고등학생을 대상으로 한 양극성 장애의 선별검사
Screening of Bipolar Disorders in High School Students
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참고문헌
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초록
저자들은 K-MDQ를 이용하여 국내에서 전국 규모로 처음 시도되는 고등학생을 대상으로 한 양극성 장애 선별검사를 시행하였다. 2,000명의 대상자 중 104명(5.2%)에서 양극성 범주 장애로 선별할 수 있었다. 이러한 결과는 최근에 이루어진 한국인의 정신병 유병률의 결과에 비해서 높은 수치를 보이지만, 오히려 외국의 연구 결과들과는 근접하는 수치로서 비교적 이른 연령층에서부터 양극성 장애에 대해 체계적인 선별이 필요함을 의미한다. 그러나 본 연구의 결과는 K-MDQ를 이용한 양극성 범주 장애가 의심되는 경우를 단순히 선별검사를 통해서 파악한 수준이기 때문에 향후에 보다 구체적인 연구를 통해서 청소년에서의 양극성 범주 장애의 유병률을 확인하는 작업이 반드시 필요할 것으로 여겨진다.
Abstract
Objectives: This study aimed to assess the prevalence of bipolar spectrum disorders among Korean high school students (individuals in late adolescence) using the Korean version of the Mood Disorder Questionnaire (K-MDQ). Methods: Two thousand male and female participants were proportionately selected from among high school students nationwide. From November 2007 through February 2008, we conducted an epidemiological survey of, and administered the K-MDQ to, these participants, assessed their psychometric properties, and compared characteristics between K-MDQ-positive and K-MDQ-negative participants. Results: The K-MDQ’s internal consistency (Cronbach’s alpha) was 0.74. The item-total score correlations ranged from 0.35 to 0.57, and all were statistically significant (p<.001). Factor analysis with varimax rotation revealed 3 factors that explained 42.6% of total variance. We found the cutoff endorsement of the K-MDQ score (7 or more in criteria 1) in 1207 students (60.4%) and found 104 (5.2%) subjects were K-MDQ-positive, meeting all 3 K-MDQ criteria. The mean K-MDQ total score was 7.2±2.9 and total scores of K-MDQ-positives and K-MDQ-negatives were 9.9±1.7 and 7.0±2.9, respectively. K-MDQ-positives and K-MDQ-negatives showed no differences in the sociodemographic variables we assessed. Endorsement of items in total subject ranged from 15.7% to 77.7%. All items except item 8 (more energy) differed significantly in endorsement between K-MDQ-positives and K-MDQ-negatives. Items accounting for over 30% of the endorsement differences between K-MDQ-positives and K-MDQ-negatives were“feel so good,” “so irritable,” and“excessive, foolish, risky behavior.” Conclusion: The K-MDQ was a relatively valid screening tool for Korean high school students. Per the result of the K-MDQ survey, suspected lifetime prevalence of bipolar spectrum disorders for those in late adolescence (high school students) seems to be 5.2%, suggesting that systemic screening for bipolar spectrum disorder should be required for this age group.
참고문헌 (29)
- Angst J, "The evolving epidemiology of bipolar disorder", World Psychiatry, 1, pp.146~148 (2002)
- Hantouche EG, "Systematic clinical methodology for validating bipolar-Ⅱ disorder: data in mid-stream from a French national multisite study (EPIDEP)", J Affect Disord, 50, pp.163~173 (1998)
- Benazzi F, "Prevalence of bipolar Ⅱ disorder in outpatient depression: a 203-case study in private practice", J Affect Disord, 43, pp.163~166 (1997)
- Altshuler LL, "Antidepressant-induced mania and cycle acceleration: a controversy revisited", Am J Psychiatry, 152, pp.1130~1138 (1995)
- Spitzer RL, "The Structured Clinical Interview for DSM-Ⅲ-R (SCID), Ⅰ: history, rationale, and description", Arch Gen Psychiatry, 49, pp.624~629 (1992)
- Judd LL, "The long-term natural history of the weekly symptomatic status of bipolar Ⅰ disorder", Arch Gen Psychiatry, 59, pp.530~537 (2002)
- Judd LL, "A prospective investigation of the natural history of the longterm weekly symptomatic status of bipolar Ⅱ disorder", Arch Gen Psychiatry, 60, pp.261~269 (2003)
- 전 덕 인, "한국형 기분장애 질문지의 타당화 연구", 신경정신의학, 44(5), pp.583~590 (2005), 대한신경정신의학회
- Hirschfeld RM, "Development and validation of a screening instrument for bipolar spectrum disorder; the mood disorder questionnaire", Am J Psychiatry, 157, pp.1873~1875 (2000)
- Hirschfeld RM, "Validity of the mood disorder questionnaire: a general population study", Am J Psychiatry, 160, pp.178~180 (2003)
- Hirschfeld RM, "Screening for Bipolar Disorder in the Community", J Cline Psychitry, 64, pp.53~59 (2003)
- Miller CJ, "Sensitivity and specificity of the Mood Disorder Questionnaire for detecting bipolar disorder", J Affect Disorder, 81, pp.167~171 (2004)
- Calabrese JR, "Predictors of bipolar disorder risk among patients currently treated for major depression", Med Gen Med, 8, pp.38~ (2006)
- Kim B, "Bipolarity in depressive patients without histories of diagnosis of bipolar disorder and the use of the Mood Disorder Questionnaire for detecting bipolarity", Compr Psychiatry, 49, pp.469~475 (2008)
- Wagner KD, "Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents", J Clin Psychiatry, 67, pp.827~830 (2006)
- Yoon BH, "Screening of bipolar disorder in university students", Poster presentation at the 7th International Forum on Mood and Anxiety Disorders (2007)
- Benazzi F, "The dual factor structure of self-rated MDQ hypomania: energized-activity versus irritable-thought racing", J Affect Disord, 73, pp.59~64 (2003)
- Mangeli L, "Assessing the community prevalence of bipolar spectrum symptoms by the Mood Disorder Questionnaire", Psychother Psychosom, 74, pp.120~122 (2005)
- Chung KF, "Validation of the Chinese version of Mood Dosrder Questionnaire in a psychiatric population in Hong Kong", Psychiatr Clini Neurosci, 62, pp.464~471 (2008)
- Sanchez-Moreno J, "Adaptation and validation of the Spanish version of the Mood Disorder Questionnaire for the detection of bipolar disorder", Bipolar Dis, 10, pp.400~412 (2008)
- Dell'Osso L, "Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features", Bipolar Disord, 4, pp.315~322 (2002)
- Goldney RD, "Bipolar Ⅰ and Ⅱ disorders in a random and representative Australian population", Aust N Z J Psychiatry, 39, pp.726~729 (2005)
- Angst J, "The emerging epidemiology of hypomania and bipolar Ⅱ disorder", J Affect Disord, 50, pp.143~151 (1998)
- Lee CK, "A nationwide epidemiological study of mental disorders in Korea", Psychiatry Clin Neurosci, 52, pp.S268~S274 (1998)
- Lee CK, "Psychiatric epidemiology in Korea. Part Ⅰ: Gender and age differences in Seoul", J Nerv Ment Dis, 178, pp.242~246 (1990)
- Lee CK, "Psychiatric epidemiology in Korea. Part Ⅱ: Urban and rural differences", J Nerv Ment Dis, 178, pp.247~252 (1990)
- Cho MJ, "Lifetime and 12-month prevalence of DSM-Ⅳ psychiatric disorders among Korean adults", J Nerv Ment Dis, 195, pp.203~210 (2007)
- Hammen C, "Stress reactivity in bipolar patients and its relation to prior history of disorder", Am J Psychiatry, 154, pp.856~857 (1997)
- Hammen C, "Sociotropy", autonomy and vulnerability to specific life events in patients with unipolar depression and bipolar disorders, 1989, pp.98, 154~160