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Öğe Evaluation of temperament and character traits and their subscale dimensions associated with major depressive disorder(The Medical Bulletin of Sisli Etfal Hospital, 2022) Uygur, Abdullah Burak; Özdemir Öktem, Ece; Çelik, SelimeObjectives: The relationship between major depressive disorder (MDD) and, especially harm avoidance, self-directedness, and cooperativeness has been determined based on Cloninger’s psychobiological personality model; there are not enough studies in the literature on the role of the subdimensions. Therefore, the aim of this study was to compare the patients with MDD and healthy controls in terms of temperament and character traits and especially subdimensions and thus to determine the role and predictive value of temperament and character subdimensions in major depression patients. Methods: The sample of this cross-sectional study consisted of 105 participants, 65 of whom were MDD patients, and 40 healthy controls, who voluntarily agreed to participate in the study. Sociodemographic data form, temperament and character inventory, and Hamilton depression rating scale were administered to the participants. Results: Compared with healthy controls, patients with MDD had lower self-directedness (p<0.001), cooperativeness (p=0.017), persistence (p<0.001), self-transcendence (p=0.001), and higher harm avoidance (p<0.001) scores. While there was no significant difference in novelty seeking (p=0.774); it was determined that MDD patients got higher scores in “Impulsiveness” (p=0.013) and lower scores in “Exploratory excitability” (p=0.001) subscales. Reward dependence has been identified as the only personality trait that there was no significant difference between major depression patients and healthy controls (p=0.511). As a result of the logis tic regression analysis performed to determine the predictors of temperament and character subdimensions in major depression patients, only three temperament and character traits “Fatigability, Purposefulness, and Spiritual Acceptance” were determined as significant predictors (p<0.001). Fatigability was determined to be a serious risk factor, increasing the probability of MDD 3.6 times (p<0.001); purposefulness and spiritual acceptance were found to be protective personality traits that together reduced the prob ability of MDD by 0.8 times (p<0.001). Conclusion: This study shows that the risk of developing MDD is increased in individuals with low self-directedness, cooperative ness, persistence, and self-transcendence profiles, and whereas with prominent Harm avoidance personality traits. Therapeutic in terventions, especially considering the temperament and character traits of “Fatigability, Purposefulness, and Spiritual Acceptance” determined in our study, may contribute positively to MDD treatment.Öğe Evaluation of Temperament and Character Traits and Their Subscale Dimensions Associated with Major Depressive Disorder(2022) Uygur, Abdullah Burak; Özdemir Öktem, Ece; Çelik, SelimeObjectives: The relationship between major depressive disorder (MDD) and, especially harm avoidance, self-directedness, and cooperativeness has been determined based on Cloninger's psychobiological personality model; there are not enough studies in the literature on the role of the subdimensions. Therefore, the aim of this study was to compare the patients with MDD and healthy controls in terms of temperament and character traits and especially subdimensions and thus to determine the role and predictive value of temperament and character subdimensions in major depression patients. Methods: The sample of this cross-sectional study consisted of 105 participants, 65 of whom were MDD patients, and 40 healthy controls, who voluntarily agreed to participate in the study. Sociodemographic data form, temperament and character inventory, and Hamilton depression rating scale were administered to the participants. Results: Compared with healthy controls, patients with MDD had lower self-directedness (p<0.001), cooperativeness (p=0.017), persistence (p<0.001), self-transcendence (p=0.001), and higher harm avoidance (p<0.001) scores. While there was no significant difference in novelty seeking (p=0.774); it was determined that MDD patients got higher scores in "Impulsiveness" (p=0.013) and lower scores in "Exploratory excitability" (p=0.001) subscales. Reward dependence has been identified as the only personality trait that there was no significant difference between major depression patients and healthy controls (p=0.511). As a result of the logistic regression analysis performed to determine the predictors of temperament and character subdimensions in major depression patients, only three temperament and character traits "Fatigability, Purposefulness, and Spiritual Acceptance" were determined as significant predictors (p<0.001). Fatigability was determined to be a serious risk factor, increasing the probability of MDD 3.6 times (p<0.001); purposefulness and spiritual acceptance were found to be protective personality traits that together reduced the probability of MDD by 0.8 times (p<0.001). Conclusion: This study shows that the risk of developing MDD is increased in individuals with low self-directedness, cooperativeness, persistence, and self-transcendence profiles, and whereas with prominent Harm avoidance personality traits. Therapeutic interventions, especially considering the temperament and character traits of "Fatigability, Purposefulness, and Spiritual Acceptance" determined in our study, may contribute positively to MDD treatment.Öğe Psikiyatrik Hastalıklarda İntihar ve Acil Serviste İntihar Girişimine Müdahale: Güncel Bir Gözden Geçirme(İbrahim İKİZCELİ, 2023) Çelik, Selime; Yılmaz, Banu Karakus; Uygur, Abdullah BurakDünya Sağlık Örgütü’ne göre intihar kişinin hayatını sona erdirme niyetiyle gerçekleştirdiği kendine zarar verici bir eylem olarak tanımlanmaktadır. Epidemiyolojik olarak intihar, önlenebilir erken ölümlerin önde gelen nedenlerinden biridir. Ülkemizde ve dünyada giderek artan bir halk sağlığı sorunu haline gelen intihar nedeniyle, dünya çapında her yıl 800.000’den fazla insan ölmektedir. İntihar; intihar girişimi ve tamamlanmış intihar (ölümle sonuçlanan) olarak gruplandırılmaktadır. Acil servisler genellikle intihar olgularıyla ilk karşılaşılan hastane birimidir ve intihar sonucu ölen insanların yaklaşık %40’ının ölümlerinden önceki yıl içinde en az bir kez acil servis başvurularının olduğu görülmektedir. Bu nedenle, acil servis hizmetleri fiziksel sağlık sorunlarıyla ilgilenmenin yanı sıra hastanın ruh sağlığı ihtiyaçlarını değerlendirmek açısından da kritik bir öneme sahiptir ve ciddi bir fırsatı temsil eder. İntihar girişimine acil serviste müdahale ve sonrasında yapılması gerekenler büyük önem arz etmektedir. İntihar ve intihar girişimleri çoğu durumda ruhsal bozukluklarla ilişkilendirilmiştir. İntihar girişimi sonucu ölenlerin %90’ından fazlasında bir psikiyatrik bozukluk olduğu düşünülmektedir. En sık rastlanan temel tanılar ise duygudurum bozuklukları, şizofreni ve madde kullanım bozukluklarıdır. Bireylerin intihar riskinin değerlendirilmesi ve risk altındaki bireylerin erken teşhis ve tedavilerinde çok sayıda değişkenin dikkate alınması gerekmektedir. Bu değişkenlerin en önemlilerinden biri de intihar için risk oluşturan eşlik eden psikiyatrik hastalıklardır. İntihar davranışı ile psikiyatrik hastalıkların birlikteliği düşünüldüğünde intihar girişiminde bulunan tüm hastalar için psikiyatri konsültasyonunun gerekli olduğu görülmektedir. Fakat gerçekleştirilen çalışma sonuçlarından da görüldüğü üzere; intihar girişimi sonrası acil servisten istenen psikiyatri konsültasyon sayıları oldukça düşüktür. Bu durum aynı zamanda hastaların yetersiz psikiyatrik destek aldıklarının da bir göstergesidir. İntihar girişimi sonrası hastalara yeterli destek sağlanabilmesi için psikiyatri konsültasyonlarının sayısının artırılması ve acil servis çalışanlarının "intihar" ile ilgili eğitim almalarının hastalara katkı sağlayabileceği görülmektedir. Bu derlemede psikiyatrik hastalıklarda intihar davranışı ve acil serviste intihar girişimine yaklaşım konusunun ele alınması amaçlanmıştır.
