• 제목/요약/키워드: 주요 우울장애

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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 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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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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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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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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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.

The Relationship Between Self-Esteem, Disability Acceptance, and Depression in Adults with Physical Disabilities (성인 지체장애인의 자아존중감, 장애 수용 및 우울간의 관련성)

  • Moonkyoung Park;Younghee Jeong
    • Journal of Advanced Technology Convergence
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    • v.3 no.3
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    • pp.1-7
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    • 2024
  • This study aimed to identify the factors influencing depression in adults with physical disabilities through a secondary data analysis. The study analyzed data from 867 adults who reported having physical disabilities in the 2018 Panel Survey on Disability conducted by the Korea Disabled People's Development Institute. Descriptive statistics and logistic regression analysis were performed using SPSS 29.0 with a complex sample design. The cause of disability was acquired in 98.1% of the participants, and 53.8% of them reported experiencing depression. Self-esteem (OR=0.18, 95% CI=0.08-0.39) and disability acceptance (OR=0.17, 95% CI=0.08-0.38) were significant factors influencing depression in adults with physical disabilities. These findings suggest that interventions aimed at promoting disability acceptance and enhancing self-esteem may effectively alleviate depression in this population.

The Mediating Effect of Social Support on the Relationship between Parental Stress and Depression Among Parents of Children with a Disability (장애아동부모의 양육스트레스와 우울의 관계: 사회적 지지의 매개효과)

  • Lee, Oan-Na;Park, Gyeong-A
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.4
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    • pp.411-419
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    • 2020
  • The purpose of this study was to examine the mediating effect of social support on the relationship between parenting stress and depression among parents of children with a disability. One hundred and fifty parents of children with a disability from Gwangju area were asked to complete a survey including The Parental Stress Scale, The Social Support Scale, and The Depression Scale. The data was analyzed by descriptive statistics, pearson correlation, and multiple regression analysis using SPSS 24.0. The results of the study are as follows: First, the correlation analysis showed statistically significant correlations among parental stress, social support and depression. Second, the simple regression analysis showed the direct effect of parental stress on depression. Third, the multiple regression analysis showed the mediating effect of social support on the relationship between parental stress and depression. This suggests the social support may reduce the negative effect of the parental stress on the depression. Implications, limitations, and suggestions for future study are discussed.

A Prediction Model for Depression Risk (우울증에 대한 예측모형)

  • Kim, Jaeyong;Min, Byungju;Lee, Jaehoon;Chang, Jae Seung;Ha, Tae Hyon;Ha, Kyooseob;Park, Taesung
    • The Korean Journal of Applied Statistics
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    • v.27 no.2
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    • pp.317-330
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    • 2014
  • Bipolar disorder is a psychopathy characterized by manic and major depressive episodes. It is important to determine the degree of depression when treating patients with bipolar disorder because 810% of bipolar patients commit suicide during the periods in which they experience major depressive episodes. The Hamilton depression rating scale is most commonly used to estimate the degree of depression in a patient. This paper proposes using the Hamilton depression rating scale to estimate the effectiveness of patient treatment based on the linear mixed effects model and the transition model. Study subjects were recruited from the Seoul National University Bundang Hospital who scored 8 points or above in the Hamilton depression rating scale on their first medical examination. The linear mixed effects model and the transition model were fitted using the Hamilton depression rating scales measured at the baseline, six month, and twelve month follow-ups. Then, Hamilton depression rating scale at the twenty-four month follow-up was predicted using these models. The prediction models were then evaluated by comparing the observed and predicted Hamilton depression rating scales on the twenty-four month follow-up.