Psikiyatrik Bozukluklarda Aleksitimi

Öz

Aleksitimi, duyguları tanımlama ve ifade etmede güçlüklerle karakterize bir fenomendir. Bu anlatısal derlemenin amacı, aleksitiminin kavramsal, nörobiyolojik ve klinik boyutlarını başlıca psikiyatrik tanılar çerçevesinde bütüncül biçimde sentezlemektir. Aleksitimi, güncel literatürde depresyon, anksiyete bozuklukları, bipolar bozukluk, şizofreni, obsesif-kompulsif bozukluk, travma ve ilişkili bozukluklar, somatik belirti bozuklukları, yeme bozuklukları, kişilik bozuklukları, uyku bozuklukları, dikkat eksikliği/hiperaktivite bozukluğu ve alkol ve madde kullanım bozuklukları dahil olmak üzere çeşitli psikiyatrik bozukluklarla ilişkilendirmiştir. Tanılar arasında bildirilen prevalans oranları geniş bir aralık göstermekte olup, çalışılan popülasyona göre yaklaşık %13 ile %70’in üzerine kadar değişmektedir ve özellikle somatik belirti bozukluklarında oranların %40–60 düzeylerine ulaştığı bildirilmektedir. Klinik açıdan aleksitimi, artmış belirti yükü, işlevsellikte bozulma, yaşam kalitesinde düşüş, intihar düşüncelerinde artış ve tedavi yanıtındaki kötüleşme ile ilişkilidir. Nörobiyolojik bulgular, anterior insula, anterior singulat korteks, amigdala ve prefrontal bölgelerdeki değişikliklere işaret ederek, aleksitiminin interoseptif farkındalık ve duygu düzenleme ağlarındaki bozulmalarla ilişkili tanılar arası bir yatkınlık faktörü olduğunu desteklemektedir. Aleksitiminin psikiyatrik değerlendirmeye rutin bir biçimde dâhil edilmesi, tanısal değerlendirme ve tedavi planlamasına önemli katkı sağlayabilir. Duygusal farkındalığı artırmayı, bedensel duyumlar ile duygular arasındaki bağı güçlendirmeyi ve duygu düzenleme becerilerini geliştirmeyi hedefleyen tedavi yaklaşımlarının, aleksitimik özellikler gösteren psikiyatrik bozukluğa sahip bireylerde klinik sonuçları iyileştirebileceği düşünülmektedir.

Anahtar Kelimeler

• Aleksitimi
• Duygu Düzenleme
• Psikiyatrik Bozukluklar

Alexithymia Across Psychiatric Disorders

Öz

Alexithymia is a condition characterized by difficulty in identifying and expressing emotions. This narrative review aimed to provide an integrative synthesis of the conceptual, neurobiological, and clinical dimensions of alexithymia across major psychiatric diagnoses. Recent research has connected alexithymia with various psychiatric disorders, including depression, anxiety disorders, bipolar disorder, schizophrenia, obsessive-compulsive disorder, trauma and related disorders, somatic symptom disorders, eating disorders, personality disorders, sleep disorders, attention-deficit/hyperactivity disorder, and alcohol and substance use disorders. Across diagnostic categories, reported prevalence rates vary considerably, ranging from approximately 13% to over 70% depending on the disorder and population studied, with rates exceeding 40–60% in somatic symptom disorders. Clinically, alexithymia is linked to higher symptom burden, reduced functioning, lower quality of life, increased suicidal thoughts, and poorer response to treatment. Neurobiological findings consistently implicate alterations within the anterior insula, anterior cingulate cortex, amygdala, and prefrontal regions, supporting the conceptualization of alexithymia as a transdiagnostic vulnerability factor associated with disrupted interoceptive awareness and emotion regulation networks. Including alexithymia routinely in psychiatric assessments could greatly enhance diagnosis and treatment planning. It is thought that treatment approaches that aim to increase emotional awareness, strengthen the link between bodily sensations and emotions, and improve emotion regulation skills may improve clinical outcomes in individuals with psychiatric disorders who exhibit alexithymic features.

Anahtar Kelimeler

• Alexithymia
• Emotion Regulation
• Psychiatric Disorders

Kaynakça

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