Dissosiyatif Kimlik Bozukluğu Olan Bireylerde Tiyol-Disülfid Dengesi

Öz

Amaç: Bu çalışmanın amacı, Dissosiyatif Kimlik Bozukluğu (DKB) tanılı bireylerde tiyol-disülfid homeostazı (TDH) parametrelerini değerlendirerek oksidatif stres düzeylerinde bozulma olup olmadığını araştırmak ve bu biyolojik değişikliklerin DKB ile ilişkisini incelemektir. Materyal ve Metod: DSM-5 kriterlerine göre DKB tanısı konan 56 hasta ile herhangi bir psikiyatrik bozukluğu bulunmayan 43 sağlıklı gönüllü çalışmaya dahil edilmiştir. Katılımcılardan 12 saatlik açlık sonrası kan örnek-leri alınarak tiyol-disülfid homeostazı parametreleri ölçülmüştür. Ölçümler kolorimetrik yöntemle gerçek-leştirilmiş, toplam tiyol, doğal tiyol ve disülfid düzeyleri ile bunların oranları hesaplanmıştır. Katılımcılara Dissosiyatif Yaşantılar Ölçeği (DYÖ) ve Çocukluk Çağı Travmaları Ölçeği (ÇÇTÖ) uygulanmıştır. Veriler istatistik-sel olarak bağımsız gruplar t testi, Mann-Whitney U testi, ki-kare testi ve korelasyon analizleri kullanılarak değerlendirilmiştir. Bulgular: DKB grubunda toplam tiyol (p<0.001) ve disülfid düzeyleri (p<0.001) ile disülfid/toplam tiyol oranları (p=0.02), sağlıklı kontrol grubuna göre istatistiksel olarak anlamlı derecede düşüktü. Doğal ti-yol/toplam tiyol oranı ise DKB grubunda kontrol grubuna kıyasla anlamlı derecede yüksekti (p=0.02). Kore-lasyon analizlerinde ise DKB grubunda TDH parametreleri ile DYÖ ve ÇÇTÖ skorları arasında anlamlı bir ilişki saptanmamıştır. Sonuç: Bu çalışma, DKB tanılı bireylerde tiyol-disülfid homeostazının bozulduğunu göstermektedir. Toplam tiyol düzeylerindeki düşüş, antioksidan kapasitede azalma olduğunu düşündürürken, disülfid düzeylerinin de düşük bulunması redoks sisteminin yeterince aktive olamadığını düşündürmektedir. Bulgular, DKB’nin biyolojik temelini anlamada tiyol-disülfid homeostazı dengesinin potansiyel bir biyobelirteç olabileceğini göstermekte olup, daha geniş örneklemlerle yapılacak çalışmalarla desteklenmesi gerekmektedir.

Anahtar Kelimeler

• Dissosiyatif Kimlik Bozukluğu
• Tiyol-Disülfid Homeostazı
• Oksidatif Stres

Thiol-Disulfide Balance in Patients with Dissociative Identity Disorder

Öz

Background: This study aimed to evaluate thiol-disulfide homeostasis (TDH) parameters in individuals diag-nosed with Dissociative Identity Disorder (DID) to investigate whether there is a disruption in oxidative stress levels and to examine the relationship of these biological changes with DID. Materials and Methods: Fifty-six patients diagnosed with DID according to DSM-5 criteria and 43 healthy volunteers without any psychiatric disorders were included in the study. After 12 hours of fasting, blood samples were collected from all participants to measure TDH parameters. Measurements were performed using a colorimetric method, and total thiol, native thiol, disulfide levels, and their ratios were calculated. Participants were also assessed with the Dissociative Experiences Scale (DES) and the Childhood Trauma Questionnaire (CTQ). Data were analyzed statistically using independent samples t-test, Mann-Whitney U test, chi-square test, and correlation analyses. Results: In the DID group, total thiol (p<0.001), disulfide levels (p<0.001), and disulfide/total thiol ratios (p=0.02) were significantly lower compared to the healthy control group. In contrast, the native thiol/total thiol ratio was significantly higher in the DID group than in the control group (p=0.02). However, correla-tion analyses revealed no significant relationship between TDH parameters and DES or CTQ scores within the DID group. Conclusions: This study demonstrates that thiol-disulfide homeostasis is disrupted in individuals with DID. The decrease in total thiol levels indicates reduced antioxidant capacity, while the concomitant decrease in disulfide levels suggests insufficient activation of the redox system. The results highlight the potential of thiol-disulfide homeostasis balance as a biomarker in understanding the biological basis of DID and unders-core the need for further studies with larger samples to support these findings.

Anahtar Kelimeler

• Dissociative Identity Disorder
• Thiol-Disulfide Homeostasis
• Oxidative Stress

Kaynakça

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