
Yayımlandığı Sayı Yıl 2019 Cilt: 44 Sayı: 1

Kaynak Göster

MLA Gıynaş, Fikret Ferzan vd. “Alkol-Madde kullanım bozukluğu Olan Hastalarda Tedaviye yarım bırakmanın yordayıcıları Olarak Mizaç Ve Karakter Profilleri Ve dürtüsellik”. Cukurova Medical Journal, c. 44, sy. 1, 2019, ss. 59-65, doi:10.17826/cumj.446640.