• Title/Summary/Keyword: 주요우울장애

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Clinical Characteristics and Heart Rate Variability in Patients with Comorbid Panic Disorder and Major Depressive Disorder (주요우울장애가 동반된 공황장애 환자의 임상 특징과 심박변이도)

  • Choi, Young-Hee;Kim, Won;Kim, Min-Sook;Yoon, Hye-Young;Choi, Seung-Mi;Woo, Jong-Min
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.50-57
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    • 2005
  • Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

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Alexithymia in Major Depressive Disorder and Subclinical Depression (주요 우울장애와 준임상적 우울증에서의 감정표현불능증)

  • Kim, Seog-Ju;Yu, Seung-Hee;Kim, Seong-Youn;Kim, Dong-Wook;Cho, In-Hee;Cho, Seong-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.100-106
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    • 2007
  • Objectives : The objective of the present study was to investigate alexithymia in major depressive disorder(MDD) and subclinical depression(SCD). Methods : Three hundred eighty-six community-dwelling adults(238 females and 148 males, age 19-79; mean age $43.0{\pm}13.9$) were recruited. Structured clinical Interview for DSM-IV(SCID) was conducted for the diagnosis of MDD or other Axis I psychiatric disorders. The Center for Epidemiological Studies for Depression Scale(CES-D) and the Totonto Alexithymia Scale(TAS) were administered to assess depressive symptom and alexithymia, respectively. Among subjects without MDD, those who had minor depressive disorder on the SCID or high scores(i.e. over 16) on the CES-D were defined as subjects with SCD. TAS total score and factor I, II, III scores of TAS in MDD, SCD, and non-depressive controls were compared. Results : Among 386 subjects, 38 subjects(9.8%) were diagnosed as MDD by DSM-IV criteria, while 57 subjects(14.8%) were classified into SCD group. There were significant differences between 3 groups(MDD, SCD and non-depressive controls) in total score($F_{2,383}=14.0$, p<0.01), factor I(difficulty in identifying feeling)($F_{2,383}=23.4$, p<0.01) and factor II(difficulty in describing feeling)($F_{2,383}=7.8$, p<0.01), but not factor III(external oriented thinking)($F_{2,383}=1.8$, p=0.16) of TAS. In post-hoc analysis, both MDD subjects and SCD subjects had higher scores in TAS total, factor I and factor II, compared to non-depressive controls(all p<0.01). In contrast, there were no significant differences between MDD subjects and SCD subjects in any TAS factor. Conclusion : In this study, both MDD subjects and SCD subjects were more alexithymic than non-depressive control subjects. These findings suggest that SCD, as well as MDD, is also related to alexithymia.

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Difference of Somatic Symptoms between Anxiety Disorder and Major Depressive Disorder and Their Domainal Association with Suicidal Idealization, Plan and Attempts (불안 장애와 주요우울장애에서 나타나는 신체 증상과 증상군에 따른 자살 사고, 계획, 행동과의 관계 고찰)

  • Ahn, Jun Seok;Kim, Eun young;Cho, Maeng Je;Hong, Jin Pyo;Hahm, Bong-Jin;Chung, In-Won;Ahn, Joon-Ho;Jeon, Hong Jin;Seong, Su Jeong;Lee, Dong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.174-183
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    • 2016
  • Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.

Difference in Isoproterenol-Stimulated Cyclic AMP Levels of Lymphocytes between the Subgroups of Depressive Disorders (우울장애 아형간에 Isoproterenol 자극후 임파구 Cyclic AMP Levels의 차이)

  • Bahk, Won-Myong;Jeon, Yang-Whan;Kim, Kwang-Soo;Sung, Yang-Sook
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.46-50
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    • 1996
  • This study was designed to examine the basal cyclic AMP levels and the $10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels of lymphocytes, by which ${\beta}$-adrenoceptor function was shown, between to normal controls and 17 drug free patients(8 major depresive patients and 9 dysthymic patients), who were diagnosed by DSM-III-R. The severity of depression was assessed by Hamilton Rating Scale for Depression (HDRS). Cyclic AMP levels were measured by radioimmunoassay(double antibody). The results were as follows ; 1) HDRS score was significantly higher in major depressive patients($41.8{\pm}4.6$) than in dysthymic patients($24.0{\pm}4.2$)(p<005). 2) There was no Significant difference in basal cyclic AMP levels among normal controls($3.9{\pm}1.7pmol/10^6cells/10min$), major depressive patients($2.1{\pm}0.5pmol/10^6cells/10min$), and dysthymic patients($3.9{\pm}1.8pmol/10^6cells/10min$). 3) There was significant difference in net cyclic AMP levels($10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels minus basal cyclic AMP levels) among normal controls($16.5{\pm}6.0pmol/10^6cells/10min$), major depressive patients($3.0{\pm}1.4pmol/10^6cells/10min$), dysthymic patients($10.9{\pm}4.4pmol/10^6cells/10min$)(p <005). 4) The net cyclic AMP levels were significantly correlated with HDRS scores in major depressive patients(${\gamma}=-0.8^6$, p<0.05), but not in dysthymic patients(${\gamma}=0.43$, p=0.25). In conclusion, we suggested that the dysthymic disorder might differ from the molar depressive disorder not only in the severity of depressive symptoms but also in ${\beta}$-adrenergic responsiveness of lymphocytes, which was regarded as a biological marker of depressive disorder.

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Psychological Characteristics of Suicide Attempters with Major Depressive Disorder using the Minnesota Multiphasic Personality Inventory-2 Restructured Form (다면적 인성검사 II 재구성판으로 살펴본 주요우울장애 자살 시도자의 심리적 특성)

  • Choi, Ji-Hyun;Park, Eun-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.1-10
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    • 2021
  • Objectives : This study was conducted to investigate differences in psychological characteristics between major depressive disorder (MDD) patients with and without suicide attempt using MMPI-2-RF. Methods : Subjects were 107 MDD patients who had visited the department of psychiatry of hallym university hospital and met the DSM-IV diagnostic criteria of MDD by the korean version of MINI-Plus 5.0.0. The patients were divided into suicidal attempters (n=43) and non-suicidal attempters (n=64) using C-SSRS. The one-way ANOVA was used to compare MMPI-2-RF scale scores between two groups. Additionally, ANCOVA was conducted considering the severity of depressive symptom and comorbidity as covariate. Results : Our results showed that Suicide/Death Ideation (SUI), Inefficacy (NFC) and Interpersonal Passivity (IPP) scales were significantly higher in the MDD patients with suicidal attempt compared to MDD patients without suicidal attempt (p<0.05). However, after controlling for the severity of depressive symptom and comorbidity, SUI scale showed a significant tendency (p<0.10). Conclusions : The result suggests that MMPI-2-RF scales could be a useful tool for identifying patients transitioning to actual suicidal attempts in the moderate or severe major depressive disorder group. Limitations of this study and directions for further research are also discussed.

Decreased White Matter Structural Connectivity in Psychotropic Drug-Naïve Adolescent Patients with First Onset Major Depressive Disorder (정신과적 투약력이 없는 초발 주요 우울장애 청소년 환아들에서의 백질 구조적 연결성 감소)

  • Suh, Eunsoo;Kim, Jihyun;Suh, Sangil;Park, Soyoung;Lee, Jeonho;Lee, Jongha;Kim, In-Seong;Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.153-165
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    • 2017
  • Objectives : Recent neuroimaging studies focus on dysfunctions in connectivity between cognitive circuits and emotional circuits: anterior cingulate cortex that connects dorsolateral orbitofrontal cortex and prefrontal cortex to limbic system. Previous studies on pediatric depression using DTI have reported decreased neural connectivity in several brain regions, including the amygdala, anterior cingulate cortex, superior longitudinal fasciculus. We compared the neural connectivity of psychotropic drug naïve adolescent patients with a first onset of major depressive episode with healthy controls using DTI. Methods : Adolescent psychotropic drug naïve patients(n=26, 10 men, 16 women; age range, 13-18 years) who visited the Korea University Guro Hospital and were diagnosed with first onset major depressive disorder were registered. Healthy controls(n=27, 5 males, 22 females; age range, 12-17 years) were recruited. Psychiatric interviews, complete psychometrics including IQ and HAM-D, MRI including diffusion weighted image acquisition were conducted prior to antidepressant administration to the patients. Fractional anisotropy(FA), radial, mean, and axial diffusivity were estimated using DTI. FMRIB Software Library-Tract Based Spatial Statistics was used for statistical analysis. Results : We did not observe any significant difference in whole brain analysis. However, ROI analysis on right superior longitudinal fasciculus resulted in 3 clusters with significant decrease of FA in patients group. Conclusions : The patients with adolescent major depressive disorder showed statistically significant FA decrease in the DTI-based structure compared with healthy control. Therefore we suppose DTI can be used as a bio-marker in psychotropic drug-naïve adolescent patients with first onset major depressive disorder.

발달장애자녀 양육경험이 중년기 어머니의 우울증에 미치는 영향: 자기자비의 매개효과와 자기이해의 조절효과

  • 이금자;변상해
    • 한국벤처창업학회:학술대회논문집
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    • 2023.11a
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    • pp.151-156
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    • 2023
  • 대부분의 발달장애를 돌보는 어머니의 양육경험 속에는 스트레스로 인한 부정적 정서 및 우울증을 포함하지만, 어떤 어머니들은 장애자녀로 인해 가족 및 사회적 친화력을 높이고 긍정적인 정서경험을 통해 자신 및 가족의 삶의 질을 향상시켜 나간다. 본 연구는 발달장애를 돌보는 중년기 어머니들의 양육경험과 우울증의 상관관계에 있어 어머니의 자기자비와 중년기의 신체 및 심리적 특성에 대한 자기이해가 어떠한 영향을 미치는가에 대해 탐색하고자 한다. 연구수행에 필요한 자료 수집을 서울, 경기를 포함한 전국에 사는 발달장애 중년기 어머니 700명을 대상으로 하며, 자료는 SPSS PC+ Ver 28을 활용하여 빈도분석과 주요 변수에 대한 기술통계를 실시하고, 변인 간 상관관계, 회귀분석을 실행한다. 본 연구의 의의는 발달장애인 자녀를 돌보는 어머니의 양육 스트레스를 줄이고 건강한 가족회복을 위해 어머니의 자존감을 향상시킬 수 있는 자기자비의 역할과 중년기에 대한 자기이해를 강화하도록 도울 수 있는 장애인 가족지원 정책 및 사회 서비스 개발에 기여하고자 한다.

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The Characteristics of Depression in Cancer Patients on Chemotherapy (항암제 투여 환자의 우울 양상)

  • Joo, Yeol;Seo, Wan-Seok;Kim, Jin-Sung;Lee, Jong-Bum;Cheung, Seung-Douk;Song, Shin-Ho;Bai, Dai-Seog;Lee, Kyung-Hee;Hyun, Myung-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.154-165
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    • 2002
  • Objectives : The purpose of this study was to identify characteristics of depression in cancer patients treated with chemotherapy. Methods : Subjects were 37 cancer inpatients of oncology in Yeungnam university hospital. BDI and ZDS were done and HDS was performed through semistructured interview. Results: 1) There were no significant differences of depression scale score according to sex, education, religion, marital status. 2) The mean scores of BDI, ZDS and HDS in 37 cancer patients were 18.27${\pm}$7.73, 36.51${\pm}$10.82, 15.14${\pm}$6.60, respectively. 3) HDS, ZDS scores were significantly higher in other cancer group receiving high dose chemotherapy. 4) Item score for depressed mood, diurnal variation(p<0.001), dissatisfaction(p<0.01), physical anxiety, decreased libido, sleep disturbance(p<0.05) were significantly higher in other cancer group than others. 5) Eight patients were diagnosed as having major depressive disorder, 11 as adjustment disorder, and 18 patients had no axis I diagnosis. 6) In major depressive disorder group, the score of the depressed mood item in ZDS was high (p<0.05). HDS item score for depressed mood, work difficulty, anxiey(p<0.001), psychomotor retardation(p<0.01) were significantly higher in major depressive disorder group. 7) In patients with adjustment disorder, ZDS item score of constipation(p<0.001), fatigue, anorexia (p<0.01), emptiness, sleep disturbance, dissatisfaction, weight loss(p<0.01) were high. HDS item score of hypochondriasis(p<0.01), agitation(p<0.01), fatigue, decreased libido(p<0.05) were significantly higher in adjustment disorder group. Conclusion : Some psychiatric disorders, such as adjustment disorder and major depressive disorder were common in the cancer patients in chemotherapy. Psychiatric intervention will increase compliance of cancer treatment and improve the quality of life. This study suggests that it would be important to consider the nature of somatic symptoms in diagnosing depression in cancer patients.

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Comparison of Emotional and Psychological Characteristics between Suicide Attempters and Non-Attempters in Depressed Patients : Using MMPI-2 Profiles (우울장애 환자의 자살 시도 여부에 따른 심리적 특성의 차이 : MMPI-2 프로파일을 중심으로)

  • Lee, Seul-Ah;Kim, Keun-Hyang;Suh, Shin-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.40-49
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    • 2012
  • Objectives : To examine emotional and psychological characteristics associated with suicide attempts in depressed patients. Methods : A sample of 37 inpatients diagnosed with major depressive disorder or depressive disorder NOS was divided into two groups : lifetime suicide attempters(N=15 ; 40.54%), non-attempters(N=22 ; 59.46%). Beck Depression Scale(BDI), Beck Anxiety Scale(BAI), Hamilton Depression Rating Scale(HDRS), Hamilton Anxiety Rating Scale(HARS), and MMPI-2 were used to evaluate symptoms severity and psychological characteristics. Results : Suicide attempters scored higher on the BDI though there were no group differences on the HDRS and on the both anxiety scales. Also they showed higher scores on the F, Fb, Pa, RC1, DEP, HEA, PK, AAS among MMPI-2 subscales. Our findings suggest that suicide attempters among depressed patients undergo more severe subjective distress and difficulties in adjustment than non-attempters. Also they were more hostile to others and showed lower trust. Lastly, they showed more somatic complaints and substance related problems. Conclusion : The present study showed that suicide attempters among depressed patients have distinct emotional and psychological characteristics. MMPI-2 would be helpful to assess suicidal risk of depressed patients.

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