Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study

GÖNCÜ, Tuğba; izci, filiz; SEMİZ, Ümit Başar; Yalçın, Murat; BİLİCİ, Rabia; AKDUR, Özgür; TERZİ, Ayşe; ZİNCİR BOZKURT, Selma; GICA, ŞAKİR; zincir, serkan

Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study

Filiz İZCİ, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Selma ZİNCİR BOZKURT, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Serkan ZİNCİR, (Gölcük Askeri Hastanesi, Psikiyatri Kliniği, İstanbul, Türkiye)

Rabia BİLİCİ, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Murat YALÇIN, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Ayşe TERZİ, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Tuğba GÖNCÜ, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Özgür AKDUR, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Şakir GICA, (Erenköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Ümit Başar SEMİZ (Muğla Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, Muğla, Türkiye)

Journal of Mood Disorders

9 3

Yıl: 2015 Cilt: 5 Sayı: 1 Sayfa Aralığı: 8 - 15 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study

Öz:

Amaç: Bu çalışmada; İki Uçlu Bozukluk (İUB) hastalarındaintihar girişimi öyküsü olan ve olmayan hastaların mizaçkarakter özellikleri ile dürtüsellik ve işlevsellik düzeylerininkarşılaştırılması amaçlandı. Yöntem: Çalışmaya Erenköy Ruh ve Sinir HastalıklarıEğitim ve Araştırma Hastanesi psikiyatri polikliniğine başvuran 101 İUB hastası ile yaş ve cinsiyet açısından eşleştirilmiş 50 sağlıklı bireyden oluşan kontrol grubu alındı.Hasta ve kontrol grubuna DSM-IV Eksen-I Bozuklukları içinYapılandırılmış Klinik Görüşme Ölçeği (SCID-I), Mizaç veKarakter Envanteri (MKE), Barratt Dürtüsellik Ölçeği-11(BDÖ-11) uygulanırken, hasta grubuna ek olarak HamiltonDepreyon Ölçeği (HAM-D), Young-Mani DerecelendirmeÖlçeği (YMDÖ), İki Uçlu Bozukluk İşlevsellik Ölçeği (İUBİÖ)uygulandı.Bulgular: Hasta ve kontrol grubu arasında sosyodemografik özellikler açısından anlamlı bir fark yoktu (p<0,05).Hasta grubun yaş ortalaması 35,69±12,10, kontrol grubunun yaş ortalaması 32,00±9,24 idi. Hasta grupta 38(%37,62) kişinin intihar girişiminde bulunduğu saptandı.İntihar girişiminde bulunan hasta grubu ile intihar girişimiolmayan hasta grubunun sağlıklı kontrol grubu ile karşılaştırılması sonucu; işbirliği yapma (İY), kendini yönetme(KY), kendini aşma (KA), yenilik arayışı alt grubu (YA2),zarardan kaçınma alt grubu (ZK4), ödül bağımlılığı altgrubu (ÖB2), BİÖ, BDÖ toplam skorlarında gruplar arasındaanlamlı fark vardı.Tartışma: Araştırmamızda intihar girişimi olan hasta grubunun, kişilik patolojilerine yatkınlığı gösteren İY, KY skorlarının anlamlı olarak düşük bulunması İUB hastalarındakişilik bozukluklarının intihar girişimi ile ilişkili olabileceğinidüşündürmüştür. Ayrıca intihar girişimi olan hasta grubunun dürtüsellik düzeylerinin daha yüksek çıkması ve ikiuçlu bozukluk işlevsellik düzeylerinin daha düşük olmasıintihar girişiminin bu hastalarda işlevsellik düzeylerinidaha bozduğunu, intiharın bu hastalarda daha dürtüselolarak ortaya çıkmış olabileceğini göstermiştir.

Anahtar Kelime:

Konular: Psikiyatri

İntihar girişimi olan ve olmayan İki Uçlu Bozukluk hastalarında mizaç-karakter özel- likleri, dürtüsellik ve işlevsellik düzeyleri: Kontrollü bir çalışma

Öz:

Objective: In this study, we aimed to comparetemperament-character features, impulsiveness andfunctionality levels of bipolar patients who attemptedsuicide and who did not. Methods: One hundred one patients admitted to ErenköyMental Health Training and Research Hospital who werediagnosed with bipolar disorder according to DSM-IV-TR and50 healthy age and gender-matched controls are includedin this study. We applied Sociodemographical and ClinicalData Form and Diagnostic and Statistical Manual of MentalDisorders Axis-I Structured Clinical Interview for DSM-IV(SCID-I), Temperament and Character Inventory (TCI),Barratt Impulsiveness Scale-11 (BIS-11) to both patientand control groups; Hamilton Rating Scale for Depression(HRSD), Young Mania Rating Scale (YMRS), Bipolar DisorderFunctioning Questionnaire (BDFQ) to only patient group. Results: There was not any statistically significantdifference in sociodemographic features between thepatient and control group (p>0.05). Mean age of thepatient group was 35,69±12,10, mean age of the controlgroup was 32,00±9,24. 38 individuals (%37,62) in thepatient group were found to have one or more suicidalattempts. In the comparison between the patient groupthat attempted suicide and the patient group withoutsuicidal attempt, statistically significant differences werefound in cooperativeness (C), self-directedness (SD), selftranscendence (ST), novelty seeking subgroup (NS2), harmavoidance subgroup (HA4), reward dependency subgroup(RD2) and total scores of BDFQ and BIS-11. Discussion: In our study, the statistically significant lowerC and SD scores found in suicide attempters, which pointsout tendency to personality disorders, suggests thatpersonality disorders might be associated with suicideattempts in bipolar disorder patients. In addition to this,higher impulsiveness and lower bipolar functionalityscores that found in suicide attempters suggests that thesesuicide attempts might be more impulsive attempts andimpair patients functionality.

Anahtar Kelime:

Konular: Psikiyatri

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Özsoy S, Eşel E. İntihar (Özkıyım). Anadolu Psikiyatri Dergisi. 2003;4:175-85.
2. Qin P, Agerbo E, Mortensen PB. Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark 1981- 1997. Am J Psychiatry. 2003;160:765-72.
3. Beautrais AL, Joyce PR, Mulder RT, Pergusson DM, Deavoll BJ, Nightingale SK. Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study. Am J Psychiatry. 1996;153:1009-14.
4. Schneider B, Wetterling T, Sargk D, Schneider F, Schnabel A, Maurer K, Fritze J. Axis I disorders and personality disorders as risk factors for suicide. European Archives of Psychiatry Clinical Neuroscience. 2006;256:17-27.
5. Groholt B, Ekeberg O, Wichstrom L, Haldorsen T. Suicidal and non-suicidal adolescents: different factors contribute to self- esteem. Suicide Life Threat Behavior. 2005;35:525-35.
6. Dilsaver SC, Chen YW, Swann AC, Shoaib AM, Tsai-Dilsaver Y, Krajewski KJ. Suicidality, panic disoder and psychosis in bipolar depression, depressive-mania and pure-mania. Psychiatry Research. 1997;73:47-56.
7. Tidemalm D, Elofsson S, Stefansson CG, Waern M, Runeson B. Predictors of suicide in a community-based cohort of individuals with severe mental disorder. Social Psychiatry and Psychiatric Epidemiology. 2005;40:595-600.
8. Ak M, Özmenler KN, Özşahin A. İntihar girişimi ile mizaç ve karakter özellikleri arasındaki ilişkinin major depresif bozukluk örnekleminde irdelenmesi. Klinik Psikiyatri Dergisi. 2008;11:33-41.
9. Becerra B, Paez F, Robles-Garcia R, Vela GE. Temperament and character profile of persons with suicide attempt. Actas Esp Psiquiatr. 2005;33:117-22.
10. Bulik CM, Sullivan PF, Joyce PR. Temperament, character and suicide attemts in anorexia nervosa, bulimia nervosa and major depression. Acta Psychiatr Scandinavica. 1999;100:27-32.
11. Engstrom C, Brandstrom S, Sigvardsson S, Cloninger CR, Nylander PO. Bipolar Disorder. III: harm avoidance a risk factor for suicide attempts. Bipolar Disorders Journal. 2004;6:130-8.
12. Heeringen CV, Audenaert K, Van LK, Dumont F, Slegers G, Mertens J et al. Prefrontal 5-HT2a receptor binding index, hopelessness and personality characteristics in attempted suicide. Journal of Affective Disorders. 2003;74:149-58.
13. Grucza RA, Przybeck TR, Cloninger CR. Personality as a mediator of demographic risk factors for suicide attempts in a community sample. Comprehensive Psychiatry Journal. 2005;46:214-22.
14. Young LT, Bagby MR, Cooke RG, Parker JDA, Levitt AJ, Joffe RT. A comparison of Tridimensional Personality Questionnaire dimensions in bipolar patients and unipolar depression. Psychiatry Research. 1995;58:139-43.
15. Osher Y, Lefkifker E, Kotler M. Low persistence in euthymic manic- depressive patients: a replication. Journal Affective Disorders. 1999;53:87-90.
16. Jylha P, Ketokivi M, Mantere O, Melartin T, Suominen K, Vuorilehto M, Holma M, Holma I, Isometsa. Temperament, character and personality disorders. European Psychiatry. 2013;28:483-91.
17. Pawlak J, Dmitrzak-Weglarz M, Skibinska M, Szczepankiewicz A, Leszczynska-Rodziewicz A, Rajewska-Rager A, Maciukiewicz M, Czerski P, Hauser J. Suicide attempts and psychological risk factors in patients with bipolar and unipolar affective disorder. General Hospital Psychiatry. 2013;35:309-13.
18. Strakowski SM, Stoll AL, Tohen M, Faedda GL, Goodwin DC. TPQ as a predictor of six-month outcome in first episode mania. Journal Of Psychiatric Research. 1993;48:1-8.
19. First MB, Spitzer RL, Gibbon M Williams, JBW, Benjamin LS. Structured Clinical Interview for DSM-IV Clinical Version (SCID-I/ CV),Washington DC, American Psychiatric Press, 1997.
20. Çorapcıoğlu A. SCID-I Klinik versiyon,Ankara, Hekimler Yayın Birliği Matbaası, 1999.
21. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Archives of General Psychiatry. 1993;50:975-90.
22. Köse S, Sayar K, Ak I, Aydın N, Kalelioğlu Ü, Kırpınar I, Reeves RA, Przybeck TR, Cloninger CR. Mizaç Ve Karakter Envanteri (Türkçe TCI): Geçerlik, Güvenirliği ve Faktör Yapısı. Klinik Psikofarmakoloji Bülteni. 2004;14:107-31.
23. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Consult Clin Psychol. 1995;51:768-74.
24. Gulec H, Tamam L, Gulec MY, Turhan M, Karakuş G, Zengin M, Stanford MS. Psychometric properties of Turkish version of BIS- 11. Klinik Psikofarmakoloji Bülteni. 2008;18:251-8.
25. Williams BW. A structured interview guide for Hamilton Depression Rating Scale. Arch Gen Psychiatr. 1978;45:742-7.
26. Akdemir A, Örsel S, Dağ İ, Türkçapar MH, İşcan N, Özbay H. Hamilton depresyon derecelendirme ölçeği (HDDÖ)nin geçerliliği, güvenilirliği ve klinikte kullanımı. Psikiyatri Psikoloji Psikofarmakoloji Dergisi. 1996;4:251-9.
27. Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-35.
28. Karadağ F, Oral ET, Aran Yalçın F, Eren E. Young Mani Derecelendirme Ölçeğinin Türkiyede geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi. 2001;13:107-14.
29. Aydemir Ö, Eren İ, Savaş H, Oğuzhanoğlu NK, Koçal N, Özgüven HD, Akkaya C, Başterzi AD, Karlıdağ R, Yenilmez Ç, Özerdem A, Kora K, Tamam L, Gülseren Ş, Oral T, Vahip S. Bipolar bozuklukta işlevsellik ölçeğinin geliştirilmesi, güvenilirlik ve geçerliliği. Türk Psikiyatri Dergisi. 2007;18:344-52.
30. Barraclough B, Bunch J, Nelson B et al. One hundred cases of intihare: clinical aspects. Br J Psychiatry. 1974;125:355-73.
31. Dorpat TL, Ripley HS. A study of intihare in the Seattle Area. Compr Psycihatry. 1960;1:349 59.
32. Shaffer D, Gould MS, Fisher P, Trautman P, Moreau D, Kleinman M, Flory M. Psychiatric diagnosis in child and adolesan suicide. Arc Gen Psychiatry. 1996;53:339-48.
33. Drake RE, Bartels SJ, Torrey WC. We suicide in schizophrenia: clinical approaches, in depression in schizophrenics. New York: Plenum, 1989:171-186.
34. Murphy GE. Intihare and substance abuse. Arch Gen Psychiatry. 1988:45:593-4.
35. Murphy GE. The life time risk of suicide in alcoholism. Arch Gen Psychiatry. 1990:47:383-92.
36. Murphy GE, Wetzel RD, Robins E, Mc Evoy L. Multiple risk factors predict suicide in alcholism. Arch Gen Psychiatry. 1992;49:459-63.
37. Frances A, Fyrer M, Clarkin J. Personality and suicide. Ann N Y Acad Sci. 1986:487;281-93.
38. Oral T. İki uçlu bozukluk, Cilt 5, WPA serisi, İstanbul. CSA Medikal Yayın Ajansı, 2002:1-188.
39. Cloninger CR. A systematic method for clinical description and classification of personality variants: a proposal. Arch Gen Psychiatry 1987;44:573-88.
40. Cloninger CR, Przybeck TR, Svrakic DM, Wetzel RD. The Temperament and Character Inventory (TCI): A Guide to its Development and Use. Center for Psychobiology of Personality. Washington, Washington University School of Medicine, Department of Psychiatry 1994;16:120-25.
41. Köse S. A psychobiological model of temperament and character: TCI. Yeni Symposium Dergisi. 2003;41:86-97.
42. Engström C, Brandström S, Sigvardsson S, Cloninger R, Nylander PO. Bipolar Disorders II. Bipolar disorder. 2003;5:3408.
43. Brown SL, Svrakic DM, Przybeck TR. The relationship of personality to mood and anxiety states: a dimensional approach. Psychiatry Research. 1992;26:192-211.
44. Svrakic DM, Whitehead C, Przybeck TR, Cloninger CR.Differential diagnosis of personality disorders by the sevenfactor model of temperament and character. Arch Gen Psychiatry. 1993;50:991-9.
45. Maris RW, Berman AL, Silverman MM. Comprehensive Textbook of suicidology, New York, The Guilford Press, 2000.
46. Rihmer Z, Kiss K. Bipolar disorders and suicidal behaviour. Bipolar Disord. 2002;4(Suppl.1):21-5.
47. Simon TR, Swann AC, Powell KE, Potter LB, Kresnow M, OCarroll PW. Characteristics of impulsive suicide attempts and attempters. Suicide Life Threat Behav. 2001;32(suppl 1):S30S41
48. Swann C, Donald M, Peggy J. Increased impulsivity associated with severity of suicide attemp history in patients with bipolar disorder. Am J Psychiatry. 2005;162:1680-7.
49. Oquendo MA, Waternaux C, Brodsky B, Parsons B, Haas GL, Malone KM, Mann JJ. Suicidal behavior in bipolar mood disorder: clinical characteristics of attempters and nonattempters. J Affect Disord. 2000;59:107-17.
50. Goodwin RD, Jacobi F, Bittner A, Wittchen HU. Epidemiology of Mood Disorders. Textbook of Mood Disorders, (editors) Stein DJ, Kupfer DJ, Schatzberg AF, Arlington American Psychiatric Publishing, 2005:33-54.
51. Cerit C, Filizer A, Tural Ü, Tufan AE. Stigma: a corefactor on predicting functionality in bipolar disorder. Compr Psychiatry. 2012;53:484-9.
52. Vázquez GH, Kapczinski F, Magalhaes PV, Córdoba R, Lopez Jaramillo C, Rosa AR, Sanchez de Carmona M, Tohen M.Ibero- American Network on Bipolar Disorders group. Stigma and functioning in patients with bipolar disorder. J Affect Disord. 2011;130:323-7.

APA	izci f, ZİNCİR BOZKURT S, zincir s, BİLİCİ R, Yalçın M, TERZİ A, GÖNCÜ T, AKDUR Ö, GICA Ş, SEMİZ Ü (2015). Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. , 8 - 15.
Chicago	izci filiz,ZİNCİR BOZKURT Selma,zincir serkan,BİLİCİ Rabia,Yalçın Murat,TERZİ Ayşe,GÖNCÜ Tuğba,AKDUR Özgür,GICA ŞAKİR,SEMİZ Ümit Başar Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. (2015): 8 - 15.
MLA	izci filiz,ZİNCİR BOZKURT Selma,zincir serkan,BİLİCİ Rabia,Yalçın Murat,TERZİ Ayşe,GÖNCÜ Tuğba,AKDUR Özgür,GICA ŞAKİR,SEMİZ Ümit Başar Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. , 2015, ss.8 - 15.
AMA	izci f,ZİNCİR BOZKURT S,zincir s,BİLİCİ R,Yalçın M,TERZİ A,GÖNCÜ T,AKDUR Ö,GICA Ş,SEMİZ Ü Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. . 2015; 8 - 15.
Vancouver	izci f,ZİNCİR BOZKURT S,zincir s,BİLİCİ R,Yalçın M,TERZİ A,GÖNCÜ T,AKDUR Ö,GICA Ş,SEMİZ Ü Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. . 2015; 8 - 15.
IEEE	izci f,ZİNCİR BOZKURT S,zincir s,BİLİCİ R,Yalçın M,TERZİ A,GÖNCÜ T,AKDUR Ö,GICA Ş,SEMİZ Ü "Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study." , ss.8 - 15, 2015.
ISNAD	izci, filiz vd. "Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study". (2015), 8-15.

APA	izci f, ZİNCİR BOZKURT S, zincir s, BİLİCİ R, Yalçın M, TERZİ A, GÖNCÜ T, AKDUR Ö, GICA Ş, SEMİZ Ü (2015). Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. Journal of Mood Disorders, 5(1), 8 - 15.
Chicago	izci filiz,ZİNCİR BOZKURT Selma,zincir serkan,BİLİCİ Rabia,Yalçın Murat,TERZİ Ayşe,GÖNCÜ Tuğba,AKDUR Özgür,GICA ŞAKİR,SEMİZ Ümit Başar Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. Journal of Mood Disorders 5, no.1 (2015): 8 - 15.
MLA	izci filiz,ZİNCİR BOZKURT Selma,zincir serkan,BİLİCİ Rabia,Yalçın Murat,TERZİ Ayşe,GÖNCÜ Tuğba,AKDUR Özgür,GICA ŞAKİR,SEMİZ Ümit Başar Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. Journal of Mood Disorders, vol.5, no.1, 2015, ss.8 - 15.
AMA	izci f,ZİNCİR BOZKURT S,zincir s,BİLİCİ R,Yalçın M,TERZİ A,GÖNCÜ T,AKDUR Ö,GICA Ş,SEMİZ Ü Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. Journal of Mood Disorders. 2015; 5(1): 8 - 15.
Vancouver	izci f,ZİNCİR BOZKURT S,zincir s,BİLİCİ R,Yalçın M,TERZİ A,GÖNCÜ T,AKDUR Ö,GICA Ş,SEMİZ Ü Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study. Journal of Mood Disorders. 2015; 5(1): 8 - 15.
IEEE	izci f,ZİNCİR BOZKURT S,zincir s,BİLİCİ R,Yalçın M,TERZİ A,GÖNCÜ T,AKDUR Ö,GICA Ş,SEMİZ Ü "Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study." Journal of Mood Disorders, 5, ss.8 - 15, 2015.
ISNAD	izci, filiz vd. "Temperament-Character Features, Levels of Impulsiveness and Functionality in Bipolar Disorder Patients with and Without Suicide Attempts: A Controlled Study". Journal of Mood Disorders 5/1 (2015), 8-15.