Bipolar Disorder and Cancer

Yıl 2012, Cilt: 4 Sayı: 2, 223 - 236, 01.06.2012

Sermin Kesebir Arzu Bayrak

https://doi.org/10.5455/cap.20120414

Öz

Prevalence studies and studies on causation relations have shown that the relation between psychiatric disorders and chronic physical diseases is neglected. For heterogeneous diseases an increasing number of susceptibility variants are being defined. Alzheimer disease, bipolar disorder, breast and prostate cancer, coronary artery disease, Chron's disease, systemic lupus eritematosus, type 1 and type 2 diabetes mellitus are mentioned together with epigenetic concept. In acrocentric zone of chromosome 13, breast cancer, retinoblastoma, chronic Iymphocytic leukemia genes with B cells, dopamin loci of bipolar disorder are found together. Among bipolar and healthy individuals, an increase risk of breast cancer in female cases has been resported. On the other hand, psychosocial factors that affect stress and response to stress itself may be important variables in prognosis and progression of different cancer types. During the course of many cancer types –especially brain tumors- and during treatment of chemotherapeutic agents, bipolar symptomatology may appear. In this article, it is reviewed with relevant literature that whether an etiological relation between bipolar disorder and cancer exist and how both diseases affect each other's course and treatment.

Anahtar Kelimeler

Bipolar disorder, cancer, psychotropic drugs

Bipolar Bozukluk ve Kanser

Öz

Yaygınlık çalışmaları ve nedensel ilişki arayan çalışmalar psikiyatrik bozukluklar ile kronik fiziksel hastalıklar arasındaki ilişkinin ihmal edildiğini göstermektedir. Farklı hastalık grupları için artan sayıda yatkınlık varyantları tanımlanmaya başlamıştır. Epigenetik ilkeleri çerçevesinde, Alzheimer hastalığı, bipolar bozukluk, meme ve prostat kanseri, koroner arter hastalığı, Chron\\\\\\\\\\\\\\\'s hastalığı, sistemik lupus eritematozus ve tip 1 ve 2 diyabet birlikte anılmaktadır. Kromozom 13 akrosentrik bölgede, meme kanseri, retinoblastom, B hücreli kronik lenfositik lösemi genleri ve bipolar bozukluğun dopaminerjik lokusları birlikte yer almaktadır. Bipolar bozukluğu olan ve sağlıklı bireyler arasında, meme kanseri riski kadın olgularda artmış bulunmuştur. Diğer taraftan stresi ve stres yanıtını etkileyen psikososyal etkenler, farklı kanser tiplerinin prognozunda ve ilerlemesinde etkin önemli değişkenler olabilir. En başta beyin tümörleri olmak üzere, pek çok kanser tipi ve kemoterapötik ajan ile bipolar bozukluk belirtileri ortaya çıkabilmektedir. Bu yazıda bipolar bozukluk ile kanser arasında olası bir etiyolojik ilişkinin olup olamayacağı, her iki hastalığın birbirinin gidişini ve tedavisini nasıl etkilediği ilgili literatür bulguları eşliğinde gözden geçirilmiştir.

Anahtar Kelimeler

Bipolar bozukluk, kanser, psikotrop ilaçlar

Kaynakça

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• Sermin Kesebir, Doç.Dr., Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul; Arzu
• Bayrak, Dr., Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul