정신신체의학 (Korean Journal of Psychosomatic Medicine)
- 제11권1호
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- Pages.25-35
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- 2003
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- 1225-6471(pISSN)
파킨슨병 환자에서의 우울증상
Depressive Symptoms in Patients with Parkinson's Disease
- 이문숙 (동아대학교 의과대학 정신과학교실) ;
-
양창국
(동아대학교 의과대학 정신과학교실) ;
- 한홍무 (동아대학교 의과대학 정신과학교실) ;
- 김재우 (동아대학교 의과대학 신경과학교실)
- Lee, Moon-Sook (Department of Psychiatry, College of Medicine, Dong-A University) ;
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Yang, Chang-Kook
(Department of Psychiatry, College of Medicine, Dong-A University) ;
- Hah, Hong-Moo (Department of Psychiatry, College of Medicine, Dong-A University) ;
- Kim, Jae-Woo (Department of Neurology, College of Medicine, Dong-A University)
- 발행 : 2003.06.15
초록
연구목적: 파킨슨병 환자에서 다양한 정신증상이 동반되는 것으로 보고되고 있으며, 특히 우울증상의 동반율이 매우 높다고 보고되고 있다. 특히 파킨슨병은 완치가 어렵고, 치료의 초점이 질병의 진행 억제나 증상의 완화에 있기 때문에 파킨슨병 환자에서의 우울증상에 대한 관심과 치료는 중요하다. 본 연구는 통원치료 중인 파킨슨병 환자들을 대상으로 파킨슨병 관련 임상요인들과 우울증상 사이의 관련성을 조사하는데 목적이 있다. 연구대상 및 방법: 일 대학교병원 신경과 파킨슨병 클리닉에서 특발성 파킨슨병으로 진단 받고 치료중인 환자들 중 본 연구에 참여하기로 동의한 118명의 환자를 대상으로 하였다. 일반적인 인구통계학적 자료, 파킨슨병 관련 자료[발병연령, 치료약물 용량, 임상양상, Hoehn과 Yahr의 단계(Hoehn and Yahr stage, H&Y stage), 일상생활 평가척도(Modified Schwab and England Activities of Daily Living, ADL)], 파킨슨병 환자의 삶의 질 설문지(Parkinson's Disease quality of Life questionnaire, PDQL), 스필버그 상태/특성 불안척도, 간이정신 검사 등을 조사하였고, 우울증상의 평가는 Beck 우울척도(Beck Depression Inventory, BDI)를 이용하였다. 결 과: 대상군의 평균 연령은
Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.