• 한국산학기술학회논문지
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• 제18권6호
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• pp.646-652
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• 2017

본 연구는 한국 아동 청소년 패널조사를 활용하여 청소년의 우울과 신체화 증상에 대한 종단적 상호 인과관계를 자기회귀교차지연 모형을 통해서 확인하기 위해 실시하였다. 본 연구의 대상자들은 한국청소년정책연구원에서 실시하는 한국 아동 청소년 패널조사 2011년 2차, 2013년 4차, 2015년 6차에 모두 참여한 1968명의 청소년들을 대상자로 선정하였고, SPSS 18.0 프로그램과 AMOS 18.0 프로그램을 이용하여 자료를 분석하였다. 연구결과, 이전 시점의 우울과 신체화 증상은 모두 다음 시점의 우울과 신체화 증상에 영향을 미치는 것으로 나타났으며, 이전 시점의 우울은 다음 시점의 신체화 증상의 교차지연효과에도 영향을 미치는 것으로 나타나 이전 시점의 우울의 정도가 높을수록 다음 시점의 신체화 증상의 정도가 높아지는 것으로 나타났다. 또한 이전 시점의 신체화 증상은 다음 시점의 우울의 교차지연효과에도 영향을 미치는 것으로 나타나 이전 시점의 신체화 증상의의 정도가 높을수록 다음 시점의 우울의 정도가 높아지는 것으로 나타났다. 본 연구는 청소년의 정신건강 간호중재를 위한 기초자료를 마련했다는데 의의가 있으나, 인지적이고 심리적인 요인들은 다양한 요인들에 의해 변화하기 때문에 이와 관련된 종단적 연구들도 필요하다고 생각한다.

• 정신신체의학
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• 제31권2호
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• pp.108-117
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• 2023

연구목적 신체 증상 장애(Somatic Symptom Disorder, SSD)는 다양한 신체 증상의 발현을 특징으로 하며, 현재까지 환자군 내에서 증상 심각도에 따른 자율신경계 활성의 차이에 대해서는 연구된 바가 거의 없다. 이에 본 연구에서는 신체 증상 장애 환자군에서 심박변이도(Heart Rate Variability, HRV) 차이를 검정하여 증상 심각도에 따른 자율신경계 변화를 반영하는 대표적 지표를 분석하였다. 방 법 2020년 9월 18일부터 2021년 10월 29일까지 강남세브란스병원 정신건강의학과에 내원했던 환자 중, DSM-5 진단 기준에 따라 SSD로 진단받은 환자 총 51명의 의무기록을 후향적으로 수집하였다. 이후, 집단 간 인구사회학 및 임상적 선택편의 보정을 위해 역확률 가중치(Inverse Probability Treatment Weighting, IPTW)를 적용하여 HRV 지표 차이 검정을 실시하였다. 결 과 신체 증상 심각도와 LF (nu), HF (nu), LF/HF, 그리고 SD1/SD2, Alpha1/Alpha2는 통계적으로 유의한 상관관계를 보였으며, IPTW 적용 후 비중증군은 27명(53.0%), 중증군은 24명(47.0%)로 보정되었고, 인구사회학적 요인 및 임상적 특성 차이가 유의미하지 않아 동질성이 확보되었다. 본 모형 분석 결과 고위험군일수록 시간 영역의 RMSSD (β=-0.70, p=0.003), pNN20 (β=-1.04, p=0.019), 주파수 영역은 LF (nu) (β=0.29, p<0.001), HF (nu) (β=-0.29, p<0.001), LF/HF (β=1.41, p=0.001), 그리고 비선형 영역에서는 SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), Alpha1/Alpha2 (β=0.43, p=0.001)에서 유의미한 차이가 검정되었다. 결 론 신체 증상 심각도에 따른 HRV 지표의 차이는 시간과 주파수 영역, 그리고 비선형 영역 전반에서 검정되었으며, 신체 증상이 심할수록 교감신경의 과활성화 및 부교감신경의 저하를 시사하는 HRV 지표들이 유의미하게 높은 경향성을 보였다.

• 정신신체의학
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• 제24권2호
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• pp.174-183
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• 2016

연구목적 본 연구에서는 불안장애와 주요우울장애 및 불안장애와 우울장애가 동반된 중복 진단군의 신체 증상의 빈도와 특성의 차이를 알아보고 여러 신체 증상군과 자살 사고, 자살 계획, 자살 시도와의 관련성에 대해 분석하고자 한다. 방 법 본 연구는 국가적 역학조사연구인 2011년 정신질환 실태 역학 조사 연구(Korean Epidemiologic Catchment Area Study-2011, KECA-2011)에 참여한 만 18세 이상에서 74세 이하의 참여자 6027명 중 지난 1 년 동안 주요우울장애 또는 불안장애의 진단 기준을 만족 하면서, 같은 시기에 최소 1가지 이상의 신체증상을 호소한 378명을 대상으로 하였다. 이후 조사된 신체 증상을 통증 증상군, 소화기 증상군, 가성신경학적 증상군의 세군으로 분류하여, 각 증상군에 따른 자살 사고, 자살 계획 및 자살 시도의 정도를 비교하였다. 면담 도구로는 한국어판 CIDI를 사용하였으며, 이 중 신체 증상에 대한 항목이 포함된 C장과 자살관련 항목이 포함된 S장의 일부 질문을 연구에 사용하였다. 결 과 진단별로 신체 증상의 차이를 비교하였을 때, 주요우울장애에서는 흉통(p=0.016, 95%CI)이, 불안장애에서는 두통(p=0.004, 95%CI)과 묽은 변이나 설사를 나타내는 증상(p=0.018, 95%CI)이, 주요우울장애와 불안 장애의 중복진단군에서는 균형을 잡기 힘든 것(p=0.006), 기절할 것 같은 느낌(p=0.020, 95%CI), 기억을 잃음(p=0.034, 95%CI)의 증상이 유의하게 많았다. 자살 계획의 경우 통증 증상군에서 자살 계획이 있었던 군의 증상의 평균 개수가 계획이 없는 군에 비해 유의하게 높았다(p=0.026, 95%CI). 자살 시도의 경우 소화기 증상군(p=0.004, 95%CI) 및 가성신경학적 증상군(p=0.013, 95%CI) 에서 자살 시도가 있었던 군의 증상의 개수가 시도가 없었던 군에 비해 유의하게 높았다. 자살 사고, 자살 계획, 자살 시도로 갈수록 각 증상군의 신체 증상의 평균의 개수는 증가하는 경향성을 보였다. 결 론 본 연구는 불안장애와 주요우울장애의 신체증상의 특성에 차이가 있음을 보여주었으며, 증상의 개수가 자살 사고에서 자살 계획, 자살 시도로 진행되는 단계로 갈수록 증가하며 일부 증상군에서는 자살 계획과 자살 시도의 유무의 유의한 차이를 보여주는 것으로 나타났다. 이 결과는 비 정신과적 임상 현장에서 다양하고 많은 숫자의 신체 증상을 호소하는 환자의 경우 정신과적인 적극적인 평가 및 자살 위험도에 대한 적극적인 평가가 필요함을 시사한다.

• 대한상한금궤의학회지
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• 제13권1호
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• pp.45-59
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• 2021

Objectives: This study was conducted to confirm the reproducibility of the diagnosis of greater yin disease (太陰病) and the efficacy of herbal treatment using Gyejigajakyak-tang or Gyejigadaehwang-tang in somatic symptom disorder (SSD). We also further refined the characteristics of greater yin disease in SSD. Methods: We analyzed the demographic and treatment data of seven patients with SSD from four Korean medical clinics. The reliability of diagnosis and the efficacy of the treatments were evaluated by the Beck Anxiety Inventory (BAI), a numerical rating scale (NRS), and the patients' statements. Finally, we analyzed patients according to the diagnostic points of Shanghanlun provision 273. Results: Seven SSD patients took Gyejigajakyak-tang or Gyejigadaehwang-tang. The mean age of the patients was 52.1±15.8 years old, and the herbal medication period was 82.2±38.2 days. At the first visit, the patients showed hypochondriasis, obvious stress, and a severe BAI score (40.4±10.9). The NRS significantly decreased from 8.9±1.6 to 0.7±0.7 after the treatments. There were no side effects reported. As a result of analyzing these 7 cases, hypochondriasis, obvious stress, and anxiety were identified, which had been previously suggested as 自痛, 因爾, and 結硬. Conclusions: We confirmed the reproducibility of greater yin disease in 7 SSD cases from 4 medical institutions. These results imply that there could be a considerable relation between SSD and greater yin disease as defined by the Shanghanlun provisions.

• 대한치과기공학회지
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• 제35권4호
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• pp.405-414
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• 2013

Purpose: The purpose of this study was to examine the relationship of the general characteristics of health-related majors to their life expectancy scale, depression scale, health perception scale, subjective wellbeing scale, somatic symptom scale and college life stress scale. And it's also meant to analyze influential factors for their stress about college life. Methods: The subjects in this study were the students who were in the department of dental laboratory technology and the department of dental hygiene at a college located in the region of Iksan, North Jeolla Province. Data were gathered in November and December, 2012. The life expectancy scale, depression scale, health perception scale, subjective wellbeing scale, physical symptom scale, somatic symptom scale and college life stress scale of the general characteristics were analyzed by t-test and one way analyses of variance (ANOVA) and the Duncan's multiple range test at the 95% confidence level to assess the statistical significance. And stepwise multiple regression analysis was conducted to determine what factors would affect the stress of the students about college life. The data were analyzed with the windows ver. 12.0(SPSS GmbH, Germany) statistical software program. Results: Among the general characteristics, there were significant differences according to gender and age in all the variables that were life expectancy scale, depression scale, health perception scale, subjective wellbeing scale, physical symptom scale and college life stress scale. 61.3% of the students responded they slept for six hours or less, and the respondents who slept for six hours or less scored significantly statistically lower in health perception scale, subjective wellbeing scale and physical symptom scale. As for college life stress, the respondents who got depressed more often, whose subjective peace or happiness was lower, whose life expectancy was lower, who had worse physical symptoms, whose living standard was lower and whose academic year was lower were under heavier stress about their college lives. Conclusion: As the worse physical health and worse mental health(life expectancy, depression, health perception, subjective wellbeing and physical symptoms, etc.) of the college students led to heavier stress about college life, how to promote their physical health and mental health should discreetly be considered, and every necessary measure should be taken to improve their physical and mental health.

• 대한불안의학회지
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• 제3권2호
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• pp.116-122
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• 2007

Objective : The purpose of this study was to investigate the strategies used to cope with stress and the cognitive characteristics of somatic symptom perception in patients with panic disorder. Methods : A total of 101 patients who met the DSM-IV criteria for panic disorder and 60 normal controls were recruited for participation in this study. We evaluated the subjects using The Way of Stress Coping Questionnaire (SCQ), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and the Panic Disorder Severity Scale (PDSS). We analyzed the data using an independent t-test and Pearson correlation analysis (p<0.05). Results : The patients who used emotionally focused coping strategies scored significantly lower on the SCQ. The patients with panic disorder showed greater amplification of body sensations in the SSAS, a significantly higher score on the physical interpretation subset of the SIQ, and a lower score on the environmental interpretation subset of the SIQ than the normal controls. The PDSS scores were positively correlated with the SSAS score and physical interpretation score on the SIQ. Conclusion : These results show that patients with panic disorder have poor emotionally focused strategies for coping with stress, greater amplification of body sensations, and a tendency towards a physical interpretation of somatic symptoms.

• 생물정신의학
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• 제16권1호
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• pp.46-52
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• 2009

Objectives : The goal of this study was to compare the clinical characteristics of panic disorder respiratory subtype(PD-R) and non-respiratory subtype(PD-NR). Methods : 84 patients with panic disorder were enrolled and divided into 2 groups, 29 PD-R and 55 PD-NR. Diagnosis of panic disorder was evaluated using Diagnostic and Statistical Manual of Mental Disorders $4^{th}$ edition and Mini International Neuropsychiatric Interview. They were also measured with Hamilton Rating Scale for Anxiety(HAM-A), Hamilton Rating Scale for Depression(HAM-D), and Panic Disorder Severity Scale (PDSS). Results : PD-R group showed significantly higher scores in PDSS than those of PD-NR group(p=.027). After controlling for the severity of panic disorder and gender, PD-R group showed higher HAM-D and somatic anxiety subscale of HAM-A than those of PD-NR group. Furthermore, results of logistic regression analysis suggested that the somatic anxiety was a possible risk factor of PD-R(OR=1.404,p=0.009). Conclusion : These results suggest that somatic anxiety and depressive symptom would be important clinical characteristics of PD-R.

• 대한간호학회지
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• 제37권7호
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• pp.1131-1138
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• 2007

Purpose: The purpose of this study was to investigate the relationships among depression, somatic symptoms, and activities of daily living of elderly women in urban areas. Method: After obtaining participant's consent forms, a one-time, face-to-face, and private interview was conducted with each participant from Sep, 2006 to Jan, 2007 by trained graduate-level students. The questionnaire consisted of K-GDS, PHQ-15, Barthel Index, and Instrumental Activity of Daily Living. The collected data was analyzed with the SPSS/PC 12.0 program, which was used for frequency, percentage, mean, standard deviation, Pearson correlation coefficients, and multiple regression. Results: The major findings of this study were as follows 1) 34.1% of participants belonged to the depression group. 2) There were significant relationships between depression and monthly income, somatic symptoms, ADL, IADL, and number of chronic disease. 3) Significant factors influencing depression were somatic symptoms, ADL, and monthly income. Conclusion: The results of this study give useful information for designing interventions and program development for appropriate depression management and care for elderly women.

• Human Ecology Research
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• 제60권2호
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• pp.289-302
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• 2022

This study examined the effect of private educational expenditure on adolescent depression and somatic symptoms. The sample comprised 2,589 first-grade middle-school students who completed the 2018 Korea Children and Youth Panel Survey. Data were analyzed using ANOVA (the generalized linear model), multiple regression, and quantile regression analysis. The principal results were as follows. First, 15.15% of adolescents reported depression symptoms, and 15.57% reported somatic symptoms. Second, levels of depression were significantly different among classes with a different level of private educational expenditure. Third, depression level was significantly negatively associated with private educational expenditure, in that the higher the private educational expenditure, the lower the depression level. Fourth, the effect of private educational expenditure on adolescent depression was significant at the 70~90th quantile regression, suggesting that private educational expenditure was associated with a higher level of depression symptoms. The results indicate that private education was viewed as a consumption commodity rather than a complementary educational practice or investment in human capital. Private education as a commodity might induce the highly developed and costly private education market. In turn, there is an increased financial burden for education at one end of the social-economic continuum and depression caused by relative deprivation at the other end.

• 한국환경보건학회지
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• 제30권3호
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• pp.283-292
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• 2004

Valid evaluation of community reaction to road-traffic noise exposure is important for the policy making and quality of life. The purpose of this study is to evaluate the relationship between community reaction and nighttime road-traffic noise. The study measured nighttime roadside noise caused by high traffic which is greater than LAeq(22:00-07:00) 65dB(A) and lower than 65dB(A) at Chonju city, from March to April, 2003. Three hundred sixty seven subjects, aged from 20 to 65, were selected from those who are residing close to the major roads. They were asked to answer the questions regarding noise source, stress(PWI-SF), annoyance, disturbance of specific activity, disturbance of sleep, somatic symptom, and four suggested confounding factors. The relationship between annoyance, somatic symptom and noise exposure was not significant. Adjusted odds ratio(95% C.I.) for disturbance of communication　 and disturbance of attention and rest　 were 1.59(1.03-2.71), 1.64(1.06-2.81), respectively. On the other hand sleep disturbance　 was indicated as 1.34(0.77-2.32). The results suggested that federal policy-making about road-traffic noise should consider community reaction evaluated by various perspective including annoyance, disturbance of specific activity, disturbance of sleep, and confounding factors.