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    Dissociation in bipolar disorder: Relationships between clinical variables and childhood trauma
    (ELSEVIER SCIENCE BV, 2015) Hariri, Aytul Gursu; Gulec, Medine Yazici; Orengul, Fatma Fariha Cengiz; Sumbul, Esra Aydin; Elbay, Rumeysa Yeni; Gulec, Huseyin
    Objective: The dissociative experiences of patients with bipolar disorder (BD) differ from those of patients with other psychiatric disorders with regard to certain features. The primary goal of this study was to evaluate the relationship between the clinical variables of BD and childhood trauma using the factor structure, psychometric features, and potential subdimensions of the Dissociative Experience Scale (DES). Method: This study included 200 BD patients who were in a remission period and 50 healthy volunteers. The BD patients were recruited from two psychiatry clinic departments in Turkey. The sociodemographic data of the two groups and their scores on the DES and Childhood Trauma Questionnaire (CTQ)-28 were compared. Results: The overall DES scores and the scores for each DES item accurately and reliably measured dissociation in the BD patients (item total correlation r scores: > 0.20, Cronbach's alpha: 0.95), and a factor analysis revealed two subdimensions of the DES for BD: identity confusion/alteration (SubDES-1) and amnesia and clepersonalizaLion/clerealizaLion (SubDES-2). Although age at onset of ED was significantly correlated with both subdimensions, illness duration was significantly correlated only with the SubDES2. 01 all the subjects, 19.5% (39/200 patients) were identified as having dissociative experiences by the DES-Taxon (DES-T), and subjects in this subscale (DES-T-positive) had significantly higher total scores on the CTQ-28 as well as higher scores on each subgroup of this scale. The highest CTQ-28 subgroup score was emotional neglect, which was followed by emotional abuse and physical neglect and then sexual abuse and physical abuse. There was a significant correlation between total scores on the CTQ-28 and SubDES-2 but none of the CTQ-28 subscale scores was significantly correlated with either SubDES-1 or Sub DES-2. Conclusion: The DES sufficiently and reliably identified the experience of dissociative symptoms on the part of BD patients, and a factor analysis revealed two subdimensions of BD on this scale. In particular, DES-T-positive subjects experienced a greater amount of childhood trauma and, as a result, had an earlier age at onset of BD. Additionally, SubDES-2, which was associated with amnesia and depersonalization/derealization, was closely related to illness duration. (C) 2015 Elsevier B.V. All rights reserved.
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    Personality organization in obsessive compulsive disorder with and without insight
    (CUKUROVA UNIV, FAC MEDICINE, 2019) Giynas, Fikret Ferzan; Kizilkurt, Ozlem Kazan; Gulec, Medine Yazici; Gulec, Huseyin
    Purpose: The aim of this study was to investigate personality organization level in patients with and without insight of Obsessive Compulsive Disorder (OCD). Materials and Methods: We conducted a cross-sectional study in Erenkoy Psychiatry and Neurological Diseases Training and Research Hospital. The study's universe consisted of 100 patients who applied with OCD diagnosis to Anxiety Policlinic of our hospital. Sociodemographic data form and Yale Brown Obsessive-Compulsive scale (Y-BOCS) Personality Organization Diagnostic Form (PODF) was completed for each participant at the first interview. Results: The proportion of patients with poor insight group in our study was 23%. Significant differences were found between the Y-BOCS general severity scores of the groups.The patients in two groups achieved significantly different total scores in identity, scores in primitive and mature defense mechanisms and reality testing. There was significant difference between patients with good insight OCD and poor insight OCD in terms of general personality organization. The total score of PODF identity had a predictive effect on insight in the linear direction. Conclusion: The present study indicated that patients with poor insight OCD had lower level of personality organization as compared to patients with good insight OCD. According to the scores obtained in the subscales of PODF, patients with poor insight OCD showed high diffusion identity as compared to patients with good insight OCD. Besides this, it was observed that the group with poor insight mostly used primitive defense mechanisms, their reality testing was relatively disturbed and they had low level of object relations.