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천식 환자에서 우울과 천식의 중증도 및 조절과의 관련성

Depressive Conditions in Relation to Asthma Severity and Control

  • 김원진 (부산대학교 의학전문대학원 내과학교실) ;
  • 배현숙 (부산대학교 의학전문대학원 예방의학 및 산업의학교실) ;
  • 최보경 (부산대학교 의학전문대학원 내과학교실) ;
  • 황종민 (부산대학교 의학전문대학원 내과학교실) ;
  • 신경화 (부산대학교 의학전문대학원 내과학교실) ;
  • 김미현 (부산대학교 의학전문대학원 내과학교실) ;
  • 이광하 (부산대학교 의학전문대학원 내과학교실) ;
  • 김기욱 (부산대학교 의학전문대학원 내과학교실) ;
  • 전두수 (부산대학교 의학전문대학원 내과학교실) ;
  • 박혜경 (부산대학교 의학전문대학원 내과학교실) ;
  • 김윤성 (부산대학교 의학전문대학원 내과학교실) ;
  • 이민기 (부산대학교 의학전문대학원 내과학교실) ;
  • 박순규 (부산대학교 의학전문대학원 내과학교실)
  • Kim, Won-Jin (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Bae, Hyun-Sook (Department of Preventive and Occupational Medicine, Pusan National University School of Medicine) ;
  • Choi, Bo-Kyung (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Hwang, Jong-Min (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Shin, Kyung-Hwa (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Mi-Hyun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Kwang-Ha (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Ki-Uk (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Jeon, Doo-Soo (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Hye-Kyung (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Yun-Seong (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Min-Ki (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Soon-Kew (Department of Internal Medicine, Pusan National University School of Medicine)
  • 투고 : 2010.07.07
  • 심사 : 2010.08.09
  • 발행 : 2010.10.30

초록

Background: Psychological factors are increasingly recognized for their influence on the course of asthma, on a worldwide basis. The aim of this study was to assess the presence of depression, anxiety, and asthma-related quality of life in patients with asthma and to evaluate their impact on severity and control of asthma. Methods: We assessed the severity of asthma by comparing patients' current medications to GINA guideline. The patients were classified into the controlled group (asthma patients with controlled disease) or into the uncontrolled group (asthma patients with uncontrolled disease), which included partly controlled and uncontrolled patients, again based on GINA guideline 2004. Patient-reported depressive symptoms, anxiety, and asthma-related quality of life were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and Korean asthma quality of life (KAQLQ). Results: One hundred and twenty patients were enrolled (mean age, $55{\pm}1$ years; 65% women). Among the 120 patients, 14 (12%) patients were classified as having mild asthma, 88 (73%) as having moderate asthma, and 18 (15%) as having severe asthma. Eighty-one (67%) of the 120 patients were controlled. The asthma-related quality of life showed the difference according to severity of asthma (p=0.002). The prevalence of depression was lower (10% vs 26%, p=0.024) and the asthma-related quality of life was higher (59.951 (29~75) vs 35.103 (18~72), $p{\leq}0.001$) in the controlled group. Higher trait anxiety score and lower asthma-related quality of life were associated with depression (p<0.001, p=0.002, respectively). Conclusion: Psychological factors, such as anxiety and depression, are strongly associated with asthma control. Therefore, screening and management of depression is needed in patients with asthma.

키워드

참고문헌

  1. Cho SH, Park HW, Rosenberg DM The current status of asthma in Korea. J Korean Med Sci 2006;21:181-7. https://doi.org/10.3346/jkms.2006.21.2.181
  2. Global Initiative for Asthma (GINA). 2006 revision: global strategy for asthma management and prevention [Internet]. GINA; 2006 [cited 2010 Oct 14]. Available from: http://ginasthma.org.
  3. Kim DI, Kwon HS, Song WJ, Lee SM, Kim SH, Sohn SW, et al. Characteristics of the elderly asthma. J Asthma Allergy Clin Immunol 2008;28:98-104.
  4. Ryu YJ, Chun EM, Sim YS, Lee JH. Depression and anxiety in outpatients with chronic obstructive pulmonary disease. Tuberc Respir Dis 2007;62:11-8. https://doi.org/10.4046/trd.2007.62.1.11
  5. Oraka E, King ME, Callahan DB. Asthma and serious psychological distress: prevalence and risk factors among US adults, 2001-2007. Chest 2010;137:609-16. https://doi.org/10.1378/chest.09-1777
  6. Strine TW, Mokdad AH, Balluz LS, Berry JT, Gonzalez O. Impact of depression and anxiety on quality of life, health behaviors, and asthma control among adults in the United States with asthma, 2006. J Asthma 2008;45:123-33. https://doi.org/10.1080/02770900701840238
  7. Hahn HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Chung KJ. A standardization study of Beck depression inventory in Korea. J Korean Neuropsychiatr Assoc 1986;25:487-502.
  8. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory (Form X). Palo Alto: Consulting Psychologists Press; 1970.
  9. Park JW, Cho YS, Lee SY, Nahm DH, Kim YK, Kim DK, et al. Multi-center study for the utilization of quality of life questionnaire for adult Korean asthmatics (QLQAKA). J Asthma Allergy Clin Immunol 2000;20:467-80.
  10. Moy ML, Israel E, Weiss ST, Juniper EF, Dube L, Drazen JM, et al. Clinical predictors of health-related quality of life depend on asthma severity. Am J Respir Crit Care Med 2001;163:924-9. https://doi.org/10.1164/ajrccm.163.4.2008014
  11. Vollmer WM, Markson LE, O'Connor E, Sanocki LL, Fitterman L, Berger M, et al. Association of asthma control with health care utilization and quality of life. Am J Respir Crit Care Med 1999;160:1647-52. https://doi.org/10.1164/ajrccm.160.5.9902098
  12. Kwon HS, Lee SH, Yang MS, Lee SM, Kim SH, Kim DI, et al. Correlation between the Korean version of asthma control test and health-related quality of life in adult asthmatics. J Korean Med Sci 2008;23:621-7. https://doi.org/10.3346/jkms.2008.23.4.621
  13. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002;346:1221-31. https://doi.org/10.1056/NEJMra011775
  14. Korea Pharmaceutical Manufacturers Association. Drug market statistics in 2004 [Internet]. Seoul: Korea Pharmaceutical Manufactures Association; c2009 [cited 2005 Jan 23]. Available from: http://www.kpma.or.kr
  15. Ryu YJ, Chun EM, Lee JH, Chang JH. Prevalence of depression and anxiety in outpatients with chronic airway lung disease. Korean J Intern Med 2010;25:51-7. https://doi.org/10.3904/kjim.2010.25.1.51
  16. Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire. Int J Geriatr Psychiatry 2000;15:1090-6. https://doi.org/10.1002/1099-1166(200012)15:12<1090::AID-GPS249>3.0.CO;2-L
  17. Goldney RD, Ruffin R, Fisher LJ, Wilson DH. Asthma symptoms associated with depression and lower quality of life: a population survey. Med J Aust 2003;178: 437-41.
  18. Opolski M, Wilson I. Asthma and depression: a prag pragmatic review of the literature and recommendations for future research. Clin Pract Epidemiol Ment Health 2005; 1:18.
  19. Chun TH, Weitzen SH, Fritz GK. The asthma/mental health nexus in a population-based sample of the United States. Chest 2008;134:1176-82. https://doi.org/10.1378/chest.08-1528
  20. Yellowlees PM, Kalucy RS. Psychobiological aspects of asthma and the consequent research implications. Chest 1990;97:628-34. https://doi.org/10.1378/chest.97.3.628
  21. Moy ML, Israel E, Weiss ST, Juniper EF, Dube L, Drazen JM, et al. Clinical predictors of health-related quality of life depend on asthma severity. Am J Respir Crit Care Med 2001;163:924-9. https://doi.org/10.1164/ajrccm.163.4.2008014
  22. Dean BB, Calimlim BM, Kindermann SL, Khandker RK, Tinkelman D. The impact of uncontrolled asthma on absenteeism and health-related quality of life. J Asthma 2009;46:861-6. https://doi.org/10.3109/02770900903184237
  23. Mancuso CA, Peterson MG, Charlson ME. Effects of depressive symptoms on health-related quality of life in asthma patients. J Gen Intern Med 2000;15:301-10. https://doi.org/10.1046/j.1525-1497.2000.07006.x
  24. Deshmukh VM, Toelle BG, Usherwood T, O'Grady B, Jenkins CR. The association of comorbid anxiety and depression with asthma-related quality of life and symptom perception in adults. Respirology 2008;13: 695-702. https://doi.org/10.1111/j.1440-1843.2008.01310.x
  25. Kim JT, Shin DK. A Study based on the standardization of the STAI for Korea. New Med J 1978;21:69-75.
  26. Mancuso CA, Wenderoth S, Westermann H, Choi TN, Briggs WM, Charlson ME. Patient-reported and physician- reported depressive conditions in relation to asthma severity and control. Chest 2008;133:1142-8. https://doi.org/10.1378/chest.07-2243

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