Aleksitimi ve Behçet Hastalığı

Yıl 2021, Cilt: 13 Sayı: 2, 186 - 191, 07.06.2021

Munise Daye , İnci Mevlitoğlu Mine Şahingöz , Tahir Kemal Şahin

https://doi.org/10.18521/ktd.834163

Öz

Amaç: Behçet Hastalığı (BH) immunoinflamatuar sistemik bir hastalıktır. Genç erişkinlerde sıklıkla genital ülserasyon, üveit ve oral aft ile seyretmektedir. Bazı hastalarda BH santral sinir sistemini etkileyebilmektedir ve bazen psikiyatrik semptomlar hastalığa eşlik edebilmektedir.Literatürde BH'nın aleksitimi ile ilişkisini değerlendiren az sayıda çalışma bulunmaktadır. Bu çalışmada BH ve aleksitimi arasındaki ilişki değerlendirilmektedir.

Gereç ve Yöntem: İnternasyonal Çalışma Grubu Behçet hastalığı tanı kriterlerine göre tanı almış 50 olgu çalışmaya dahil edildi. Olgulara, yaş cinsiyet eşlemeli 50 kişilik kontrol grubu oluşturuldu. Beck Depresyon Envanteri (BDE), Beck Anksiyete Envanteri (BAE) ve Toronto Aleksitimi s kalasının (TAS) Türkçe versiyonu olgulara ve kontrollere uygulandı.

Bulgular: TAS skalasının aleksitimi: yok, orta ve şiddetli aleksitimik olarak sınıflandırıldı. TAS sınıflandırılmasında olgu ve kontrol grubu arasında anlamlı fark saptandı (p = 0.019). Behçet hastalığı olan olgularda aleksitimi kontrole göre 6 kat daha fazlaydı (OR = 6.139) (95% CI = 1,657-23.913).

Sonuç: Behçet hastalığı aleksitimi ile kuvvetle ilişkilidir. Bu psikiyatrik semptomları farketmek Behçet olgularını tedavi etmek açısından önemlidir. Dermatologların olgularında psikoterapotik değerlendirmeleri unutmaması gerektiğini düşünmekteyiz.

Anahtar Kelimeler

Behçet hastalığı, Aleksitimi, Toronto alkesitimi skalası

Alexithymia And Behçet’s Disease

Öz

Objective: Behçet’s Disease (BD) is an immunoinflammatory systemic disease. In young adults, it is seen as genital ulceration, uveitis and oral aphthae. In some patients, BD may affect the central nervous system and some psychiatric symptoms may accompany this disease. There are few studies in the literature evaluating the relationship between BD and alexithymia. In this study, the relationship between BD and alexithymia is evaluated.

Methods: Fifty patients diagnosed according to the International Study Group for Behçet’s Disease diagnostic criteria and fifty age and gender-matched healthy individuals were included in the study. Turkish versions of Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Toronto Alexithymia Scale (TAS-20) were applied to the patients and controls.

Results: According to the TAS-20 scale, alexithymia was classified as: non-alexithymia, moderate and severe alexithymia. In the classification of TAS, there was a significant difference between the cases and the control group (p = 0.019).In patients with BD, alexithymia was 6 times higher than control group (OR = 6.139)(95% CI = 1,657-23.913).

Conclusions: Behçet’s disease is strongly associated with alexithymia. Recognizing of these psychiatric symptoms is important for the management of BD patients. Psychotherapeutic interventions should be planned by dermatologists.

Anahtar Kelimeler

Behçet’s disease, alexithymia, Toronto Alexithymia Scale

Kaynakça

• 1. Cho SB, Cho S, Bang D. New insights in the Clinical Aspects of Understanding of Behçet's Disease Yonsei Med J 2012;53(1):35-42.
• 2. Calıkoglu E, Onder M, Cosar B, Candan, Sayar S: Depression, anxiety levels andgeneral psychological profile in Behçet’s disease. Dermatology 2001; 203: 238-40.
• 3. Monastero R, Camarda C, Pipia C, Lopez G, Camarda L et al. Cognitive impairment in Behcet’s disease patients without overt neurological involvement. J Neurol Sci 2004; 220: 99–104.
• 4. Epstein RS, Cummings NA, Sherwood EB, Bersma D. Psychiatric aspects of Behçet’s syndrome. J Psychosom Res 1970; 14:161–72.
• 5. Gupta MA, Gupta AK. Psychodermatology: an update. J Am Acad Dermatol 1996;34:1030–46.
• 6. Willemsen R, Roseeuw D, Vanderlinden J. Alexithymia and dermatology: the state of the art. Int J Dermatol 2008;47:903–10.
• 7. Bagby RM, Parker JDA, Taylor GJ. The twenty-item Toronto Alexithymia Scale: I. Item selection and cross-validation of the factor structure. J Psychosom Res 1994;38:23 – 32.
• 8. Parker JDA, Bagby RM, Taylor GJ, Endler NS, Schmidt P. Factorial validity of the 20-item Toronto Alexithymia Scale. Eur J Pers 1993;7:221– 32.
• 9. Espina A. Alexithymia in parents of daughters with eating disorders Its relationships with psychopathological and personality variables. J Psychosomatic Research 2003; (55):553– 60.
• 10. Taylor GJ, Ryan DP, Bagby RM. Toward the development of a new self-report alexithymia scale. Psychother Psychosom 1985;44:191–9.
• 11. Taylor GJ, Bagby RM. New trends in alexithymia research. Psychoter Psychosom 2004;73:68–77.
• 12. Sunay D, Baykir M, Ateş G, Ekşioğlu M. Alexithymia and Acne Vulgaris: A Case Control Study. Psychiatry Investig 2011; 8:327-333.
• 13. Talamonti M, Galluzzo M, Servoli S, Bianchi SDL. Alexithymia and Plaque Psoriasis: Preliminary Investigation in a Clinical Sample of 250 Patients. Dermatology 2016;232:648-654.
• 14. Sellami R, Masmoudi J, Ouali U, Mnif L, Amouri M, Turki H et al. The Relationship Between Alopecia Areata and Alexithymia, Anxiety and Depression: A Case-Control Study. Indian J Dermatol 2014; 59(4): 421.
• 15. International Study Group for Behçet’s Disease. Criteria for diagnosis of Behçet’s disease. Lancet 1990; 335: 1078–1080.
• 16. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; (4): 561–571.
• 17. Hisli N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerliliği ve güvenilirliği. Psikoloji Dergisi 1989;( 7):3–13.
• 18. Beck AT, Epstein N, Brown G, Steer RA.. An inventory of measuring clinical anxiety psychometric properties. J Consult Clin Psychol 1998;( 56): 893–97.
• 19. Ulusoy M, Sahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cognit Psychother 1998; 12: 28–35.
• 20. Güleç H, Köse S, Yazıcı, Güleç M ve ark. Yirmi soruluk Toronto Aleksimi Ölçeği'nin Türkçe uyarlamasının geçerlik ve güvenirliğinin incelenmesi. Klinik Psikofarmakoloji Bülteni 2009;19(3):213-219.
• 21. Takeuchi M. Kastner DL, Remmers EF. The immunogenetics of Behçet's disease: A comprehensive review. Journal of Autoimmunity 2015;(64):137-148.
• 22. Gül IG, BE Kartalcı,Y Cumurcu . S Karıncaoğlu, Karlıdağ R.Evaluation of sexual function in patients presenting with Behcet’s disease with or without depression. JEADV 2012;27(10):1244-1251. 23. Karlıdağ R, Ünal S, Evereklioğlu C, Sipahi B, Er H, Yologlu S.. Stressful life events, anxiety, depression and coping mechanisms in patients with Behçet’s disease. J Eur Acad Dermatol Venereol 2003; 17: 670–675.
• 24. Wise TN, Mann LS, Mitchell JD, Hryvniak M, Hill B. Secondary alexithymia: an empirical validation. Compr Psychiatry 1990; 31: 284–288.Gupta MA, Gupta AK. Psychodermatology: an update. J Am Acad Dermatol 1996; 34:1030–46.
• 25. Berthoz S, Consoli S, Perez-Diaz F. Alexithymia and anxiety: compounded relationships? A psyhometric study. Eur Psychiatry 1999; 14:372–8.
• 26. Karukivi M, Hautala L, Kaleva O. Alexithymia is associated with anxiety among adolescents. J Affective Disorders 2010; 125(1–3):383–7.
• 27. Taylor GJ. Recent developments in alexithymia theory and research. Can J Psychiatry 2000; 45:134–42. 28. Korkoliakou P, Christodoulou C, Kouris A, Kokkevi A,Porichi E, Efstathiou V, Kaloudi E, Stavrianeas N Papageorgiou C, Douzenis A. Alexithymia, anxiety and depression in patients with psoriasis: a case–control study. Annals of General Psychiatry 2014;(13):38 .
• 29. Picardi A, Pasquini P, Cattaruzza MS, Gaetano P, Melchi CF, Baliva G,et al. Stressful life events, social support, attachment security and alexithymia in vitiligo. A case-control study. Psychother Psychosom 2003;72:150-158.
• 30. Bozkurt A, Kose O, Karlıdere T, Erdem M, Ak M, Özmenler N. Alexithymia in patients with seborrhoeic dermatitis. Anatol J Psychiatry 2011; 12:44–8.
• 31. Cömert A, Akbaş B, Kılıç EZ, Akın O, Gökçe E, Göktuna Z, et al. Psychiatric Comorbidities and Alexithymia in Patients with Seborrheic Dermatitis: A Questionnaire Study in Turkey. Am J Clin Dermatol 2013; 14:335–342.