한국 노년기 혈관성 우울증의 임상적 특성에 관한 연구
Clinical Characteristics of Vascular Depression in Korean Elderly People
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초록
본 연구는 혈관성 우울증의 가설을 지지하는 여러 연구들을 토대로 하여, 한국 노인 인구에 있어서도 혈관성 우울증의가설을 지지할 만한 여러 가지 임상적인 특징들이 관찰되는지를 규명하려 하였다. 혈관성 우울증 환자의 경우, 비혈관성우울증 환자에 비해 여러 영역의 신경심리학적 기능, 특히 실행기능에 있어서 두드러진 저하를 보였으나 우울증상 자체에있어서는 유의미한 차이가 관찰되지 않았다. 본 연구의 결과를 토대로 볼 때, 혈관성 우울증 환자에 있어서 인지기능의 저하, 특히 실행기능의 저하는 일상생활 수행에 장애를 일으킬것으로 보이며, 우울증 자체의 완전한 관해에 도달하는 데에도 지장을 줄 것으로 추정된다. 따라서 향후에는 혈관성 우울증 환자들의 치료경과 및 예후를 규명하는 장기적인 연구가더 필요할 것으로 보인다.
Abstract
Objectives This study was done in Korean elderly people in order to examine the relationship of white matter hyperintensity with clinical neuropsychological function and depression symptom severity. Methods A total of 148 subjects diagnosed first major depressive episode after age of 60 years were included. Brain magnetic resonance imaging scan was rated with the modified Fazekas White Matter Rating Scale by researcher blinded to clinical information. Cognitive function was evaluated with a comprehensive neurological battery and depression severity was assessed by Hamilton Depression Scale. Subjects were divided into vascular depression group and non vascular group according to the degree of white matter hyperintensity. Independent t-test was used to compare clinical difference between two groups and correlation analysis was used to identify whether white matter hyperintensity severity is correlated with neuropsychological function and depressive symptom. Results Vascular depression group was significantly poorer performance in verbal fluency, Boston naming test, Mini-Mental State Examination, trail making test B and stroop test (p<0.05). Furthermore, trail making test B and stroop test performance was correlated with white matter hyperintensity severity. However, Hamilton Depression Scale score was not significantly different between two groups. Conclusion Several findings from our study suggest that white matter hyperintensity is associated with neuropsychological performance, especially executive function. Moreover, executive dysfunction might contribute to poor treatment outcome of vascular depression group.
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