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Yatarak tedavi gören bipolar bozukluk hastalarında dissosiyatif bozukluk eştanısı olan ve olmayan hasta gruplarının karşılaştırılması

Yıl 2016, Cilt: 1 Sayı: 2, 35 - 42, 30.08.2016

Bahadır Bakım , Elif Baran Sinan Yayla Abdullah Akpinar , Hakan Serdar Sengul Hulya Ertekin , Mehmet Diyaddin Güleken Onur Tankaya Omer Akil Ozer Kayıhan Oguz Karamustafalioglu

https://doi.org/10.22391/920.256690
Cited By: 1

Öz

Giriş: Bu çalışmada dissosiyatif bozukluk (DB) eştanısı olan ve olmayan bipolar bozukluk (BB) hastalarının sosyodemografik karakteristiklerinin karşılaştırılması ve eştanı varlığının tedaviye etkisinin değerlendirilmesi amaçlanmıştır.

Yöntem: BB tanısı ile Şişli Etfal Hastanesi Psikiyatri Kliniği’nde 2010-2011 yılları arasında yatışı yapılan ardışık 149 hasta çalışmaya alınmıştır. Hastalara SCID-D uygulanarak DB tanısı, SCID-I ile BB tanısı konmuş, sosyodemografik karakteristikleri, YMDÖ, HAM-D, KPDÖ, DYÖ puanları ve hastanede yatış süre ve sayıları incelenmiştir.

Bulgular: 23 hastada (%15,4) başka türlü adlandırılamayan dissosiyatif bozukluk, 4 hastada (% 2,6) dissosiyatif kimlik bozukluğu, 1 hastada (%0,6) dissosiyatif amnezi tespit edildi. DB eştanısı olan BB hastalarının daha genç ve daha fazla oranda kadın olduğu belirlendi (sırasıyla p=0,002, p=0,015). DB eştanılı BB hastalarının DYÖ toplam puanının BB hastaların daha yüksek olduğu tespit edildi (p<0,001). Tüm örneklemde DYÖ toplam puanı ile hastanede kalış süresi arasında korelasyon bulunmuştur (p=0,001, Spearman r=0.336). Başvuru sırasında toplam HDÖ puanı eştanılı grupta anlamlı olarak daha yüksek (p=0,027), intihar maddesi hem başvuru hem taburculukta anlamlı olarak yüksek bulunmuştur (p<0,001 ve p=0,035). Başvuru esnasında KPDÖ puanlarından, halüsinatuar davranış maddesi eştanılı grupta yüksek bulunmuştur (p=0,019). YMDÖ puanlarından konuşma hız ve miktarı hem başvuru hem taburculukta (sırasıyla p=0,027, p=0,006), içgörü maddesi ise başvuru esnasında eştanının olmadığı bipolar hasta grubunda yüksek bulunmuştur (p=0,018).

Sonuç: BB hastalarında DB eştanısı sorgulanmalıdır. DB eştanılı hastaların daha çok kadın cinsiyette ve daha genç yaşta olduğu, daha fazla depresyon puanlarına sahip olduğu; daha uzun süreli hastanede kalış süresine sahip olduğu bulunmuştur. Dissosiyasyon eştanısı varlığında, intihar girişim sayısı ve halüsinatuar davranışlarda artış görülebilir.

Anahtar Kelimeler

Bipolar bozukluk disosiyatif bozukluk komorbidite

Kaynakça

  • Kessler RC, Rubinow DR, Holmes C, Abelson JM, Zhao S. The epidemiology of DSM-III-R bipolar disorder I disorder in a general population survey. Psychol Med 1997;27: 1079-89.
  • Akiskal HS, Bourgeois ML, Angst J, Post R, Moller H,Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord 2000; 59(suppl 1): S5-S30.
  • Angst J, Gamma A, Benazzi F, Ajdacic V, Eich D, Rossler W. Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord 2003; 73:133-46.
  • McElroy SL. Diagnosing and treating comorbid (complicated) bipolar disorder. J Clin Psychiatry 2004; 65(suppl 15):35-44.
  • Vieta E, Colom F, Corbella B, et al. Clinical correlates of psychiatric comorbidity in bipolar I patients. Bipolar Disord 2001; 3:253-8.
  • Loewenstein RJ. Diagnosis, epidemiology, clinical course, treatment, and cost effectiveness of treatment for dissociative disorders and MPD: report submitted to the Clinton Administration. Dissociation 1994; 7:3–11.
  • Ross CA, Joshi S, Currie R. Dissociative experiences in the general population. American Journal of Psychiatry 1990; 147:1547–52.
  • Gershuny BS, Thayer JF. Relations among psychological trauma, dissociative phenomena, and trauma-related distress: a review and integration. Clin Psychol Rev 1999; 19:631-57.
  • Steiner H, Carrion V, Plattner B et al. Dissociative symptoms in posttraumatic stress disorder: diagnosis and treatment. Child Adolesc Psychiatr Clin N Am 2003; 12:231-49.
  • Schäfer I, Ross CA, Read J. Childhood trauma in psychotic and dissociative disorders. In Moskowitz A, Schäfer I, Dorahy MJ, (eds). Psychosis, trauma and dissociation. Emerging perspectives on severe psychopathology. Wiley-Blackwell; 2008.
  • Yargic LI, Sar V, Tutkun H, Alyanak B. Comparison of dissociative identity disorder with other diagnostic groups using a structured interview in Turkey. Compr Psychiatry 1998; 39:345–51.
  • Lipsanen T, Korkeila J, Peltola P, Jarvinen J, Langen K, Lauerma H. Dissociative disorders among psychiatric patients comparison with a nonclinical sample. Eur Psychiatry 2004; 19:53–5.
  • First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinical Version. Washington D.C, American Psychiatric Press; 1997.
  • Çorapçıoğlu A, Aydemir Ö, Yıldız M ve ark. DSM-IV Eksen I Bozuklukları (SCID-I) İçin Yapılandırılmış Klinik Görüşme, Klinik Versiyon. Ankara, Hekimler Yayın Birliği; 1999.
  • Hamilton M. A Rating Scale For Depression By Max Hamilton. J Neurol Neurosurg Psychiat 1960; 23: 56.
  • Akdemir A. Hamilton depresyon derecelendirme ölçeğinin geçerliği–güvenirliği ve klinikte kullanımı. 3P Dergisi 1996; 4: 251-9.
  • Young RC, Biggs JT, Ziegler et al. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978; 133: 429-35.
  • Karadağ F. Young mani değerlendirme ölçeğinin Türkçe çevirisinin güvenirlik ve geçerlik çalışması. Turk Psikiyatri Derg 2002; 13: 107-14.
  • Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Reports 1962;10: 799-812.
  • Soykan C. Institutional differences and case typicality as related to diagnosis system severity, prognosis and treatment. Master tezi, Ortadoğu Teknik Üniversitesi, Ankara; 1982.
  • Carlson EB. Putnam FW. Ross CA, et al. Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: a multicenter study. Am J Psychiatry 1993:150:1030-6.
  • Yargıç Lİ, Tutkun H, Şar V. The reliability and validity of the Turkish version of the Dissociative Experiences Scale. Dissociation 1995; 8:10-3.
  • Steinberg M: Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Revised. Washington, DC, American Psychiatric Press; 1994.
  • Şar V, Tutkun H, Yargıç Lİ ve ark: DSM-IV Dissosiyatif Bozukluklar İçin Yapılandırılmış Görüşme Çizelgesi (SCID-D) Türkçe Versiyon. İstanbul Tıp Fakültesi Psikiyatri Anabilim Dalı Klinik Psikoterapi Birimi, İstanbul; 1996.
  • Modestin J, Erni T. Testing the dissociative taxon. Psychiatry Res 2004;126:77-82.
  • Spitzer C, Barnow S, Grabe HJ et al. Frequency, clinical and demographic correlates of pathological dissociation in Europe. J Trauma Dissociation 2006; 7:51-62.
  • Latz TT, Kramer SI, Hughes DL. Multiple personality disorder among female inpatients in a state hospital. Am J Psychiatr 1995; 152:1343-8.
  • Saxe GN, van der Kolk BA, Berkowitz R, et al. Dissociative disorders in psychiatric inpatients. Am J Psychiatr 1993; 150:1037-42.
  • Tutkun H, Sar V, Yargic LI, Ozpulat T, Yanik M, Kiziltan E. Frequency of dissociative disorders among psychiatric inpatients in a Turkish University Clinic. Am J Psychiatr 1998; 155:800-5.
  • Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry 2005; 186:121-5.
  • Sar V, Akyuz G, Dogan O. Prevalence of dissociative disorders among women in the general population. Psychiatr Res 2007; 149:169–76.
  • Coryell W, Endicott J, Maser JD, Keller MB, Leon AC, Akiskal HS. Long-term stability of polarity distinctions in the affective disorders. Am J Psychiatry 1995; 152(3):385–90.
  • Fiedorowicz JG, Endicott J, Leon AC, Solomon DA, Keller MB, Coryell WH. Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder. Am J Psychiatry 2011;168(1):40-8.
  • Ross CA, Norton GR. Multiple personality patients with a past diagnosis of schizophrenia. Dissociation 1988; 1(2):39-42.
  • Coryell W. Single case study. Multiple personality and primary affective disorder. J Nerv Ment Dis 1983; 171(6):388-90.
  • Bliss EL. A symptom profile of patients with multiple personalities, including MMPI results. J Nerv Ment Dis 1984;172:197–202.
  • Steingard S, Frankel FH. Dissociation and psychotic symptoms. Am J Psychiatry 1985; 142(8): 953.
  • Gupta R, Chawla LS. Dissociation in endogenous psychosis. Am J Psychiatry 1991; 148(3):395-6.
  • Giese AA, Thomas MR, Dubovsky SL. Dissociative symptoms in psychotic mood disorders: an example of symptom nonspecificity. Psychiatry 1997; 60:60-6.
  • Michelson L, June K, Vives A, et al. The role of trauma and dissociation in cognitive-behavioral psychotherapy outcome and maintenance for panic disorder with agoraphobia. Behav Res Ther 1998; 36:1011-50.
  • Rufer M, Held D, Cremer J, et al. Dissociation as a predictor of cognitive behavior therapy outcome in patients with obsessive compulsive disorder. Psychother Psychosom 2006; 75:40-6.
  • Daruy-Filho L, Brietzke E, Lafer B, Grassi-Oliveira R. Childhood maltreatment and clinical outcomes of bipolar disorder. Acta Psychiatr Scand 2011
  • McIntyre RS, Soczynska JK, Mancini D, et al. The relationship between childhood abuse and suicidality in adult bipolar disorder. Violence Vict 2008; 23(3):361-72.
  • Seedat S, Stein MB, Forde DR. Prevalence of dissociative experiences in a community sample: relationship to gender, ethnicity, and substance use. J Nerv Ment Dis 2003; 191:115-20.
  • Foote B, Smolin Y, Neft DI, Lipschitz D. Dissociative disorders and suicidality in psychiatric outpatients. J Nerv Ment Dis 2008; 196(1):29-36.
  • Ross AC. Multiple personality disorder. Diagnosis, clinical features, and treatment. John Wiley & Sons, NewYork, 1989.
  • Oztürk E, Sar V. Somatization as a predictor of suicidal ideation in dissociative disorders. Psychiatry Clin Neurosci 2008; 62(6):662-8.
  • Sar V, Akyuz G, Kundakci T, et al. Childhood trauma, dissociation,and psychiatric comorbidity in patients with conversion disorder. Am J Psychiatry 2004; 162:271–6.
  • Ross CA, Norton GR. Differences between men and women with multiple personality disorder. Hosp Community Psychiatry 1989; 40(2):186-8.
  • Kluft RP. The dissociative disordes. In Talbot JA, HalesRE, Yudofsky SC (eds). The American Psychiatric Press Textbook of Psychiatry. Washington DC, American Psychiatric Press; 1988.
  • Putnam FW. Diagnosis and treatment of multiple personality disorder. NewYork, Guilford; 1989.
  • Ashton AK. Structured sexual therapy with severely dissociative patients. J Sex Marital Ther 1995; 21(4):276-81.
  • Coons PM, Milstein V. psychosexual disturbances in ple personality: characteristics, etiology, and treatment. J Clin Psychiatry 1986; 47:106-10.
  • Allen JG, Coyne L, Console DA. Dissociative detachment relates to psychotic symptoms and personality decompensation. Comprehensive Psychiatry 1997; 38:327–34.
  • Sar V, Kundakci T, Kiziltan E, et al. The Axis-I dissociative disorder comorbidity of borderline personality disorder among psychiatric outpatients. J Trauma Dissociation 2003; 4:119–36.
  • Coons PM, Sterne AL. Initial and follow-up psychological testing on a group of patients with multiple personality disorder. Psychol Rep 1986; 58:43-9.
  • Akyüz G, Doğan O, Şar V, et al. Frequency of dissociative identity disorder in the general population in Turkey. Compr Psychiatry 1999; 40:20-4.
  • American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington D.C., American Psychiatric Association; 1994.

Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder

Yıl 2016, Cilt: 1 Sayı: 2, 35 - 42, 30.08.2016

Bahadır Bakım , Elif Baran Sinan Yayla Abdullah Akpinar , Hakan Serdar Sengul Hulya Ertekin , Mehmet Diyaddin Güleken Onur Tankaya Omer Akil Ozer Kayıhan Oguz Karamustafalioglu

https://doi.org/10.22391/920.256690
Cited By: 1

Öz

Introduction: This study aims to compare sociodemographic characteristics of the patients with bipolar disorder (BD) with and without comorbid dissociative disorder (DD) and to investigate the eventual effect of the comorbidity on the treatment.

Methods: We enrolled a total of 149 patients diagnosed with BD and treated as inpatients consecutively in Şişli Etfal Hospital, Psychiatry Clinic between 2010 and 2011. For the patients who were diagnosed with DD using SCID-D and with BD using SCID-I, sociodemographic characteristics, YMRS, HAM-D, BPRS, DES scores and duration and number of hospital stays were evaluated.

Results: 23 patients (15.4%) had dissociative disorder not otherwise specified (DD-NOS), 4 patients (2.6%) had dissociative identity disorder (DID) and 1 patient (0.6%) had dissociative amnesia. BD patients with comorbid DD were found to be predominantly female (p=0.015) and younger (p=0.002) and to have significantly higher DES scores than BD patients without DD (p<0.001). The total score of DES was correlated with duration hospital stay (p=0.001, Spearman r=0.336) in the total sample. Total HAM-D score at the time of admission was significantly higher in the comorbidity group (p=0.027), and suicide item was found to be significantly higher both at admission and at discharge (p<0.001 and p=0.035). Among BPRS scores at admission, hallucinatory behavior item was found to be higher in the comorbidity group (p=0.019). Among YMRS scores both at admission and at discharge, velocity and amount of speech item (p=0.027) and insight item at admission (p=0.006) was found to be significantly higher in the pure bipolar group (p=0.018).

Conclusion: In patients with BD, DD comorbidity should be investigated. The BD patients with DD comorbidity tend to be female and younger, and show higher depression scores, leading to a prolonged hospital stay. In the presence of dissociation comorbidity, attempts and number of suicides and hallucinatory behaviors seem to be increased.

Anahtar Kelimeler

bipolar disorder dissociative disorder comorbidity

Kaynakça

  • Kessler RC, Rubinow DR, Holmes C, Abelson JM, Zhao S. The epidemiology of DSM-III-R bipolar disorder I disorder in a general population survey. Psychol Med 1997;27: 1079-89.
  • Akiskal HS, Bourgeois ML, Angst J, Post R, Moller H,Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord 2000; 59(suppl 1): S5-S30.
  • Angst J, Gamma A, Benazzi F, Ajdacic V, Eich D, Rossler W. Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord 2003; 73:133-46.
  • McElroy SL. Diagnosing and treating comorbid (complicated) bipolar disorder. J Clin Psychiatry 2004; 65(suppl 15):35-44.
  • Vieta E, Colom F, Corbella B, et al. Clinical correlates of psychiatric comorbidity in bipolar I patients. Bipolar Disord 2001; 3:253-8.
  • Loewenstein RJ. Diagnosis, epidemiology, clinical course, treatment, and cost effectiveness of treatment for dissociative disorders and MPD: report submitted to the Clinton Administration. Dissociation 1994; 7:3–11.
  • Ross CA, Joshi S, Currie R. Dissociative experiences in the general population. American Journal of Psychiatry 1990; 147:1547–52.
  • Gershuny BS, Thayer JF. Relations among psychological trauma, dissociative phenomena, and trauma-related distress: a review and integration. Clin Psychol Rev 1999; 19:631-57.
  • Steiner H, Carrion V, Plattner B et al. Dissociative symptoms in posttraumatic stress disorder: diagnosis and treatment. Child Adolesc Psychiatr Clin N Am 2003; 12:231-49.
  • Schäfer I, Ross CA, Read J. Childhood trauma in psychotic and dissociative disorders. In Moskowitz A, Schäfer I, Dorahy MJ, (eds). Psychosis, trauma and dissociation. Emerging perspectives on severe psychopathology. Wiley-Blackwell; 2008.
  • Yargic LI, Sar V, Tutkun H, Alyanak B. Comparison of dissociative identity disorder with other diagnostic groups using a structured interview in Turkey. Compr Psychiatry 1998; 39:345–51.
  • Lipsanen T, Korkeila J, Peltola P, Jarvinen J, Langen K, Lauerma H. Dissociative disorders among psychiatric patients comparison with a nonclinical sample. Eur Psychiatry 2004; 19:53–5.
  • First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinical Version. Washington D.C, American Psychiatric Press; 1997.
  • Çorapçıoğlu A, Aydemir Ö, Yıldız M ve ark. DSM-IV Eksen I Bozuklukları (SCID-I) İçin Yapılandırılmış Klinik Görüşme, Klinik Versiyon. Ankara, Hekimler Yayın Birliği; 1999.
  • Hamilton M. A Rating Scale For Depression By Max Hamilton. J Neurol Neurosurg Psychiat 1960; 23: 56.
  • Akdemir A. Hamilton depresyon derecelendirme ölçeğinin geçerliği–güvenirliği ve klinikte kullanımı. 3P Dergisi 1996; 4: 251-9.
  • Young RC, Biggs JT, Ziegler et al. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978; 133: 429-35.
  • Karadağ F. Young mani değerlendirme ölçeğinin Türkçe çevirisinin güvenirlik ve geçerlik çalışması. Turk Psikiyatri Derg 2002; 13: 107-14.
  • Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Reports 1962;10: 799-812.
  • Soykan C. Institutional differences and case typicality as related to diagnosis system severity, prognosis and treatment. Master tezi, Ortadoğu Teknik Üniversitesi, Ankara; 1982.
  • Carlson EB. Putnam FW. Ross CA, et al. Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: a multicenter study. Am J Psychiatry 1993:150:1030-6.
  • Yargıç Lİ, Tutkun H, Şar V. The reliability and validity of the Turkish version of the Dissociative Experiences Scale. Dissociation 1995; 8:10-3.
  • Steinberg M: Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Revised. Washington, DC, American Psychiatric Press; 1994.
  • Şar V, Tutkun H, Yargıç Lİ ve ark: DSM-IV Dissosiyatif Bozukluklar İçin Yapılandırılmış Görüşme Çizelgesi (SCID-D) Türkçe Versiyon. İstanbul Tıp Fakültesi Psikiyatri Anabilim Dalı Klinik Psikoterapi Birimi, İstanbul; 1996.
  • Modestin J, Erni T. Testing the dissociative taxon. Psychiatry Res 2004;126:77-82.
  • Spitzer C, Barnow S, Grabe HJ et al. Frequency, clinical and demographic correlates of pathological dissociation in Europe. J Trauma Dissociation 2006; 7:51-62.
  • Latz TT, Kramer SI, Hughes DL. Multiple personality disorder among female inpatients in a state hospital. Am J Psychiatr 1995; 152:1343-8.
  • Saxe GN, van der Kolk BA, Berkowitz R, et al. Dissociative disorders in psychiatric inpatients. Am J Psychiatr 1993; 150:1037-42.
  • Tutkun H, Sar V, Yargic LI, Ozpulat T, Yanik M, Kiziltan E. Frequency of dissociative disorders among psychiatric inpatients in a Turkish University Clinic. Am J Psychiatr 1998; 155:800-5.
  • Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry 2005; 186:121-5.
  • Sar V, Akyuz G, Dogan O. Prevalence of dissociative disorders among women in the general population. Psychiatr Res 2007; 149:169–76.
  • Coryell W, Endicott J, Maser JD, Keller MB, Leon AC, Akiskal HS. Long-term stability of polarity distinctions in the affective disorders. Am J Psychiatry 1995; 152(3):385–90.
  • Fiedorowicz JG, Endicott J, Leon AC, Solomon DA, Keller MB, Coryell WH. Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder. Am J Psychiatry 2011;168(1):40-8.
  • Ross CA, Norton GR. Multiple personality patients with a past diagnosis of schizophrenia. Dissociation 1988; 1(2):39-42.
  • Coryell W. Single case study. Multiple personality and primary affective disorder. J Nerv Ment Dis 1983; 171(6):388-90.
  • Bliss EL. A symptom profile of patients with multiple personalities, including MMPI results. J Nerv Ment Dis 1984;172:197–202.
  • Steingard S, Frankel FH. Dissociation and psychotic symptoms. Am J Psychiatry 1985; 142(8): 953.
  • Gupta R, Chawla LS. Dissociation in endogenous psychosis. Am J Psychiatry 1991; 148(3):395-6.
  • Giese AA, Thomas MR, Dubovsky SL. Dissociative symptoms in psychotic mood disorders: an example of symptom nonspecificity. Psychiatry 1997; 60:60-6.
  • Michelson L, June K, Vives A, et al. The role of trauma and dissociation in cognitive-behavioral psychotherapy outcome and maintenance for panic disorder with agoraphobia. Behav Res Ther 1998; 36:1011-50.
  • Rufer M, Held D, Cremer J, et al. Dissociation as a predictor of cognitive behavior therapy outcome in patients with obsessive compulsive disorder. Psychother Psychosom 2006; 75:40-6.
  • Daruy-Filho L, Brietzke E, Lafer B, Grassi-Oliveira R. Childhood maltreatment and clinical outcomes of bipolar disorder. Acta Psychiatr Scand 2011
  • McIntyre RS, Soczynska JK, Mancini D, et al. The relationship between childhood abuse and suicidality in adult bipolar disorder. Violence Vict 2008; 23(3):361-72.
  • Seedat S, Stein MB, Forde DR. Prevalence of dissociative experiences in a community sample: relationship to gender, ethnicity, and substance use. J Nerv Ment Dis 2003; 191:115-20.
  • Foote B, Smolin Y, Neft DI, Lipschitz D. Dissociative disorders and suicidality in psychiatric outpatients. J Nerv Ment Dis 2008; 196(1):29-36.
  • Ross AC. Multiple personality disorder. Diagnosis, clinical features, and treatment. John Wiley & Sons, NewYork, 1989.
  • Oztürk E, Sar V. Somatization as a predictor of suicidal ideation in dissociative disorders. Psychiatry Clin Neurosci 2008; 62(6):662-8.
  • Sar V, Akyuz G, Kundakci T, et al. Childhood trauma, dissociation,and psychiatric comorbidity in patients with conversion disorder. Am J Psychiatry 2004; 162:271–6.
  • Ross CA, Norton GR. Differences between men and women with multiple personality disorder. Hosp Community Psychiatry 1989; 40(2):186-8.
  • Kluft RP. The dissociative disordes. In Talbot JA, HalesRE, Yudofsky SC (eds). The American Psychiatric Press Textbook of Psychiatry. Washington DC, American Psychiatric Press; 1988.
  • Putnam FW. Diagnosis and treatment of multiple personality disorder. NewYork, Guilford; 1989.
  • Ashton AK. Structured sexual therapy with severely dissociative patients. J Sex Marital Ther 1995; 21(4):276-81.
  • Coons PM, Milstein V. psychosexual disturbances in ple personality: characteristics, etiology, and treatment. J Clin Psychiatry 1986; 47:106-10.
  • Allen JG, Coyne L, Console DA. Dissociative detachment relates to psychotic symptoms and personality decompensation. Comprehensive Psychiatry 1997; 38:327–34.
  • Sar V, Kundakci T, Kiziltan E, et al. The Axis-I dissociative disorder comorbidity of borderline personality disorder among psychiatric outpatients. J Trauma Dissociation 2003; 4:119–36.
  • Coons PM, Sterne AL. Initial and follow-up psychological testing on a group of patients with multiple personality disorder. Psychol Rep 1986; 58:43-9.
  • Akyüz G, Doğan O, Şar V, et al. Frequency of dissociative identity disorder in the general population in Turkey. Compr Psychiatry 1999; 40:20-4.
  • American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington D.C., American Psychiatric Association; 1994.
Toplam 58 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Bahadır Bakım

Elif Baran

Sinan Yayla

Abdullah Akpinar

Hakan Serdar Sengul

Hulya Ertekin

Mehmet Diyaddin Güleken

Onur Tankaya

Omer Akil Ozer

Kayıhan Oguz Karamustafalioglu

Yayımlanma Tarihi 30 Ağustos 2016
Gönderilme Tarihi 20 Nisan 2016
Kabul Tarihi 13 Temmuz 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 1 Sayı: 2

Kaynak Göster

APA Bakım, B., Baran, E., Yayla, S., … Akpinar, A. (2016). Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder. Family Practice and Palliative Care, 1(2), 35-42. https://doi.org/10.22391/920.256690
AMA Bakım B, Baran E, Yayla S, vd. Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder. Fam Pract Palliat Care. Ağustos 2016;1(2):35-42. doi:10.22391/920.256690
Chicago Bakım, Bahadır, Elif Baran, Sinan Yayla, Abdullah Akpinar, Hakan Serdar Sengul, Hulya Ertekin, Mehmet Diyaddin Güleken, Onur Tankaya, Omer Akil Ozer, ve Kayıhan Oguz Karamustafalioglu. “Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder”. Family Practice and Palliative Care 1, sy. 2 (Ağustos 2016): 35-42. https://doi.org/10.22391/920.256690.
EndNote Bakım B, Baran E, Yayla S, Akpinar A, Sengul HS, Ertekin H, Güleken MD, Tankaya O, Ozer OA, Karamustafalioglu KO (01 Ağustos 2016) Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder. Family Practice and Palliative Care 1 2 35–42.
IEEE B. Bakım vd., “Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder”, Fam Pract Palliat Care, c. 1, sy. 2, ss. 35–42, 2016, doi: 10.22391/920.256690.
ISNAD Bakım, Bahadır vd. “Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder”. Family Practice and Palliative Care 1/2 (Ağustos2016), 35-42. https://doi.org/10.22391/920.256690.
JAMA Bakım B, Baran E, Yayla S, Akpinar A, Sengul HS, Ertekin H, Güleken MD, Tankaya O, Ozer OA, Karamustafalioglu KO. Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder. Fam Pract Palliat Care. 2016;1:35–42.
MLA Bakım, Bahadır vd. “Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder”. Family Practice and Palliative Care, c. 1, sy. 2, 2016, ss. 35-42, doi:10.22391/920.256690.
Vancouver Bakım B, Baran E, Yayla S, Akpinar A, Sengul HS, Ertekin H, vd. Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder. Fam Pract Palliat Care. 2016;1(2):35-42.

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Investigation of the comorbidity of dissociative disorders in patients with bipolar disorder
The European Research Journal
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https://doi.org/10.18621/eurj.412272
 Kapak Resmi İndir

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505