불안장애 및 주요우울장애 환자의 우울 증상의 차이
Depressive Symptoms in Anxiety Disorder and Major Depressive Disorder
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objectives Depressive symptoms are often exhibited by individuals with anxiety disorders. Co-morbidity with depressive disorder is associated with more severe symptoms and poorer outcomes in the course of illness. In this study we investigated the symptomatic and sociodemographic correlates of depressive symptoms in anxiety disorders and compared them with those in major depressive disorder. Methods At a psychiatric ward of a university-affiliated hospital, 192 outpatients with anxiety disorders and 119 with major depressive disorder (MDD) were recruited for a consecutive sample. They completed a questionnaire that included Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory, and socio-demographic variables. Results Compared to those with depressive disorders, patients with anxiety disorders showed significantly lower levels of depressive symptoms. However, the difference was confined to the negative attitude sub-scale of BDI, not somatic symptoms and performance difficulty. Multiple regression analysis showed factors that a Global Severity Index of SCL-90-R, state anxiety, lower education, and older age predicted depression in anxiety disorders. In contrast, the Global Severity Index and trait anxiety were extracted for MDD. Conclusion This cross-sectional study indicated that depressive symptoms in anxiety disorders can be differentiated from those of MDD so as to lower level of the core cognitive symptoms of depression. Further studies may benefit from looking at both depressive symptoms and co-morbid depressive diagnosis.
Abstract
Objectives Depressive symptoms are often exhibited by individuals with anxiety disorders. Co-morbidity with depressive disorder is associated with more severe symptoms and poorer outcomes in the course of illness. In this study we investigated the symptomatic and sociodemographic correlates of depressive symptoms in anxiety disorders and compared them with those in major depressive disorder. Methods At a psychiatric ward of a university-affiliated hospital, 192 outpatients with anxiety disorders and 119 with major depressive disorder (MDD) were recruited for a consecutive sample. They completed a questionnaire that included Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory, and socio-demographic variables. Results Compared to those with depressive disorders, patients with anxiety disorders showed significantly lower levels of depressive symptoms. However, the difference was confined to the negative attitude sub-scale of BDI, not somatic symptoms and performance difficulty. Multiple regression analysis showed factors that a Global Severity Index of SCL-90-R, state anxiety, lower education, and older age predicted depression in anxiety disorders. In contrast, the Global Severity Index and trait anxiety were extracted for MDD. Conclusion This cross-sectional study indicated that depressive symptoms in anxiety disorders can be differentiated from those of MDD so as to lower level of the core cognitive symptoms of depression. Further studies may benefit from looking at both depressive symptoms and co-morbid depressive diagnosis.
참고문헌 (30)
- Kessler RC, "Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication", Arch Gen Psychiatry, 62, pp.617~627 (2005)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders (4th ed)" (1994), Washington DC: American Psychiatric Association
- Brown TA, "Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample", J Abnorm Psychol, 110, pp.585~599 (2001)
- Sanderson WC, "Syndrome comorbidity in patients diagnosed with a DSM-III-R anxiety disorder", J Abnorm Psychol, 99, pp.308~312 (1990)
- Alonso J, "12-Month comorbidity patterns and associated factors in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project", Acta Psychiatr Scand Suppl, pp.28~37 (2004)
- Breier A, "Major depression in patients with agoraphobia and panic disorder", Arch Gen Psychiatry, 41, pp.1129~1135 (1984)
- Lesser IM, "Secondary depression in panic disorder and agoraphobia. I. Frequency, severity, and response to treatment", Arch Gen Psychiatry, 45, pp.437~443 (1988)
- Reich J, "Comorbidity of panic and major depressive disorder", J Psychiatr Res, 27(1), pp.23~33 (1993)
- van Balkom AJ, "Comorbid depression, but not comorbid anxiety disorders, predicts poor outcome in anxiety disorders", Depress Anxiety, 25, pp.408~415 (2008)
- Bruce SE, "Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study", Am J Psychiatry, 162, pp.1179~1187 (2005)
- Wittchen HU, "Critical issues in the evaluation of comorbidity of psychiatric disorders", Br J Psychiatry Suppl, pp.9~16 (1996)
- Wittchen HU, "Why do people with anxiety disorders become depressed? A prospective-longitudinal community study", Acta Psychiatr Scand Suppl, pp.14~23 (2000)
- Di Nardo PA, "Syndrome and symptom comorbidity in the anxiety disorders. In Comorbidity in anxiety and mood disorders", pp.205~230 (1990), Washington DC: American Psychiatric Press
- Brown TA, "Comorbidity among anxiety disorders: implications for treatment and DSM-IV", J Consult Clin Psychol, 60, pp.835~844 (1992)
- Mountjoy CQ, "Studies in the relationship between depressive disorders and anxiety states. Part 1. Rating scales", J Affect Disord, 4, pp.127~147 (1982)
- Lee K, "Factor analysis of the Korean version of the state-trait anxiety inventory in patients with anxiety disorders", Anxiety and Mood, 4, pp.104~110 (2008)
- Beck AT, "Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation", Clin Psychol Rev, 8, pp.77~100 (1988)
- Beck AT, "Depression: Clinical, Experimental, and Theoretical Aspects" (1967), NewYork: Harper & Row
- Lee YH, "A Study of the reliability and the validity of the BDI, SDS, and MMPI-D scales", Korean J Clin Psychol, 10, pp.98~113 (1991)
- Derogatis LR, "The SCL-90 and the MMPI: a step in the validation of a new self-report scale", Br J Psychiatry, 128, pp.280~289 (1976)
- Kim JH, "The standardization study of symptom checklist-90-R in Korea III", Ment Health Res, 2, pp.278~311 (1984)
- Spielberg CD, "Manual for the State-Trait Anxiety Inventory" (1970), Palo Alto, California: Consulting Psychologist Press
- Kim JT, "Relationship between trait anxiety and social relatedness" (1978), Seoul: Korea University
- Shin MS, "The cut-off score of the Korean version of Beck Depression Inventory", Korean J Clin Psychol, 12, pp.71~81 (1993)
- Hahn HM, "A standardization study of beck depression inventory in Korea", J Korean Neuropsychiatr Assoc, 25, pp.487~502 (1986)
- Richter P, "On the validity of the Beck Depression Inventory. A review", Psychopathology, 31, pp.160~168 (1998)
- Steer RA, "Differentiation of depressive disorders from generalized anxiety by the Beck Depression Inventory", J Clin Psychol, 42, pp.475~478 (1986)
- Wetzler S, "Problems with the differentiation of anxiety and depression", J Psychiatr Res, 23, pp.1~12 (1989)
- Wang PS, "Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication", Arch Gen Psychiatry, 62, pp.603~613 (2005)
- Mak WW, "The phenomenon of somatization among community Chinese Americans", Soc Psychiatry Psychiatr Epidemiol, 39, pp.967~974 (2004)
