한국 주요정신장애의 유병률 및 관련요인：2006 전국정신질환역학조사
Prevalence and Correlates of Major Mental Disorders among Korean Adults：A 2006 National Epidemiologic Survey
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초록
표준화 진단도구인 K-CIDI를 이용하여 전국 12개 지역에서 18~64세 성인 6,510명에 대한 정신장애 역학조사를 실시하였다. 전체 정신장애의 평생 유병률이 29.0% 로 매우 높게 평가되었다. 전체 정신장애의 일 년 유병률과 일 개월 유병률도 16.9%와 14.9%로 현재 집중적인 의학적 관심이 필요한 환자도 상당히 많은 것으로 나타났다. 알코올 사용장애의 평생 유병률이 16.2%로 가장 높았고 니코틴 사용장애(9.0%), 주요우울장애(5.6%), 특정공포증(3.8%) 등이 높은 유병률을 보였다. 정신분열병은 0.1%로 매우 낮은 평생 유병률을 보였다. 과거 한국의 역학조사와 비교했을 때 알코올 사용장애의 유병률은 지속적으로 낮아졌고 주요우울장애의 유병률은 증가하였다. 국내외 역학연구들과의 비교고찰에서, 정신장애의 유병률은 국가에 따라 큰 차이를 보였으나, 중국이나 일본과 같은 아시아권과는 서로 비슷한 경향을 보였다. 이러한 현상은 실제 정신장애 유병률이 낮을 가능성과 함께 DSM-IV와 같은 서구권에서 정의하는 정신장애 진단기준의 적용에 대한 문화적 차이 등 에 의해 영향 받았을 것으로 보인다. 또한 본 연구를 통하여 사회문화적 환경의 영향을 받는 정신장애 환자들의 특성을 파악하고, 해당 질환의 예방을 위한 사회인구학적 특성, 의료서비스 이용실태장애 등에 대한 연구의 필요성이 제기되었다.
Abstract
Objectives: The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods: The Korean Epidemiologic Catchment Area study Replication (KECA-R) was conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target population included all eligible residents aged 18 to 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results: A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of specific disorders were as follows：1) alcohol use disorder, 16.2% and 5.6%；2) nictotine use disorder, 9.0% and 6.0%；3) specific phobia, 3.8% and 3.4%；4) major depressive disorder, 5.6% and 2.5%；and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion: The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.
참고문헌 (29)
- Fleming JA, "Introduction to Epidemiologic Research Methods. in: Textbook in psychiatric epidemiology, 2nd ed", pp.3~4 (2002), John Wiley & Sons
- Robins LN, "National institute of mental health diagnostic interview schedule. Its history, characteristics, and validity", Arch Gen Psychiatry, 38, pp.381~389 (1981)
- Regier DA, "The NIMH epidemiologic catchment area program. Historical context, major objectives, and study population characteristics", Arch Gen Psychiatry, 41, pp.934~941 (1984)
- Lee CK, "Psychiatric epidemiology in Korea. Part I: Gender and age differences in Seoul", J Nerv Ment Dis, 178, pp.242~246 (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)
- 조맹제, "한국어판 Composite International Diagnostic Interview(K-CIDI)의 개발", 신경정신의학, 41(1) (2002), 대한신경정신의학회
- Korea Center for Disease Control and Prevention, "In-depth Analyses of the Third National Health and Nutrition Examination Survey: The Health Interview and Health Behavior Survey Part", 33~34 (2007)
- Alonso J, "Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project", Acta Psychiatr Scand Suppl, pp.21~27 (2004)
- Kessler RC, "Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey", Arch Gen Psychiatry, 51, pp.8~19 (1994)
- Kessler RC, "Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication", Arch Gen Psychiatry, 62, pp.593~602 (2005)
- Helzer JE, "Alcoholism--North America and Asia. A comparison of population surveys with the Diagnostic Interview Schedule", Arch Gen Psychiatry, 47, pp.313~319 (1990)
- Lee S, "Lifetime prevalence and inter-cohort variation in DSM-IV disorders in metropolitan China", Psychol Med, 37, pp.61~71 (2007)
- Kawakami N, "Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002-2003", Psychiatry Clin Neurosci, 59, pp.441~452 (2005)
- Korean Association of Smoking & Health, "Smoking statistics", ~ (2008)
- Chang SM, "Cross-national difference in the prevalence of depression caused by the diagnostic threshold", J Affect Disord, 106, pp.159~167 (2008)
- Chiu E, "Epidemiology of depression in the Asia Pacific region", Australas Psychiatry, 12, pp.S4~S10 (2004)
- Merikangas KR, "Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication", Arch Gen Psychiatry, 64, pp.543~552 (2007)
- Kessler RC, "Validity of the assessment of bipolar spectrum disorders in the WHO CIDI 3.0", J Affect Disord, 96, pp.259~269 (2006)
- Everlyn J, Bromet, "Epidemiology of Psychosis with Special Reference to Schizophrenia (2nd ed). in: Textbook in psychiatric epidemiology", pp.368~369 (2002), John Wiley & Sons
- Bijl RV, "Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS)", Soc Psychiatry Psychiatr Epidemiol, 33, pp.587~595 (1998)
- Saha S, "Incidence of schizophrenia does not vary with economic status of the country: evidence from a systematic review", Soc Psychiatry Psychiatr Epidemiol, 41, pp.338~340 (2006)
- Sung Man Chang, "Economic Burden of Schizophrenia in South Korea", Journal of Korean Medical Science, 23(2), pp.167~175 (2008), 대한의학회
- 2006 The Central Mental Health Supporting Committee Report, "Suh TW", K.I.f.H.A.S.A. Ministry of Health and Welfare, Central Mental Health Supporting Committee, ~ (2006)
- Ministry of Health and welfare and National Health Insurance Corporation, "2005 Medical Aid statistical Yearbook" (2006), Ministry of Health and welfare and National Health Insurance Corporation
- Health Insurance Review Agency and National Health Insurance Corporation, "2005 National Health Insurance Statistical Yearbook" (2006), Health Insurance Review Agency and National Health Insurance Corporation
- Demyttenaere K, "Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys", JAMA, 291, pp.2581~2590 (2004)
- Wittchen HU, "Reliability and procedural validity of UM-CIDI DSM-III-R phobic disorders", Psychol Med, 26, pp.1169~1177 (1996)
- Blazer DG, "The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey", Am J Psychiatry, 151, pp.979~986 (1994)
- Kessler RC, "Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey", Br J Psychiatry, pp.17~30 (1996)