생물정신의학 (Korean Journal of Biological Psychiatry)

  • 제23권2호
  • /
  • Pages.63-68
  • /
  • 2016
  • /
  • 1225-8709(pISSN)
  • /
  • 2005-7571(eISSN)
대한생물정신의학회 (The Korean Society of Biological Psychiatry)
권호 표지

해녀 우울장애 환자의 임상적 특징

Clinical Characteristics of Haenyeo with Depressive Disorders

  • 박준혁 (제주대학교 의학전문대학원 제주대학교병원 정신건강의학교실) ;
  • 전병선 (제주대학교 의학전문대학원 제주대학교병원 정신건강의학교실) ;
  • 이창인 (제주대학교 의학전문대학원 제주대학교병원 정신건강의학교실) ;
  • 김문두 (제주대학교 의학전문대학원 제주대학교병원 정신건강의학교실) ;
  • 정지운 (제주특별자치도 광역치매센터) ;
  • 정영은 (제주대학교 의학전문대학원 제주대학교병원 정신건강의학교실)
  • Park, Joon Hyuk (Department of Psychiatry, Jeju National University Hospital, School of Medicine, Jeju National University) ;
  • Jun, Byoung Sun (Department of Psychiatry, Jeju National University Hospital, School of Medicine, Jeju National University) ;
  • Lee, Chang In (Department of Psychiatry, Jeju National University Hospital, School of Medicine, Jeju National University) ;
  • Kim, Moon-Doo (Department of Psychiatry, Jeju National University Hospital, School of Medicine, Jeju National University) ;
  • Jeong, Ji Woon (Jeju Dementia Center) ;
  • Jung, Young-Eun (Department of Psychiatry, Jeju National University Hospital, School of Medicine, Jeju National University)
  • 투고 : 2016.04.19
  • 심사 : 2016.05.02
  • 발행 : 2016.05.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives Haenyeo are Korean professional women breath-hold divers in Jeju island. The aim of this study was to investigate the clinical characteristics of depressed Haenyeo group, compared to non-Haenyeo depressed group. Methods This study included 75 Haenyeo and 340 non-Haenyeo with depressive disorders recruited from the Dementia Early Detection Program in Jeju island. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview. All patients completed the questionnaires, including the Subjective Memory Complaints Questionnaire (SMCQ), the Patient Health Questionnaire-15 (PHQ-15), and the Blessed dementia scale. Depression was evaluated by the Korean version of short form the Geriatric Depression Scale (K-SGDS) and cognition was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment packet. Results Although the mean scores of the K-SGDS were similar between Haenyeo and non-Haenyeo depressed groups, the Haenyeo group showed a higher mean score on the PSQ-15 (p < 0.001, ANCOVA adjusting for age, the K-SGDS and education). The Haenyeo group showed poorer performance on the Korean Version of Frontal Assessment Batter (p < 0.001), the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (p < 0.018), the word fluency test (p < 0.001), and the word list memory test (p = 0.012) in ANCOVA adjusting for age and education. The mean SMCQ score was higher in the Haenyeo depressed group than in the non-Haenyeo depressed group. Conclusions The Haenyeo depressed group shows cognitive dysfunction, especially frontal lobe dysfunction, compared to the non-Haenyeo depressed group, indicating the Haenyeo depressed group may have more severe frontolimbic dysfunction due to chronic exposure to hypoxia. The Haenyeo depressed group suffers more somatic symptoms than the non-Haenyeo depressed group.

키워드

참고문헌

  1. Kim HT, Yoo B, KIm WS, KIm YW, Han SK, Shim SS, et al. Pulmonary Function Test and Diving Capacity of Woman Divers in Cheju Island. Tuberc Respir Dis 1989;36:68-74.
  2. Fregly MJ. Activity of the hypothalamic-pituitary-thyroid axis during exposure to cold. Pharmacol Ther 1989;41:85-142. https://doi.org/10.1016/0163-7258(89)90103-4
  3. Choi JC, Lee JS, Kang SY, Kang JH, Bae JM. Chronic daily headache with analgesics overuse in professional women breath-hold divers. Headache 2008;48:1037-1043. https://doi.org/10.1111/j.1526-4610.2007.01017.x
  4. Paranthaman R, Greenstein AS, Burns AS, Cruickshank JK, Heagerty AM, Jackson A, et al. Vascular function in older adults with depressive disorder. Biol Psychiatry 2010;68:133-139. https://doi.org/10.1016/j.biopsych.2010.04.017
  5. Greenstein AS, Paranthaman R, Burns A, Jackson A, Malik RA, Baldwin RC, et al. Cerebrovascular damage in late-life depression is associated with structural and functional abnormalities of subcutaneous small arteries. Hypertension 2010;56:734-740. https://doi.org/10.1161/HYPERTENSIONAHA.110.152801
  6. Iadecola C. Neurovascular regulation in the normal brain and in Alzheimer's disease. Nat Rev Neurosci 2004;5:347-360. https://doi.org/10.1038/nrn1387
  7. Yoo SW, Kim YS, Noh JS, Oh KS, Kim CH, Namkoong K, et al. Validity of Korean version of the Mini-International Neuropsychiatric Interview. Anxiety Mood 2006;2:50-55.
  8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. 4th ed. Washington, DC: American Psychiatric Association;1994.
  9. Cho MJ, Bae JN, Suh GH, Hahm BJ, Kim JK, Lee DW, et al. Validation of Geriatric Depression Scale, Korean Version (GDS) in the Assessment of DSM-III-R Major Depression. J Korean Neuropsychiatr Assoc 1999;38:48-63.
  10. Lee JH, Lee KU, Lee DY, Kim KW, Jhoo JH, Kim JH, et al. Development of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. J Gerontol B Psychol Sci Soc Sci 2002;57:P47-P53. https://doi.org/10.1093/geronb/57.1.P47
  11. Youn JC, Kim KW, Lee DY, Jhoo JH, Lee SB, Park JH, et al. Development of the Subjective Memory Complaints Questionnaire. Dement Geriatr Cogn Disord 2009;27:310-317. https://doi.org/10.1159/000205512
  12. Lee DW, Kim KW, Yoon JC, Jhoo JH, Lee JH, Woo JI, et al. Development of an Informant Report Questionnaire for Dementia Screening: Seoul Informant Report Questionnaire for Dementia (SIRQD). J Korean Neuropsychiatr Assoc 2004;43:209-218.
  13. Han C, Pae CU, Patkar AA, Masand PS, Kim KW, Joe SH, et al. Psychometric properties of the Patient Health Questionnaire-15 (PHQ-15) for measuring the somatic symptoms of psychiatric outpatients. Psychosomatics 2009;50:580-585.
  14. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968;114:797-811. https://doi.org/10.1192/bjp.114.512.797
  15. Taylor WD, Aizenstein HJ, Alexopoulos GS. The vascular depression hypothesis: mechanisms linking vascular disease with depression. Mol Psychiatry 2013;18:963-974. https://doi.org/10.1038/mp.2013.20
  16. Alexopoulos GS. Frontostriatal and limbic dysfunction in late-life depression. Am J Geriatr Psychiatry 2002;10:687-695. https://doi.org/10.1097/00019442-200211000-00007
  17. Godbout JP, Johnson RW. Age and neuroinflammation: a lifetime of psychoneuroimmune consequences. Neurol Clin 2006;24:521-538. https://doi.org/10.1016/j.ncl.2006.03.010
  18. Maes M. Depression is an inflammatory disease, but cell-mediated immune activation is the key component of depression. Prog Neuropsychopharmacol Biol Psychiatry 2011;35:664-675. https://doi.org/10.1016/j.pnpbp.2010.06.014
  19. Wilson I. Depression in the patient with COPD. Int J Chron Obstruct Pulmon Dis 2006;1:61-64.
  20. Stage KB, Middelboe T, Stage TB, Sorensen CH. Depression in COPD--management and quality of life considerations. Int J Chron Obstruct Pulmon Dis 2006;1:315-320.
  21. Di Marco F, Verga M, Reggente M, Maria Casanova F, Santus P, Blasi F, et al. Anxiety and depression in COPD patients: the roles of gender and disease severity. Respir Med 2006;100:1767-1774. https://doi.org/10.1016/j.rmed.2006.01.026
  22. Gozal D, Daniel JM, Dohanich GP. Behavioral and anatomical correlates of chronic episodic hypoxia during sleep in the rat. J Neurosci 2001;21:2442-2450. https://doi.org/10.1523/JNEUROSCI.21-07-02442.2001
  23. Lewin DS, Rosen RC, England SJ, Dahl RE. Preliminary evidence of behavioral and cognitive sequelae of obstructive sleep apnea in children. Sleep Med 2002;3:5-13. https://doi.org/10.1016/S1389-9457(01)00070-3
  24. Rey de Castro J, Rosales-Mayor E. Depressive symptoms in patients with obstructive sleep apnea/hypopnea syndrome. Sleep Breath 2013;17:615-620. https://doi.org/10.1007/s11325-012-0731-1
  25. Pamidi S, Knutson KL, Ghods F, Mokhlesi B. Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Med 2011;12:827-831. https://doi.org/10.1016/j.sleep.2011.08.003
  26. Kim J, Choi N, Lee YJ, An H, Kim N, Yoon HK, et al. High altitude remains associated with elevated suicide rates after adjusting for socioeconomic status: a study from South Korea. Psychiatry Investig 2014;11:492-494. https://doi.org/10.4306/pi.2014.11.4.492
  27. Asmaro D, Mayall J, Ferguson S. Cognition at altitude: impairment in executive and memory processes under hypoxic conditions. Aviat Space Environ Med 2013;84:1159-1165. https://doi.org/10.3357/ASEM.3661.2013
  28. Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M. 'Vascular depression' hypothesis. Arch Gen Psychiatry 1997;54:915-922. https://doi.org/10.1001/archpsyc.1997.01830220033006
  29. Alexopoulos GS, Meyers BS, Young RC, Kakuma T, Silbersweig D, Charlson M. Clinically defined vascular depression. Am J Psychiatry 1997;154:562-565. https://doi.org/10.1176/ajp.154.4.562
  30. Krishnan KR, Hays JC, Blazer DG. MRI-defined vascular depression. Am J Psychiatry 1997;154:497-501. https://doi.org/10.1176/ajp.154.4.497
  31. Alexopoulos GS. "The depression-executive dysfunction syndrome of late life": a specific target for D3 agonists? Am J Geriatr Psychiatry 2001;9:22-29.
  32. Alexopoulos GS, Kiosses DN, Heo M, Murphy CF, Shanmugham B, Gunning-Dixon F. Executive dysfunction and the course of geriatric depression. Biol Psychiatry 2005;58:204-210. https://doi.org/10.1016/j.biopsych.2005.04.024
  33. Paranthaman R, Greenstein A, Burns AS, Heagerty AM, Malik RA, Baldwin RC. Relationship of endothelial function and atherosclerosis to treatment response in late-life depression. Int J Geriatr Psychiatry 2012;27:967-973. https://doi.org/10.1002/gps.2811
  34. Tiemeier H, Bakker SL, Hofman A, Koudstaal PJ, Breteler MM. Cerebral haemodynamics and depression in the elderly. J Neurol Neurosurg Psychiatry 2002;73:34-39. https://doi.org/10.1136/jnnp.73.1.34
  35. Direk N, Koudstaal PJ, Hofman A, Ikram MA, Hoogendijk WJ, Tiemeier H. Cerebral hemodynamics and incident depression: the Rotterdam Study. Biol Psychiatry 2012;72:318-323. https://doi.org/10.1016/j.biopsych.2012.01.019
  36. Martin KC, Barad M, Kandel ER. Local protein synthesis and its role in synapse-specific plasticity. Curr Opin Neurobiol 2000;10:587-592. https://doi.org/10.1016/S0959-4388(00)00128-8
  37. Debiec J, LeDoux JE, Nader K. Cellular and systems reconsolidation in the hippocampus. Neuron 2002;36:527-538. https://doi.org/10.1016/S0896-6273(02)01001-2
  38. Kleim JA, Bruneau R, Calder K, Pocock D, VandenBerg PM, Mac-Donald E, et al. Functional organization of adult motor cortex is dependent upon continued protein synthesis. Neuron 2003;40:167-176. https://doi.org/10.1016/S0896-6273(03)00592-0
  39. Moody DM, Bell MA, Challa VR. Features of the cerebral vascular pattern that predict vulnerability to perfusion or oxygenation deficiency: an anatomic study. AJNR Am J Neuroradiol 1990;11:431-439.
  40. Markus HS, Lythgoe DJ, Ostegaard L, O'Sullivan M, Williams SC. Reduced cerebral blood flow in white matter in ischaemic leukoaraiosis demonstrated using quantitative exogenous contrast based perfusion MRI. J Neurol Neurosurg Psychiatry 2000;69:48-53. https://doi.org/10.1136/jnnp.69.1.48
  41. Ghiadoni L, Virdis A, Magagna A, Taddei S, Salvetti A. Effect of the angiotensin II type 1 receptor blocker candesartan on endothelial function in patients with essential hypertension. Hypertension 2000;35(1 Pt 2):501-506. https://doi.org/10.1161/01.HYP.35.1.501
  42. Nagata R, Kawabe K, Ikeda K. Olmesartan, an angiotensin II receptor blocker, restores cerebral hypoperfusion in elderly patients with hypertension. J Stroke Cerebrovasc Dis 2010;19:236-240. https://doi.org/10.1016/j.jstrokecerebrovasdis.2009.08.004
  43. Metternich B, Schmidtke K, Hull M. How are memory complaints in functional memory disorder related to measures of affect, metamemory and cognition? J Psychosom Res 2009;66:435-444. https://doi.org/10.1016/j.jpsychores.2008.07.005
  44. Yokoyama O, Miura N, Watanabe J, Takemoto A, Uchida S, Sugiura M, et al. Right frontopolar cortex activity correlates with reliability of retrospective rating of confidence in short-term recognition memory performance. Neurosci Res 2010;68:199-206. https://doi.org/10.1016/j.neures.2010.07.2041