Abstract
SUMMARY In this study, 62 adult euthymic outpatients with bipolar I disorders recruited from the consecutive subjects who sought psychiatric care at the Psychiatric Outpatient Clinic of the Yüzüncü Yıl University Hospital. Subjects meeting DSM-IV criteria for bipolar disorder, subjects without history of schizophrenia or any psychotic disorder, organic mental disorder and substance dependence/abuse except for nicotine dependence. All of them had no manic, hypomanic, mixed or depressive episode in the course of evaluation Sixty-two (n=62) participants with bipolar I disorders completed the Structured Clinical Interview for DSM-IV. To assess the traumatic and stressful life events, a revised instrument that was developed by researches based on The Psychometric Review Of Structural Assesment Of Stressful Experiences Questionnaire, Childhood Abuse and Neglect Questionnaire, Stressful Life Experiences Screening-Short Form, and took into consideration all dimensions of trauma in the context of local cultural properties, was used. We evaluated the the existence of chilhood sexual abuse, childhood physical abuse and traumatic life events by means of this instrument. Patients who met inclusion criteria were interviewed by means of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). Twenty patients (%32) met diagnostic criteria for a dissociative disorder. The diagnostic composition of the sample with dissociative disorders consisted of dissociative amnesia (%17.7, n=ll), dissociative fugue (%6.4, n=4), dissociative identity disorders (%4.8, n=3) depersonalization disorders (%22.5, n=14). Seven patients has concurrently two or more dissociative disorder's comorbidity. In our sample; between clinical varieties men with bipolar disorders have higher nicotine abuse rate than women with bipolar disorders (#2=9.31; p<0.05). The subjects with dissociative disorder were significantly more likely to be female (n=ll; %55) compared to those without dissociative disorder (^=3.30, p<0.05). The patients with dissociative disorder had significantly lower mean age (27.5±5.9) than subjects without dissociative disorder (36±9.0) (t=3.91, p<0.05). The patients with dissociative disorder were significantly more likely to be never married (n=12, %60) compared to other group (n=10, %24) (#2=8.13, p<0.05). The twenty-one percent (n=13) of all the patients reported the experience of childhood sexual abuse, %65 (n=40) reported childhood physical abuse, %47 (n=29) reported traumatic life events. The subjects with dissociative disorders significantly more reported the experience of childhood IXsexual abuse (x2=10.3, p<0.05), childhood physical abuse (x2=8.2, p<0.05) and lifetime traumatic life events (%2=9.5, p<0.05), compared to those without dissociative disorders. In the group with dissociative disorder, %45 of patients reported the experience of childhood sexual abuse, %90 reported childhood physical abuse and %75 reported lifetime traumatic life events Conclusively, the comorbidy of bipolar disorder and dissociative disorder was found to be high. This high comorbidity rate may be accounted for that both bipolar disorder and dissociative disorder associate with traumatic experiences. Key words: Bipolar Disorder; Dissociation, Childhood Abuse, Trauma, Early Stress.
