• 제목/요약/키워드: Subsyndromal depression

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아증후군적 우울증 (Subsyndromal Depression)

  • 박준혁;김기웅
    • 생물정신의학
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    • 제18권4호
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    • pp.210-216
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    • 2011
  • Subsyndromal depression (SSD) is found to be more prevalent than major depressive disorder (MDD) and minor depressive disorder (MnDD). SSD is also associated with adverse clinical outcomes, increased risk of suicide, increased social dysfunction and disability, increased risk for future mood disorders, and increased uses of medical and mental health services. DSM-IV diagnostic criteria are not suitable for capturing SSD. Although there is no agreement on gold standard to define SSD so far, three definitions of SSD are available. First, SSD is defined as having two or more current depressive symptoms without core depressive symptoms (depressive mood or loss of interest) and with time threshold (most of the day and nearly every day over at least two weeks). Second, SSD is defined as having two or more current depressive symptoms with core depressive symptoms and without time threshold. Third, SSD is defined by using cutoff points of depression rating scales. SSD may represent a prodromal, residual, or interepisode symptomatic state in the course of MDD and MnDD. More than a half of SSD patients became any type of depressive disorders (SSD, MnDD and MDD) at 1 year. SSD may represent a discrete category of its own, without prior or consequent episodes of MDD. Considering clinical significance of SSD such as its high prevalence, significant psychosocial impairment and chronicity and serious outcomes, researchers and clinicians should be more vigilant in capturing and caring for patients with SSD.

노인 아증후군적 우울증 환자의 인지기능 및 삶의 질 저하 (Cognitive Impairment and Decreased Quality of Life in Elderly Patients with Subsyndromal Depression)

  • 류재성;김문두;이창인;박준혁
    • 생물정신의학
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    • 제20권2호
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    • pp.45-53
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    • 2013
  • Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

VR 콘텐츠가 재한 중국인 유학생 아증후군적 우울 상태에 미치는 영향 연구 - 주의력회복이론을 기반으로 - (A Study on the Effect of VR Content on Sub-Syndromatic Depression of Chinese Students in Korea - Based on Attention Restoration Theory (ART) -)

  • 정선요;이연우;김치용
    • 한국멀티미디어학회논문지
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    • 제25권1호
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    • pp.124-134
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    • 2022
  • Based on existing research, the psychological state of Chinese students has become a very significant issue that needs to be resolved. In addition to paying attention to the daily life and study of Chinese students, the psychological problems of Chinese students are also worthy of attention. At the same time, if the existing psychological problems are not resolved in time, serious consequences may result. Based on the ART(Attention Restoration Theory) theory, this article uses VR (Virtual Reality) content as a medium, uses 3D modeling software to build a healing scene that helps Chinese students improve their psychological and emotional state, and presents it in a VR device. To achieve the purpose of improving the psychological and emotional state of Chinese students. According to experimental tests, the VR recovery scene constructed by this method can help improve the psychological mood of Chinese international students who already have subliminal depression. The results of independent sample T-tests after data analysis experiments show that after the intervention of the experiment, the depression of the experimental group is significantly improved compared to the control group. It is proved that the method in this study is effective for the mentality and emotion of Chinese international students who have subliminal depression. There is a significant improvement effect.

노년기 우울증 환자의 수면의 질 저하가 삶의 질에 미치는 영향 (Poor Sleep Quality and Its Effect on Quality of Life in the Elderly with Late Life Depression)

  • 최진영;박준혁
    • 생물정신의학
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    • 제21권2호
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    • pp.74-80
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    • 2014
  • Objectives More than half of the elders suffer from chronic sleep disturbances. Moreover, sleep disturbances are more prevalent in patients with depressive disorder than in community dwelling elderly. In this study, we aim to estimate the risk factors of poor sleep quality and its effect on quality of life in patients with late life depression. Methods This study included 159 depressive patients aged 65 years or older who completed Pittsburgh Sleep Quality Index (PSQI). A global PSQI score of 5 or greater indicates a poor sleeper. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview (MINI). Depression was evaluated by the Korean form of Geriatric Depression Scale (KGDS). Global cognition was assessed by Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet. Quality of life was evaluated by the Korean version of Short-Form 36-Item Health Survey (SF-36). Results The frequencies of poor sleepers were 90.5% in major depressive disorder, 71.8% in minor depressive disorder, 47.1% in subsyndromal depressive disorder, and 73.0% in all types of depressive disorders. Multivariate logistic regression analysis indicated that female [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.20-6.67] and higher KGDS score (OR = 1.13, 95% CI = 1.05-1.21) were risk factors of poor sleep quality in patients with late life depression. In the analysis of ANCOVA adjusted for age, gender, education and KGDS score, the mean scores of vitality mental health and mental component summary of SF-36 were lower in poor sleepers than in good sleepers. Conclusions Poor sleepers among patients with late life depression are very common and are associated with female and higher KGDS scores. Poor sleep quality causes a significant negative effect on mental health quality. So researchers and clinicians should be more vigilant in the evaluation and treatment of sleep disturbances in patients with late life depression.

중국인 유학생의 아증후군적 우울증 회복을 위한 방법 연구 (A Study on the Recovery of Sub-Syndromatic Depression in Chinese Students)

  • 정선요;이연우;김치용
    • 한국멀티미디어학회논문지
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    • 제24권10호
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    • pp.1425-1434
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    • 2021
  • Lately, the mental issues of Chinese worldwide understudies have become an unavoidable examination issue. As per important explores in different nations, the level of discouragement inclination of Chinese understudies has been on the ascent. This examination utilizes the Bread cook Wretchedness Scale II to test the psychological condition of 249 Chinese understudies concentrating in South Korea. The outcomes show that Chinese understudies in South Korea likewise have a specific level of mental issues. The extent has reached 34.5% of the absolute number of Chinese understudies in South Korea. This exploration investigates the current circumstance dependent on the review results, and directs a top to bottom examination of the attributes of worldwide understudies in Korea. Simultaneously, it is recommended that mental treatment can be utilized to work on their psychological state. Through the pertinent inquiries for grounds mental directing administrations, it obviously presents the issues that Chinese global understudies face in South Korean grounds mental guiding, just as the school's improvement measures. Simultaneously, this examination consolidates the media SNS social stage, investigates existing issues, and proposes how schools can adequately construct a SNS stage at the degree of mental advising, just as the adapting techniques and systems for Chinese understudies dealing with mental issues.

만성적인 신체질환이 있는 노인 환자의 우울증 조기발견을 위한 병원기반 모델 (A General Hospital-Based Model for Early Detection of Depression in the Geriatric Patients with Chronic Medical Diseases)

  • 박선철;이화영;이동우;한상우;박상호;김여주;최재성;정성원;이소영;나경세;권영준
    • 생물정신의학
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    • 제20권2호
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    • pp.31-39
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    • 2013
  • The geriatric patients with chronic physical diseases are frequently associated with the continuous clusters of depression including nonpathological sadness, subsyndromal depression, minor depressive disorder, and major depressive disorder. Because of the complex and reciprocal relationships among depression, elderly, and chronic physical diseases, screening approaches with specific nosological methods should be needed in the realm of early detection of depression. Cognitive decline is frequently manifested in geriatric depression with medical or neurological diseases. Also, somatic symptoms of depression or emotional symptoms of physical diseases can play a role as a hampering factor in the early detection of depression. Furthermore, after-care has been regarded as an essential factor of depression screening in the geriatric patients with chronic physical diseases. We reviewed the most popular examples of integrated medicine for depression in primary care. Thus, we propose a general hospital-based model for early detection of depression which includes favorable response loop between screening and therapeutic intervention. Our model can be a basis for evidence-based detection and after-care for depression in the geriatric patients with chronic medical diseases.

노년기 우울증 환자의 하지불안증후군의 임상적 중요성 (Clinical Significance of Restless Legs Syndrome in Patients with Late Life Depression)

  • 송재민;박준혁;강지언;이창인
    • 생물정신의학
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    • 제21권3호
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    • pp.107-113
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    • 2014
  • Objectives Restless legs syndrome (RLS) is a sleep disorder characterized by uncomfortable and unpleasant sensations in the legs and an urge to move the legs, usually at night. The aim of this study is to investigate the incidence of RLS in patients with late life depression and its influence on various clinical outcomes such as severity of depression, sleep quality, cognitive function, and quality of life and accordingly, to elucidate the clinical significance of RLS in patients with late life depression (LLD). Methods This study enlisted 170 depressive patients aged 65 years or older from an outpatient clinic. Structured diagnostic interviews were performed using the Korean version of the Mini-International Neuropsychiatric Interview. All patients completed the questionnaires, including the International RLS Severity Scale, the Korean version of Short-Form 36-Item Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). The severity of depression was evaluated by the Korean form of the Geriatric Depression Scale (KGDS) and the level of global cognition was assessed by the Mini-Mental State Examination in the Korean version of The Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (MMSE-KC). Results The incidence of RLS was 17.6% in LLD patients. RLS was more prevalent among the subjects with major depressive disorder (MDD) than those with minor depressive disorder or subsyndromal depressive disorder. The RLS group showed higher score in the KGDS than the Non-RLS group but the difference did not reach the statistical significance (p = 0.095, Student t-test). The mean PSQI score was significantly higher in the RLS group than in the Non-RLS group (p = 0.001, Student t-test). The MMSE-KC score was also lower in the RLS group than in Non-RLS group (p = 0.009, analysis of covariance). But, there was no difference in the score of SF-36 between the RLS group and the Non-RLS group. Conclusions RLS is common in LLD patients, especially in the patients with MDD and is associated with poor sleep quality and cognitive dysfunction, indicating that RLS is clinically significant in patients with LLD. Therefore, RLS should be considered as an important clinical issue in the management of LLD.

자동차사고 후 정신과로 의뢰된 환자의 외상후 스트레스장애 (Posttraumatic Stress Disorder of Patients Referred to Psychiatry after Motor Vehicle Accidents)

  • 연규월
    • 정신신체의학
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    • 제7권2호
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    • pp.174-183
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    • 1999
  • 본 연구는 자동차사고 이후 신체적 증상에 대한 치료를 받은 후 정신과적 진단 및 치료 또는 정신감정을 위해 정신과로 의뢰되었던 44명의 환자를 대상으로 자동차사고와 외상후 스트레스장애와의 관계를 평가하기 위한 것이다. 외상후 스트레스장애 진단은 외상후 스트레스장애 척도(CAPS)를 사용하여 DSM-IV 진단기준에 따라 분류하였고, 축소형 부상척도(AIS)를 사용하여 신체적 손상과 외상후 스트레스장애 증상과의 관계를 조사하고 외상후 스트레스장애와 Axis I 공존질환 유무에 대해 알아 보았다. 자동차 사고후 정신과에 의뢰된 대상자 44명중 20명(45.5%)이 외상후 스트레스장애로 진단되었고 13명(29.5%)이 아증후성 외상후 스트레스장애에 속하였다. 신체적 부상의 정도는 외상후 스트레스장애 증상을 예견하는 것으로 나타났다. 외상후 스트레스장애군은 외상후 스트레스장애 진단 기준 BCD 모든 증상에서 높은 비율을 나타냈고, 아증후성 외상후 스트레스장애군은 기준 B와 D 증상에서 비교적 높은 비율을 나타냈으며, 두 군 모두 기준 B 가운데 '사건에 대한 반복된 꿈' 항목의 비율이 가장 높았다. 외상후 스트레스장애군의 55%가 주요우울증을 동반하였다. 결론적으로 본연구의 결과는 외상후 스트레스장애가 자동차사고 이후 흔히 올 수 있는 정신장애임을 시사하고 있다. 따라서 자동차사고 후 신체적 손상에 대한 치료를 받고 마지막으로 정신과에 의뢰된 환자들에 대해서는 적어도 치료계획에서 외상후 스트레스장애라는 진단을 정규적으로 고려해야만 할 젓이고. 특히 취약성이 있는 환자들에 대해서는 조기 중재가 외상후 스트레스장애 증상을 예방할 수 있을 것이라고 생각된다.

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