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KONVERSİYON BOZUKLUĞUNDA ÇOCUKLUK ÇAĞI YAŞAM OLAYLARI VE AİLESEL İŞLEVLER

Year 2011, Volume: 2 Issue: 7, - , 03.03.2015

Abstract

Konversiyon bozukluğu tespit edilen hastalarda çocukluk çağı yaşam olayları ve ailesel işlevlerdeki değişikliklerin araştırılması amaçlandı. Çalışmaya 25’i erkek, 96’sı kadın 121 konversiyon hastası çalışma grubu olarak; 19’u erkek, 31’i kadın 50 depresyon hastası da kontrol grubu olarak seçildi. Hastalara kısa fiziksel ve seksüel kötüye kullanım anketi, çocukluk çağı yaşam olayları ölçeği ve aile değerlendirme ölçeği uygulandı. Çocukluk çağı yaşam olaylarında duygusal kötüye kullanım (p<0,01), fiziksel kötüye kullanım (p<0,01), cinsel kötüye kullanım (p=0,05) ve toplam puanlarda (p<0,01) aradaki fark istatistiksel olarak konversiyon bozukluğunda kontrol grubundan daha yüksekti. Ailesel işlevler açısından bakıldığında, konversiyon bozukluğunda problem çözme (p<0,01), iletişim (p<0,01), duygusal tepki (p<0,05) ve genel işlevlerde (p<0,05) istatistiksel olarak anlamlı olacak şekilde kontrol grubundan daha fazla idi. Konversiyon bozukluğunda önemli oranda çocukluk çağı duygusal, fiziksel ve cinsel kötüye kullanım öyküsü mevcuttur. Bu da konversiyon hastalarının bilinçteki çatışmaların kaynağı; aile değerlendirme ölçeğindeki değişiklikler ise hastalığın oluşumunda ailesel dinamiklerin ve tedavide ailesel dinamiklere yönelik yaklaşımın önemi hakkında fikir verici olabilir.

References

  • Richter J, Richter G, Eiseman M. Perceived parental rearing, depression and coping behaviour. A pilot study in psychiatric patients. Soc Psychiatry Psychiatr Epidemol. 1991; 26: 75-77.2. Breslau N. Psychiatric morbitidy in adult survivors of chilhood trauma. Semin Clin Neuropsychiatry 2002; 7:80-88.
  • Schafer M, Schnack B, Soyka M. Sexual and physical abuse during early childhood or adolescence and later durug addiction. Psychother Psychosom Med Psychol. 2000; 50: 38-50. 4. Bowman ES. Etiology and clinical course of pseudoseizures. Relationship to trauma, depression and dissociation. Pyschosomatics 1993; 34: 333-42.
  • Chu JA, Dill DL. Dissovciative symptoms in relation to child hood physical and sexual abuse. Am J Psychiatry 1990; 147:887-892.
  • Simeon ve ark. The rol of childhood interpersonal traumain depersonalization disorder. Am J Psychiatry 2001; 158: 1027-33.
  • Zanarini MC, Yong L, Frankenburg FR at al. Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inpatients. J Nerv Ment Dis 2002; 190: 381-7.
  • Elizabet S, Bowman ES, Markand ON. Psychodynamics and psychiatric diagnoses of pseudoseizures subjects. Am J Psychiatry 1996; 153: 57-63.
  • Bowman ES. The differential of epilepsy, pseudo seizures, dissociative identity disorder and dissociative disorder not otherwise specified. Bull Menninger Clin 2000; 64: 164-80.
  • Güz H, Doğanay Z, Çolak Esra, Tomaç Ayşin, Sarısoy G, Özkan A. Konversiyon Bozukluğunda Çocukluk Çağı Travma Öyküsünün Psikiyatrik Belirtilere Etkisi Var mı? Klinik Psikiyatri 2003; 6: 80-5.
  • Binzer M, Eiseman M. Childhood experiences and personality traits in patients with motor conversion symptoms. Acta Psychiatry Scand 1998; 98: 288-95.
  • Draijer N, Bloon S. Trauma, dissociation and dissociative disorders, in multiple personality in the Nedherlands: Astudy on reliability and validity of the diagnosis. Ed,ted by Boon S, Draijer N, Amsterdam, Swets&Zeitlinger 1993; 177-94.
  • Irwin HJ. Proneness to dissociation and traumatic chilhood events J Nerv Ment Dis. 1994; 182: 456-60.
  • Krawets P, M.D., FRCPC, Fleisher W ve ark. Family functioning in subjects with pseudo seizures and epilepsi. J Nerv Ment Dis. 2001; 189: 38-43.
  • Marshall RD, Schneier FR, Lin SH ve ark. Childhood travma and dissociative symptoms in panic disorder. Am J Psychiatry 2000; 157(3): 451-3.
  • Aslan SH, Alparslan ZN. Çocukluk Örselenme Yaşantıları Ölçeği’nin bir üniversite öğrencisi örnekleminde geçerlik, güvenirlik ve faktör yapısı. Türk Psikiyatri Dergisi 1999; 10 (4): 275-85.
  • Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, Sapareto E, Ruggiero J. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry 1994; 151: 1132-6.
  • Epstein, N. B., Baldwin, L. M., & Bishop, D. S. The McMaster family assessment device. Journal of Marital and Family Therapy 1983; 9: 171–80.
  • Bulut I. Aile değerlendirme el kitabı, Özgüzeliş Matbaası, Ankara 1990.
  • Karin Roelofs, Ph D., Ger P.J. Keijser, Ph. D. at al. Childhood abuse in patients with conversion disorder .Am J Psychiatry 2002; 159: 1908-13.
  • Rosenbaum M. Psychogenic seizures--why women? Psychosomatics 2000; 41(2): 147-9.
  • Alper K ve ark. Non epileptic seizures and child hoodsexualand physicalabuse. Neurology 1993; 43: 1950-3.
  • Şar V. M.D., Akyüz G. M.D., Kundakçı T. M.D., Kızıltan E. M.D., Doğan O. M.D. Childhood trauma, dissociation, and psychiatric comorbidity in patients with conversion disorder. Am J Psychiatry 2004; 161: 2271-6.
  • Tezcan E, Atmaca M ve ark. Dissociative disorders in turkish inpatients with conversion disorder. Comprehensive Physchiatry 2003; 44 (4): 324-30.
  • Roesler TA, McKenzie N. Effects of childhood trauma on psychological functioning in adults sexually abused as children. J Nerv Ment Dis. 1994; 182(3): 145-50.
  • Bowman ES, Markand ON. Psychodynamics and psychiatric diagnoses of pseudoseizure subjects. Am J Psychiatry. Jan. 1996; 153(1): 57-63.
  • Uğuz Ş, Toros F. Konversiyon bozukluğunda sosyodemografik ve klinik özellikler. Türk Psikiyatri Dergisi 2003; 14(1): 51-8.
  • Bhatia MS, Vaid L. Hysterical aphonia-an analysis of 25 cases. Indian J Med Sci. 2000; 54: 335-8.
  • Özen Ş, Özbulut Ö , Altındağ A , Arıcıoğulları Z. Acil serviste konversiyon bozukluğu tanısı konan hastaların sosyodemografik özellikleri, stres faktörleri,I. ve II. Eksen eş tanıları Türkiye’de Psikiyatri (2). 2000.

FAMILIAL FUNCTIONALITY AND LIFE EVENTS OF CHILDHOOD IN CONVERSION DISORDER

Year 2011, Volume: 2 Issue: 7, - , 03.03.2015

Abstract

Changes in life events and family functioning of the patients who had a conversion disorder in childhood were aimed to investigate. 25 male and 96 female patients with 121conversion were selected as the study group, while19 men, 31 women 50 patients with depression were selected as the control group. A short questionnaire including physical and sexual abuse, scale for the assessment of childhood and family life events was applied to all patients. In childhood life events, emotional abuse (p< 0.01), physical abuse (p< 0.01), sexual abuse (p=0.05) and total scores (p<0.01) difference were statistically higher in conversion disorder than control group. In terms of familial functions, results of problem-solving in conversion disorder (p = 0.00), communication (p = 0.00), emotional reaction (p = 0.01) and overall functioning (p =0.02) were greater than the control group. Emotional, physical and sexual abuse history in childhood was available in significant proportion of conversion disorder. This is a source of conflict in the conversion of consciousness of patients; the changes in the scale of the family assessment and treatment of disease, familial dynamics approach to the formation of the importance of family dynamics may be suggestive.

References

  • Richter J, Richter G, Eiseman M. Perceived parental rearing, depression and coping behaviour. A pilot study in psychiatric patients. Soc Psychiatry Psychiatr Epidemol. 1991; 26: 75-77.2. Breslau N. Psychiatric morbitidy in adult survivors of chilhood trauma. Semin Clin Neuropsychiatry 2002; 7:80-88.
  • Schafer M, Schnack B, Soyka M. Sexual and physical abuse during early childhood or adolescence and later durug addiction. Psychother Psychosom Med Psychol. 2000; 50: 38-50. 4. Bowman ES. Etiology and clinical course of pseudoseizures. Relationship to trauma, depression and dissociation. Pyschosomatics 1993; 34: 333-42.
  • Chu JA, Dill DL. Dissovciative symptoms in relation to child hood physical and sexual abuse. Am J Psychiatry 1990; 147:887-892.
  • Simeon ve ark. The rol of childhood interpersonal traumain depersonalization disorder. Am J Psychiatry 2001; 158: 1027-33.
  • Zanarini MC, Yong L, Frankenburg FR at al. Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inpatients. J Nerv Ment Dis 2002; 190: 381-7.
  • Elizabet S, Bowman ES, Markand ON. Psychodynamics and psychiatric diagnoses of pseudoseizures subjects. Am J Psychiatry 1996; 153: 57-63.
  • Bowman ES. The differential of epilepsy, pseudo seizures, dissociative identity disorder and dissociative disorder not otherwise specified. Bull Menninger Clin 2000; 64: 164-80.
  • Güz H, Doğanay Z, Çolak Esra, Tomaç Ayşin, Sarısoy G, Özkan A. Konversiyon Bozukluğunda Çocukluk Çağı Travma Öyküsünün Psikiyatrik Belirtilere Etkisi Var mı? Klinik Psikiyatri 2003; 6: 80-5.
  • Binzer M, Eiseman M. Childhood experiences and personality traits in patients with motor conversion symptoms. Acta Psychiatry Scand 1998; 98: 288-95.
  • Draijer N, Bloon S. Trauma, dissociation and dissociative disorders, in multiple personality in the Nedherlands: Astudy on reliability and validity of the diagnosis. Ed,ted by Boon S, Draijer N, Amsterdam, Swets&Zeitlinger 1993; 177-94.
  • Irwin HJ. Proneness to dissociation and traumatic chilhood events J Nerv Ment Dis. 1994; 182: 456-60.
  • Krawets P, M.D., FRCPC, Fleisher W ve ark. Family functioning in subjects with pseudo seizures and epilepsi. J Nerv Ment Dis. 2001; 189: 38-43.
  • Marshall RD, Schneier FR, Lin SH ve ark. Childhood travma and dissociative symptoms in panic disorder. Am J Psychiatry 2000; 157(3): 451-3.
  • Aslan SH, Alparslan ZN. Çocukluk Örselenme Yaşantıları Ölçeği’nin bir üniversite öğrencisi örnekleminde geçerlik, güvenirlik ve faktör yapısı. Türk Psikiyatri Dergisi 1999; 10 (4): 275-85.
  • Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, Sapareto E, Ruggiero J. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry 1994; 151: 1132-6.
  • Epstein, N. B., Baldwin, L. M., & Bishop, D. S. The McMaster family assessment device. Journal of Marital and Family Therapy 1983; 9: 171–80.
  • Bulut I. Aile değerlendirme el kitabı, Özgüzeliş Matbaası, Ankara 1990.
  • Karin Roelofs, Ph D., Ger P.J. Keijser, Ph. D. at al. Childhood abuse in patients with conversion disorder .Am J Psychiatry 2002; 159: 1908-13.
  • Rosenbaum M. Psychogenic seizures--why women? Psychosomatics 2000; 41(2): 147-9.
  • Alper K ve ark. Non epileptic seizures and child hoodsexualand physicalabuse. Neurology 1993; 43: 1950-3.
  • Şar V. M.D., Akyüz G. M.D., Kundakçı T. M.D., Kızıltan E. M.D., Doğan O. M.D. Childhood trauma, dissociation, and psychiatric comorbidity in patients with conversion disorder. Am J Psychiatry 2004; 161: 2271-6.
  • Tezcan E, Atmaca M ve ark. Dissociative disorders in turkish inpatients with conversion disorder. Comprehensive Physchiatry 2003; 44 (4): 324-30.
  • Roesler TA, McKenzie N. Effects of childhood trauma on psychological functioning in adults sexually abused as children. J Nerv Ment Dis. 1994; 182(3): 145-50.
  • Bowman ES, Markand ON. Psychodynamics and psychiatric diagnoses of pseudoseizure subjects. Am J Psychiatry. Jan. 1996; 153(1): 57-63.
  • Uğuz Ş, Toros F. Konversiyon bozukluğunda sosyodemografik ve klinik özellikler. Türk Psikiyatri Dergisi 2003; 14(1): 51-8.
  • Bhatia MS, Vaid L. Hysterical aphonia-an analysis of 25 cases. Indian J Med Sci. 2000; 54: 335-8.
  • Özen Ş, Özbulut Ö , Altındağ A , Arıcıoğulları Z. Acil serviste konversiyon bozukluğu tanısı konan hastaların sosyodemografik özellikleri, stres faktörleri,I. ve II. Eksen eş tanıları Türkiye’de Psikiyatri (2). 2000.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Articles
Authors

Mustafa Arı This is me

Yasin Bez This is me

Mustafa Özkan This is me

Yüksel Kıvrak This is me

Publication Date March 3, 2015
Submission Date February 28, 2015
Published in Issue Year 2011 Volume: 2 Issue: 7

Cite

Vancouver Arı M, Bez Y, Özkan M, Kıvrak Y. KONVERSİYON BOZUKLUĞUNDA ÇOCUKLUK ÇAĞI YAŞAM OLAYLARI VE AİLESEL İŞLEVLER. mkutfd. 2015;2(7).