우울증 센터 내원 초진 환자에서 혈중 코티솔 농도와 해밀턴 우울 평가 척도의 우울증상 항목과의 관계
Association between the Daytime Plasma Cortisol Level and Depression Component of Hamilton Depression Rating Scale in Korean Depression Clinic Outpatients
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Objectives ZZThere is evidence that Hypothalamic-Pituitary-Adrenocortical (HPA) system dysregulation plays a role in the pathophysiology of depression. However which psychiatric symptoms are related to HPA system dysregulation has not been studied well. The primary aim of this study was to investigate which symptom components of the Hamilton Depression Rating Scale (HAM-D) are related to HPA system dysregulation in Korean psychiatric outpatients. The secondary aim was to find other variables that have association with HAM-D components. MethodsZZThis study was a retrospective review of the charts of outpatients who first visited Samsung Medical Center Depression Clinic between July 2012 and October 2013. Among them those who checked the plasma cortisol level and HAM-D within one week of their first visit were selected. Fifty nine patients were selected. The HAM-D was divided into four components, including depression, anxiety, insomnia, and somatic components. Multiple regression of cortisol level was used for four subscales. \ResultsZZSignificant positive correlations were observed between the plasma cortisol level and depression component of HAM-D (beta=0.251, p=0.049). Age also showed negative correlation with the depression component of HAM-D (beta=-0.427, p=0.002). However anxiety, insomnia and somatic components of HAM-D did not show correlation with plasma cortisol level. ConclusionZZOur study suggests that in Korean depression clinic outpatients, the depression component of HAM-D is related to plasma cortisol level.
Abstract
Objectives ZZThere is evidence that Hypothalamic-Pituitary-Adrenocortical (HPA) system dysregulation plays a role in the pathophysiology of depression. However which psychiatric symptoms are related to HPA system dysregulation has not been studied well. The primary aim of this study was to investigate which symptom components of the Hamilton Depression Rating Scale (HAM-D) are related to HPA system dysregulation in Korean psychiatric outpatients. The secondary aim was to find other variables that have association with HAM-D components. MethodsZZThis study was a retrospective review of the charts of outpatients who first visited Samsung Medical Center Depression Clinic between July 2012 and October 2013. Among them those who checked the plasma cortisol level and HAM-D within one week of their first visit were selected. Fifty nine patients were selected. The HAM-D was divided into four components, including depression, anxiety, insomnia, and somatic components. Multiple regression of cortisol level was used for four subscales. \ResultsZZSignificant positive correlations were observed between the plasma cortisol level and depression component of HAM-D (beta=0.251, p=0.049). Age also showed negative correlation with the depression component of HAM-D (beta=-0.427, p=0.002). However anxiety, insomnia and somatic components of HAM-D did not show correlation with plasma cortisol level. ConclusionZZOur study suggests that in Korean depression clinic outpatients, the depression component of HAM-D is related to plasma cortisol level.
참고문헌 (25)
- Lépine JP, "The increasing burden of depression", Neuropsychiatr Dis Treat, 7(Suppl 1), pp.3~7 (2011)
- "The epidemiological survey of mental disorders in Korea" (2011)[URL]
- Akil HA, "Psychopharmacology:the fourth generation of progress", pp.773~785 (1995), Raven Press
- Chrousos GP, "The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis", JAMA, 267, pp.1244~1252 (1992)
- Tafet GE, "Correlation between cortisol level and serotonin uptake in patients with chronic stress and depression", Cogn Affect Behav Neurosci, 1, pp.388~393 (2001)
- Burke HM, "Depression and cortisol responses to psychological stress: a meta-analysis", Psychoneuroendocrinology, 30, pp.846~856 (2005)
- Keller J, "Cortisol circadian rhythm alterations in psychotic major depression", Biol Psychiatry, 60, pp.275~281 (2006)
- Faraj BA, "Expression of a high-affinity serotonin transporter in human lymphocytes", Int J Immunopharmacol, 16, pp.561~567 (1994)
- Faraj BA, "Prevalence of high serotonin uptake in lymphocytes of abstinent alcoholics", Biochem Pharmacol, 53, pp.53~57 (1997)
- Pariante CM, "The glucocorticoid receptor: part of the solution or part of the problem?", J Psychopharmacol, 20(4 Suppl), pp.79~84 (2006)
- Sapolsky RM, "The possibility of neurotoxicity in the hippocampus in major depression: a primer on neuron death", Biol Psychiatry, 48, pp.755~765 (2000)
- 여혜빈, "한국인 주요우울장애 환자에서 혈중 ACTH, Cortisol 농도와 해밀턴 우울 평가 척도의 신체증상 항목과의 상관관계", 생물치료정신의학, 17(2), pp.205~210 (2011), 대한생물치료정신의학회
- Shafer AB, "Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung", J Clin Psychol, 62, pp.123~146 (2006)
- "WebMD LLC c1994-2014"[URL]
- Yehuda R, "Cortisol regulation in posttraumatic stress disorder and major depression:a chronobiological analysis", Biol Psychiatry, 40, pp.79~88 (1996)
- Deuschle M, "Diurnal activity and pulsatility of the hypothalamus-pituitary-adrenal system in male depressed patients and healthy controls", J Clin Endocrinol Metab, 82, pp.234~238 (1997)
- Nelson JC, "DST studies in psychotic depression: a metaanalysis", Am J Psychiatry, 154, pp.1497~1503 (1997)
- Sachar EJ, "Disrupted 24-hour patterns of cortisol secretion in psychotic depression", Arch Gen Psychiatry, 28, pp.19~24 (1973)
- Posener JA, "24-Hour monitoring of cortisol and corticotropin secretion in psychotic and nonpsychotic major depression", Arch Gen Psychiatry, 57, pp.755~760 (2000)
- Watson S, "Hypothalamic-pituitary-adrenal axis function in patients with chronic depression", Psychol Med, 32, pp.1021~1028 (2002)
- Rybakowski JK, "The dexamethasone", corticotropin-releasing hormone test in depression in bipolar and unipolar affective illness, 1999, pp.33, 363~370
- Strickland PL, "Bio-social origins of depression in the community. Interactions between social adversity, cortisol and serotonin neurotransmission", Br J Psychiatry, 180, pp.168~173 (2002)
- Webster EL, "Corticotropin-releasing hormone and inflammation", Ann N Y Acad Sci, 840, pp.21~32 (1998)
- Schulkin J, "Allostasis, amygdala, and anticipatory angst", Neurosci Biobehav Rev, 18, pp.385~396 (1994)
- Gallo JJ, "Age differences in the symptoms of depression: a latent trait analysis", J Gerontol, 49, pp.P251~P264 (1994)
