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지역사회 정신보건 서비스를 이용하는 불면증을 동반한 만성 조현병 환자의 수면의 특징

The Sleep Characteristics of Chronic Schizophrenia Patients with Insomnia in Community-based Mental Health Services

남민|이유진|황동기
대한수면의학회 (Korean Academy of Sleep Medicine)|2017.12|수면정신생리 (Sleep Medicine and Psychophysiology)|제24권 제2호|pp. 97-105|DOI https://doi.org/10.14401/KASMED.2017.24.2.97

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불면·불안·지역사회 정신건강사업·조현병· 정신병적 증상.Anxiety·Community mental health services·Insomnia·Psychotic symptoms·Schizophrenia
주제분류정신과학

초록

목 적：본 연구의 목적은 불면증과 정신병적 증상이 지속되는 조현병 환자의 수면 장애와 연관된 요인과 수면의특징을 평가하는 것이다. 방 법：지역사회 정신보건 시설에 거주 중이며 불면증과정신병적 증상이 동반된 조현병 환자들이 참여하였다(n = 63). The Korean version of Insomnia Severity Index (ISIK) 와 the Korean Version of Pittsburgh Sleep Quality Index (PSQI-K)와 같은 수면 척도가 평가되었고, ISI-K 점수가 15 점 이상인 대상자들이 연구에 참여하였다. 정신병적, 불안, 우울 증상은 각각 Brief Psychotic Rating Scale (BPRS), the Korean Version of Anxiety Sensitivity Index (K-ASI) 그리고 the Korean Version of Beck Depression Inventory-I (K-BDI)로 평가하였다. 사회인구학적 자료와 ISI-K 그리고 PSQI-K 사이의 상관관계를 확인하기 위해 Pearson correlation analysis를 시행하였다. ISI-K와 PSQI-K에 영향을미치는 각각의 요인을 확인하기 위하여 다중회귀분석으로분석하였다. 결 과：ISI-K와 PSQI-K의 평균 점수는 각각 18.1 ± 2.6 점과 12.0 ± 2.2점이었다. Pearson correlation analysis 결과에서 발병 연령과 ISI-K사이의 음의 상관관계와 BPRS 와 PSQI-K 사이, K-ASI와 모든 수면 척도 사이의 양의 상관관계를 확인하였다. ISI-K와 PSQI-K에 대해 K-ASI와발병연령, K-ASI와 BPRS를 각각 단계적으로 입력한 모든다중회귀분석에서 K-ASI만이 유의한 요인으로 남았다. 결 론：본 연구는 조현병 환자의 불면 증상이 우울 또는정신병적 증상과 무관한 반면, 불안 증상과 관련이 있다는점을 제안한다.

Abstract

Objectives: To evaluate sleep characteristics and factors associated with sleep disturbance in schizophrenia patients with concurrent active psychotic symptoms and insomnia. Methods: Schizophrenia patients with insomnia and active psychotic symptoms (n = 63) were recruited from communitybased mental rehabilitative facilities. Sleep scales such as the Korean version of the Insomnia Severity Index (ISI-K) and the Korean Version of the Pittsburgh Sleep Quality Index (PSQI-K) were evaluated and those with ISI-K ＞15 were included in the study. Psychotic, anxiety and depressive symptoms were rated with the Brief Psychotic Rating Scale (BPRS), the Korean Version of the Anxiety Sensitivity Index (K-ASI), and the Korean Version of the Beck Depression Inventory-I (K-BDI), respectively. Pearson correlation analyses were performed between the sociodemographic data, ISI-K and PSQI-K. Multiple linear regression analysis was conducted to investigate the factors which affected the ISI-K and PSQI-K. Results: The mean ISI-K and PSQI-K scores were 18.1 ± 2.6 and 12.0 ± 2.2, respectively. Pearson correlation analysis showed a negative correlation between age of onset and ISI-K score and positive correlations between BRPS and PSQI-K scores and between K-ASI and both ISI-K and PSQI-K scores. Multiple regression analyses for both ISI-K and PSQI-K with K-ASI, age of onset, and BPRS as covariates revealed K-ASI as the only significant remaining factor. Conclusion: Our study suggests that anxiety symptoms are associated with insomnia symptoms in schizophrenia patients regardless of depressive or psychotic symptoms.

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