Major depresif bozuklukta somatik ağrı belirtileri
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Date
2014
Authors
Eker, Özlem Çetin
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Major depresif bozukluk (MDB) hastalarının önemli kısmında sağlık kurumlarına tek başvuru yakınması ağrı ya da ağrılı fiziksel yakınmalar olabilmektedir. Bu çalışmada depresyon hastalarında ağrı belirtilerinin depresyon belirtileri ile ilişkisinin araştırılması amaçlanmıştır. Uludağ Üniversitesi Tıp Fakültesi Hastanesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı Polikliniği' ne başvuran ve DSM-IV-TR tanı ölçütlerine göre MDB tanısı alan ve çalışmaya alma ölçütlerini karşılayan 18-65 yaş arasındaki 100 hasta çalışmaya alınmıştır. DSM-IV-TR'ye göre eşlik eden I.eksen ve/veya II. eksen tanısı olanlar, alkol ve madde kötüye kullanımı ve ağrıyı açıklayacak organik kökenli hastalığı bulunanlar çalışmaya alınmadı. Çalışmaya alınan tüm hastalara sosyodemografik veri formu, depresyon düzeyini ölçmek için Hamilton Depresyonu Derecelendirme Ölçeği (HAM-D), ağrı şiddetini ölçmek için Vizuel Analog Skala (VAS) kullanıldı. Hastaların ortalama yaşı 37.2 ± 11,3 yaş, ortalama MDB atak sayısı 1.9 ± 1.12, son atak süresi 7.2 ± 5.6 ay ve ortalama HAM-D puanı 21.8 ± 4.2 idi. Hastaların %47'sinde ağrı yakınması vardı. Ağrılı yakınmaların ortalama süresi 28.7 ± 34.4 ay, ortalama VAS puanı 55.8 idi. Hastaların en sık yakındığı ağrı, baş ağrısıydı. Ortalama ağrı lokalizasyonu sayısı 1.6 ± 0.9 olarak saptandı. Ağrılı yakınmaların varlığı daha şiddetli depresyon ile ilişkili bulundu (p<0.001). MDB ve ağrı arasında bir ilişkinin olduğu açıktır. Ayrıca ağrısı olan MDD hastalarında depresyonun daha şiddetli seyrettiği bilinmektedir. Dolayısıyla günlük klinik pratik açısından ağrı yakınmaları ayrıntısı ile sorgulanmalı ve tedavi seçenekleri buna düzenlenmesi depresyonun tedavisinde daha iyi sonuç almak için önemlidir.
Pain or painful physical complaints may be the sole complaint for admission to health care units in most of the major depression disorder (MDD) patients. In this study it is aimed to investigate the association between pain and depressive symptoms in depressed patients. 100 patients, between 18-65 years of age and diagnosed with MDD according to DSM-IV-TR diagnostic criterion, who admitted to Medical Faculty of Uludag University Hospital outpatient clinic of Psychiatry department were enrolled to the study. Patients with accompanying axis I or axis II disorders according to DSM-IV-TR, patients with alcohol or substance abuse and patients whose pain complaints are attribituble to an existing organic illness are excluded. Sociodemographic data form, Hamilton Depression Rating Scale (HDRS) which measures depression and Visual Analogue Scale (VAS) were applied to all patients who were enrolled to the study. The mean age of the patients were 37.2 ± 11.3 years, mean number of MDD episodes were 1.9 ± 1.12, duration of the recent episode were 7.2 ± 5.6 months and mean score of HDRS were 21.8 ± 4.2. 47% of the patients had pain complaint. Duration of the painful complaints were 28.7 ± 34.4 months, mean score of VAS was 55.8. The most painful complaint was headache. Mean number of painful complaint localization was 1.6 ± 0.9. The painful complaints were found to be associated with more severe depression (p<0.001). It is clear that there is an association between MDD and pain. It is also known that the course of depression is poorer in MDD patients with painful complaints. Thus, for clinical practice, painful complaints should be questioned in details and treatment options should arranged in this regard for better outcome in the treatment of MDD.
Pain or painful physical complaints may be the sole complaint for admission to health care units in most of the major depression disorder (MDD) patients. In this study it is aimed to investigate the association between pain and depressive symptoms in depressed patients. 100 patients, between 18-65 years of age and diagnosed with MDD according to DSM-IV-TR diagnostic criterion, who admitted to Medical Faculty of Uludag University Hospital outpatient clinic of Psychiatry department were enrolled to the study. Patients with accompanying axis I or axis II disorders according to DSM-IV-TR, patients with alcohol or substance abuse and patients whose pain complaints are attribituble to an existing organic illness are excluded. Sociodemographic data form, Hamilton Depression Rating Scale (HDRS) which measures depression and Visual Analogue Scale (VAS) were applied to all patients who were enrolled to the study. The mean age of the patients were 37.2 ± 11.3 years, mean number of MDD episodes were 1.9 ± 1.12, duration of the recent episode were 7.2 ± 5.6 months and mean score of HDRS were 21.8 ± 4.2. 47% of the patients had pain complaint. Duration of the painful complaints were 28.7 ± 34.4 months, mean score of VAS was 55.8. The most painful complaint was headache. Mean number of painful complaint localization was 1.6 ± 0.9. The painful complaints were found to be associated with more severe depression (p<0.001). It is clear that there is an association between MDD and pain. It is also known that the course of depression is poorer in MDD patients with painful complaints. Thus, for clinical practice, painful complaints should be questioned in details and treatment options should arranged in this regard for better outcome in the treatment of MDD.
Description
Keywords
Ağrı, Depresyon, Ağrılı fiziksel belirtiler, Pain, Depression, Painful physical symptoms
Citation
Eker, Ö. Ç. (2014). Major depresif bozuklukta somatik ağrı belirtileri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.