Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder

Atagün, Murat İlhan; APAYDİN, Zuhal Koc

Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder

Zuhal Koc APAYDİN, (1 Ankara Ataturk Training and Research Hospital, Department of Psychiatry, Ankara - Turkey)

Murat İlhan ATAGÜN (2Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Psychiatry, Ankara - Turkey)

Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi

3 1

Yıl: 2018 Cilt: 31 Sayı: 1 Sayfa Aralığı: 21 - 29 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder

Öz:

Amaç: Bipolar bozuklukta işlevsellik hastaların remisyonda olduğu dönemlerde dahi bozulabilmektedir ve dürtüsellik, eşik altı klinik belirtiler, damgalanma gibi psikopatolojik boyutların işlevselliğe etkilerinin olduğu bilinmektedir. Baş etme tutumlarıyla, bireylerin karşılaştıkları günlük olaylar karşısında tutumları ve bunların uyuma dönük olup olmadıkları ifade edilmektedir. Bu çalışmada bipolar bozuklukta baş etme tutumları ve dürtüselliğin işlevselliğe olan etkilerinin incelenmesi, dürtüselliğin uyuma dönük olan ve olmayan davranışları etkileyerek baş etme tutumları üzerinden işlevselliğe etki edip etmediğinin incelenmesi amaçlanmıştır. Yöntem: Çalışma remisyonda bipolar bozukluğu olan 74 hasta ve yaş, cinsiyet ve eğitim durumu bakımından hasta grubuyla örtüşen 74 sağlıklı kontrol ile gerçekleştirilmiştir. Katılımcılar Bipolar Bozuklukta İşlevsellik Ölçeği (BBİÖ), Baş Etme Tutumları Ölçeği (BETÖ), Barratt Dürtüsellik Ölçeği-11 (BDÖ-11), Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Young Mani Derecelendirme Ölçeği (YMDÖ), Hamilton Anksiyete Derecelendirme Ölçeği (HAM-A) ile değerlendirilmişlerdir. Bulgular: Bipolar bozukluk grubunun işlevsellik puanları kontrol grubuna göre anlamlı derecede düşüktü (p=0.027). Ayrıca bipolar bozukluk grubunda dikkat (p=0.020) ve motor (p=0.006) dürtüselliğin artmış olduğu ve de maladaptif baş etme tutumlarının daha fazla görüldüğü (p=0.032) tespit edilmiştir. BDÖ toplam puanıyla maladaptif baş etme tutumları arasında anlamlı derecede korelasyon saptanmıştır (r=0.38, p<0.01). Hiyerarşik çoklu regresyon analizinde, adaptif baş etme tutumları (B=0.23, p=0.020), dikkat (B=-0.31, p=0.037), motor (B=0.29, p=0.027) ve planlanmamış (B=-0.35, p=0.003) dürtüselliğin işlevselliğin belirleyicileri oldukları saptanmıştır (F=8.44, p<0.001). Sonuç: Bu çalışmada bipolar bozuklukta işlevselliğin dürtüsellikten olumsuz biçimde, adaptif baş etme tutumlarından olumlu biçimde etkilendiğini, baş etme tutumlarının işlevselliğe etkisinde dürtüselliğin aracı rolünün olmadığı tespit edilmiştir. Dürtüsellikle maladaptif baş etme tutumları arasında bağıntı olmasına rağmen aracılık etkisinin görülmemesi, aracılık edici bir ilişki olmadığına işaret etmektedir. Büyük örneklemli izlem çalışmalarıyla işlevselliğin belirleyicilerinin değerlendirilmesi hastalıkta görülen işlev kayıplarının kontrol edilebilmesi açısından önem taşımaktadır

Anahtar Kelime:

Bipolar bozuklukta işlevselliğin dürtüsellik ve baş etme tutumlarıyla ilişkisi

Öz:

Relationship of functionality with impulsivity and coping strategies in bipolar disorderObjective: In patients with bipolar disorder, functional losses may be observed even during remission of the disease, and psychopathological traits such as impulsivity, subthreshold clinical symptoms, or stigmatization may influence functionality. Coping strategies are defined as a person’s attitudes towards daily life events and their adaptedness. This study aimed to investigate the effects of coping strategies and impulsivity on functionality in bipolar disorder and whether the effect of impulsivity is mediated by dysfunctional coping strategies. Method: This study was conducted with patients suffering from bipolar disorder (n=74) in remission and healthy controls (n=74) matched with the patient group in terms of age, gender and education. Patients were assessed using the Bipolar Disorder Functioning Questionnaire (BDFQ), Coping Strategies Inventory (COPE), Barratt Impulsiveness Scale-11 (BIS-11), Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YRMS) and Hamilton Anxiety Rating Scale (HAM-A). Results: The functionality score of the bipolar disorder group was significantly lower than in the healthy control group (p=0.027). Moreover, attention (p=0.020) and motor (p=0.006) impulsivity scores were higher and the maladaptive coping strategies score (p=0.032) was lower in the bipolar disorder group. The correlation between the total score of the BIS and the maladaptive coping strategies subscale of the COPE in the bipolar disorder group was statistically significant (r=0.38, p<0.01). Hierarchical multiple regression analysis showed that adaptive coping strategies (B=0.23, p=0.020), attention (B=-0.31, p=0.037), motor (B=0.29, p=0.027) and nonplanning (B=-0.35, p=0.003) impulsivity were the determinants of the functionality in the regression model (F=8.44, p<0.001). Conclusion: The study has detected that functionality is affected negatively by impulsivity and positively by adaptive coping strategies in bipolar disorder, whereas the effect of coping strategies on functionality is not mediated by impulsivity. While there was a correlation between impulsivity and maladaptive coping strategies, there was no mediation between impulsivity and coping strategies, which may suggest that these dimensions are independent from each other. Prospective studies with large sample sizes should investigate the clinical determinants of functional losses in the future

Anahtar Kelime:

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

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APA	APAYDİN Z, Atagün M (2018). Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. , 21 - 29.
Chicago	APAYDİN Zuhal Koc,Atagün Murat İlhan Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. (2018): 21 - 29.
MLA	APAYDİN Zuhal Koc,Atagün Murat İlhan Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. , 2018, ss.21 - 29.
AMA	APAYDİN Z,Atagün M Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. . 2018; 21 - 29.
Vancouver	APAYDİN Z,Atagün M Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. . 2018; 21 - 29.
IEEE	APAYDİN Z,Atagün M "Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder." , ss.21 - 29, 2018.
ISNAD	APAYDİN, Zuhal Koc - Atagün, Murat İlhan. "Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder". (2018), 21-29.

APA	APAYDİN Z, Atagün M (2018). Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi, 31(1), 21 - 29.
Chicago	APAYDİN Zuhal Koc,Atagün Murat İlhan Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi 31, no.1 (2018): 21 - 29.
MLA	APAYDİN Zuhal Koc,Atagün Murat İlhan Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi, vol.31, no.1, 2018, ss.21 - 29.
AMA	APAYDİN Z,Atagün M Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi. 2018; 31(1): 21 - 29.
Vancouver	APAYDİN Z,Atagün M Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder. Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi. 2018; 31(1): 21 - 29.
IEEE	APAYDİN Z,Atagün M "Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder." Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi, 31, ss.21 - 29, 2018.
ISNAD	APAYDİN, Zuhal Koc - Atagün, Murat İlhan. "Relationship of Functionality with Impulsivity and Coping Strategies in Bipolar Disorder". Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi 31/1 (2018), 21-29.