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양극성 장애에서 발병 연령에 따른 증상 및 예후의 차이 : 전향적 1년 추적 연구

Clinical Features and Prognosis Related to Age at Onset in Bipolar Disorder : A Prospective 1 Year Follow-up

김용구|나경세
대한신경정신의학회 (Korean Neuropsychiatric Association)|2007.03|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제46권 제2호|pp. 122-128

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키워드

발병 연령·양극성 장애·경과·결과·재발·사회적응 척도.Age at onset· Bipolar disorder· Course· Outcome· Relapse· Social adjustment scale.
주제분류정신과학

초록

본 연구는 국내에서 최초로 양극성 장애의 발병 연령에 따른 증상과 예후를 전향적으로 평가했다는 점에서 그 의의가 있다고 하겠다. 본 연구 결과 양극성 장애 환자들은 그 발병 연령에 따라 1년이 경과한 시점에서의 사회직업적 기능 수준에 차이가 있음을 알 수 있었다. 30세 이전에 발병한 환자들은 정신병리 척도 점수와 무관하게 30세 이후에 발병한 환자들에 비하여 사회직업적 기능 수준이 떨어졌다. 이러한 결과는 향후 양극성 장애 환자들의 유지치료에서 사회직업적 기능 수준에 대해 별도로 평가해야 할 필요성을 제기하는 것이다. 또한 양극성 장애 환자들의 사회직업적 기능 수준에 영향을 미치는 요인에 대한 많은 연구가 이루어져야 할 것이다.

Abstract

Objectives：There have been several studies demonstrating that age at onset is associated with clinical and functional outcome in bipolar disorder. The purpose of this study was to investigate whether age at onset would influence on the prognosis of patients with bipolar I disorder in a Korean sample. Methods：Thirty-one patients with bipolar I disorder (DSM-IV) were recruited. Age at onset was split at age 30 years into early onset (n=15) and late onset (n=16) groups. These patients were followed at 1 year to assess re-hospitalization, psychiatric symptoms (Brief Psychiatric Rating Scale, Young Mania Rating Scale), and social functioning (Korean version of the Social Adjustment Scale II revised version：KSAS II-RV). The subgroups were compared by Mann-Whitney U test and chi-square test. Results：Early onset group had more psychotic symptoms at hospitalization (χ2=5.743, p=.029) and had more KSAS IIRV score after 1 year (U=49.000, p=.004). Other psychiatric symptoms except psychosis were not significantly different between early onset and late onset group. KSAS II-RV score was not significantly correlated with BPRS and YMRS score. Conclusion：Our data suggest that early onset group may have poorer social functioning than late onset group in bipolar I disorder. (J Korean Neuropsychiatr Assoc 2007;46(2):122-128)

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