정신과 외래에서 향정신성약물을 복용 중인 환자에서의 하지불편증후군
Restless Legs Syndrome in Psychiatric Outpatients with Psychotropic Agents
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정신과 외래를 방문한 146명을 대상으로 RLS의 발생율과 임상 특징을 조사하여 다음 결과를 얻었다. 1. 연구 대상자 146명 중 34명(23.3%)이 하지불편증후군(RLS)으로 진단되었다. 2. RLS로 진단된 환자 중 15명(44.1%)은 정신과 약물치료 이후에 RLS가 발생하였다. 3. RLS를 경험하고 있는 34명 중 4명(11.7%)만이 RLS에 대한 치료를 받고 있었다. 4. RLS 환자군은 비 RLS 환자군에 비하여 Beck 불안증 척도(25.6 vs. 14.0)와 Beck 우울증 척도(25.1 vs. 18.4) 점수가 유의하게 높았다 (p<0.05). 5. RLS 환자군은 비 RLS 환자군 보다 피츠버그 수면의 질 설문지(PSQI) 점수가 유의하게 높았고, 이는 RLS 환자군의 수면의 질이 비 RLS 환자군의 그것보다 더 낮음을 의미한다(10.59 vs. 8.04, p=0.003). 6. RLS 환자군에서 사건수면(p<0.01)과 신경병증 이환율(p<0.05)이 유의하게 높았다. 이상의 결과는 향정신성약물을 복용하는 정신과 외래 환자에서 RLS의 발생율이 높음을 보여준다. 또한 RLS 환자군이 우울감과 불안감을 더 호소하고 있고, 수면의 질이 더 저하되어 있음을 보여준다. 따라서 향정신성약물을 복용하는 정신과 외래 환자에서 RLS의 진단 및 치료에 대한 관심이 필요하다.
Abstract
Objectives: The purpose of this study was to investigate the clinical characteristics and incidence of restless legs syndrome (RLS) in outpatients with psychiatric illness. Methods: One-hundred forty-six adult patients (male 52, female 94) were selected from among those visited a psychiatric outpatient clinic. RLS was evaluated through an interview method using diagnostic criteria and a severity rating scale for RLS developed by the International RLS Study Group (IRLSSG). The authors also applied Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index, Barnes Akathisia Rating Scale, and neurological examination. Results: Thirty-four (23.3%) among 146 subjects were diagnosed as having RLS. Fifteen (44.1%) among those 34 RLS patients had admitted to have developed their RLS after starting their psychotropic agents and only 4 patients (11.7%) had currently been receiving treatment for their RLS. The RLS group showed higher BDI and BAI scores (p<0.01), and lower sleep quality (p<0.01) compared to those of non-RLS. The RLS group also showed a significantly higher co-morbidity of parasomnias (2=8.5, p<0.01) and peripheral neuropathy (2=5.2, p<0.05). Conclusion: The results from this study suggest that a substantial proportion of outpatients with psychiatric illness are suffering RLS. Our data suggest that clinicians should pay attention to the possible presence of RLS among their patients who are taking psychotropic agents.
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