노년기 외상후 재경험 및 우울 증상과 신경인지 기능의 관계: 한국전쟁 민간인 학살을 경험한 생존자와 유가족을 중심으로
Association of geriatric posttraumatic reexperience and depressive symptoms with neurocognitive functioning: Among survivors and families of massacre during Korean War
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
한국 사회는 근현대사에 여러 외상 사건이 있었고 이에 노년기 인구의 외상후스트레스장애(posttraumatic stress disorder, PTSD) 연구는 중요하다. PTSD 증상은 특히 신경인지 기능과 연관성이 보고되고 있어, 신경인지장애의 예방과 조기 개입을 위해서 이에 관한 근거가 필요하나 국내 근거는 부족한 실정이다. 본 연구는 한국전쟁 민간인학살 사건을 경험한 생존자와 유가족 총 48명의 참여로 한국판 국제 트라우마 인터뷰(International Trauma Interview) PTSD 면담 점수와 한국판 간이정신상태검사(Korean-Mini Mental State Examination, K-MMSE)로 측정한 신경인지 기능의 관련성을 탐색하였다. K-MMSE 총점은 교육 수준, 우울 증상과 관련이 있었다. 연령과 교육 수준을 반영하여 16%ile 미만의 신경인지 기능 수준을 보인 집단을 구분하여 로지스틱 회귀분석을 실시했을 때, PTSD 재경험과 우울 증상 각기 유의한 연관성을 보였다. 우울은 물론 PTSD는 신경인지 기능 문제의 위험요인이 될 수 있으며 이에 본 연구는 외상 후 재활에서 PTSD 치료의 중요성과 추가 연구 필요성을 제안하였다.
Abstract
The contemporary history of Korean society has been shaped by numerous traumatic events, highlighting the importance of studying posttraumatic stress disorder (PTSD) in geriatric populations. Given the reported association between PTSD and neurocognitive functioning, evidence supporting early detection and intervention of neurocognitive disorders is required but remains limited in Korean populations. This study investigated the relationship between PTSD symptoms and neurocognitive functioning in 48 individuals who directly experienced and/or are family members of survivors of a massacre during the Korean War. PTSD symptoms were assessed using the International Trauma Interview-Korean (ITI-K), while neurocognitive functioning was measured with the Korean-Mini Mental State Examination (K-MMSE). The results revealed that K-MMSE scores were significantly associated with education and depression levels. By logistic regression analysis, PTSD reexperience symptom and depression each showed significant associations with a low K-MMSE scored group, a below 16%ile group including age and education level correction. PTSD as well as depression may be a risk factor for neurocognitive functioning problems and thus we suggest the importance of PTSD treatment in post-trauma rehabilitation and to collect evidence from further studies.
참고문헌 (58)
- 강성록, "베트남전 참전 제대군인의 외상후 스트레스 장애 증상에 대한 예측 변인", Korean Journal of Clinical Psychology, 33(1), pp.35~50 (2014)
- 강연욱, "K-MMSE(Korean-Mini Mental State Examination)의 노인 규준 연구", 한국심리학회지 : 일반, 25(2), pp.1~12 (2006)
- 강연욱, "치매환자들을 대상으로 한 K-MMSE의 타당도 연구", 대한신경과학회지, 15, pp.300~307 (1997)
- 김상현, "사회경제적 형태에 따른 치매 유병률 변화 : 건강보험, 의료급여 대상자를 중심으로", HIRA RESEARCH, 3(2), pp.205~212 (2023)
- 김석웅, "5・18민주화운동 유가족 1세대 및 2세대의 집단트라우마", 민주주의와 인권, 21(3), pp.97~143 (2021)
- 5・18 희생자 유가족 집단 트라우마 실태조사, "김석웅", 5・18 민주화운동 진상규명조사위원회, ~ (2022)
- 김현, "경도인지장애의 신경인지기능 : 알쯔하이머병 환자와 정상대조군과의 비교", 재활심리연구, 14(1), pp.1~16 (2007)
- 김종원, "월남전 참전 노인에서 한글판 외상후 스트레스 장애 체크리스트-5의 정신측정학적 특성", Anxiety and Mood, 13(2), pp.123~131 (2017)
- 2023년 노근리사건 희생자심사보고서, "노근리사건 희생자심사 및 명예회복위원회", 노근리사건 희생자심사 및 명예회복위원회, ~ (2023)
- 류성곤, "노인에서의 외상 후 스트레스 장애", Anxiety and Mood, 2(1), pp.9~16 (2006)
- 송지혜, "부분 외상후 스트레스 장애의 인지기능 프로파일 : 월남전 참전 군인 연구", 대한신경정신의학회, 62(2), pp.78~85 (2023)
- 신연정, "뇌졸중노인의 인지기능 요인, 우울감 요인 및 상호관련성", 재활심리연구, 21(3), pp.453~467 (2014)
- 오은아, "치매선별검사로서 K-MMSE의 타당도 연구 : 종합적인 신경심리학적 평가와의 비교", Dementia and Neurocognitive Disorders, 9, pp.8~12 (2010)
- 이동영, "Mini-Mental State Examination의 한국 노인 정상규준 연구", 신경정신의학, 41(3), pp.508~525 (2002)
- 장일미, "지역 사회 노인의 치매와 경도인지장애 유병률과 위험 인자", Dementia and Neurocognitive Disorders, 13, pp.121~128 (2014)
- 정인과, "노인우울척도(Geriatric Depression Scale)의 신뢰도, 타당도 연구", 신경정신의학, 36(1), pp.103~112 (1997)
- 정홍주, "한국전쟁전 후 국가폭력에 의한 피해자 및 가족의 심리적 트라우마", 민주주의와 인권, 15(3), pp.385~414 (2015)
- 진영은, "5·18 트라우마와 사회적 치유 : 광주트라우마센터 사례를 중심으로", 시민과 세계, 37, pp.163~197 (2020)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR™" (2022), American Psychiatric Publishing, Inc
- Bachem, R., "Assessing complex PTSD and PTSD : Validation of the German version of the International Trauma Interview(ITI)", European Journal of Psychotraumatology, 15(1), pp.2344364~ (2024)
- Bloomberg, M., "Sex differences and the role of education in cognitive ageing: analysis of two UK-based prospective cohort studies", Public Health, 6(2), pp.e106~e115 (2021)
- Bondjers, K., "Validation of a clinician-administered diagnostic measure of ICD-11 PTSD and Complex PTSD : the International Trauma Interview in a Swedish sample", European Journal of Psychotraumatology, 10(1) (2019)
- Brayne, C., "The mini-mental state examination, will we be using it in 2001?", International Journal of Geriatric Psychiatry, 13, pp.285~290 (1998)
- Cantarero-Prieto, D., "The economic cost of dementia: A systematic review", Dementia, 19(8), pp.2637~2657 (2020)
- Choi, H, "Validation of the International Trauma Interview (ITI) among treatment-seeking people with adverse childhood experiences in South Korea", European Journal of Psychotraumatology
- Choi, H., "ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD among organized violence survivors in modern South Korean history of political oppression", Anxiety, Stress, and Coping, 34(2), pp.203~214 (2021)
- Devignes, Q., "Trauma-related intrusive memories and anterior hippocampus structural covariance : an ecological momentary assessment study in posttraumatic stress disorder", Translational Psychiatry, 14(1), pp.74~ (2024)
- Elias, A., "Risk of Dementia in Posttraumatic Stress Disorder", Journal of Geriatric Psychiatry and Neurology, 34(6), pp.555~564 (2021)
- Frederiksen, K. S., "A Literature Review on the Burden of Alzheimer's Disease on Care Partners", Journal of Alzheimer's Disease, 96(3), pp.947~966 (2023)
- Freyd, J. J., "Betrayal trauma: The logic of forgetting childhood abuse" (1996), Harvard University Press
- Fridman, A., "Coping in old age with extreme childhood trauma : Aging Holocaust survivors and their offspring facing new challenges", Aging & Mental Health, 15(2), pp.232~242 (2011)
- Huang, L. Y., "Association of occupational factors and dementia or cognitive impairment : A systematic review and meta-analysis", Journal of Alzheimer's Disease, 78(1), pp.217~227 (2020)
- Jang, J. W., "Prevalence and incidence of dementia in South Korea : A nationwide analysis of the National Health Insurance Service senior cohort", Journal of Clinical Neurology, 17(2), pp.249~256 (2021)
- Jung, Y., "Prevalence and correlates of comorbid PTSD with depression among older people exposed to the Jeju April 3 incident", Journal of Affective Disorders, 272, pp.8~14 (2020)
- Jung, N., "Dementia onset among community-dwelling older adults with mild cognitive impairment : A longitudinal study", Journal of Korean Gerontological Nursing, 26(2), pp.158~169 (2024)
- Gelezelyte, O., "Validation of the International Trauma Interview(ITI)for the clinical assessment of ICD-11 Posttraumatic Stress Disorder(PTSD)and Complex PTSD(CPTSD)in a Lithuanian sample", European Journal of Psychotraumatology, 13(1) (2022)
- Günak, M. M., "Post-traumatic stress disorder as a risk factor for dementia : systematic review and meta-analysis", British Journal of Psychiatry, 217(5), pp.600~608 (2020)
- Kaehler, L. A., "Treating complex traumatic stress disorders in children and adolescents: Scientific foundations and therapeutic models", pp.62~78 (2013), Guilford Press
- Kim, K. W., "A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea", Journal of Alzheimer's Disease, 23(2), pp.281~291 (2011)
- Mirescu, C., "Stress and adult neurogenesis", Hippocampus, 16(3), pp.233~238 (2006)
- Peters, R., "Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis", BMJ Open, 9(1), pp.e022846~ (2019)
- Petersen R. C., "Mild cognitive impairment : transition between aging and Alzheimer's disease", Neurologia, 15(3), pp.93~101 (2000)
- Prieto, S., "Posttraumatic stress symptom severity predicts cognitive decline beyond the effect of Alzheimer's disease biomarkers in Veterans", Translational Psychiatry, 13(1), pp.102~ (2023)
- Roberts, A. L., "Association of posttraumatic stress disorder with accelerated cognitive decline in middle-aged women", JAMA Network Open, 5(6), pp.e2217698~ (2022)
- Roberts, N., "International Trauma Interview (ITI) for ICD-11 PTSD and Complex PTSD Release Version 1.0", Unpublished Manuscript, ~ (2022)
- Roberts, N. P, "The International Trauma Interview (ITI): Development of a semi-structured diagnostic interview and evaluation in a UK sample"
- Sagi-Schwartz, A., "Attachment and traumatic stress in female Holocaust child survivors and their daughters", American Journal of Psychiatry, 160(6), pp.1086~1092 (2003)
- Saul, J., "Collective Trauma Collective Healing", pp.1~18 (2014), Routledge
- Scott, J. C., "A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder", Psychological Bulletin, 141(1), pp.105~140 (2015)
- Schuitevoerder, S., "A meta-analysis of cognitive functioning in older adults with PTSD", Journal of Anxiety Disorders, 27(6), pp.550~558 (2013)
- Shon, C., "Health-economic burden of dementia in South Korea", BMC Geriatrics, 21(1), pp.549~ (2021)
- Sumner, J. A., "Posttraumatic stress disorder symptoms and cognitive function in a large cohort of middle-aged women", Depression and Anxiety, 34(4), pp.356~366 (2017)
- Vindbjerg, E., "The structure of ICD-11 post traumatic stress disorder in a clinical sample of refugees based on the International Trauma Interview", Acta Psychiatrica Scandinavica, 148(3), pp.302~309 (2023)
- Wang, Q., "Risk assessment and stratification of mild cognitive impairment among the Chinese elderly : attention to modifiable risk factors", Journal of Epidemiology and Community Health, 77(8), pp.521~526 (2023)
- World Health Organization, "International Classification of Diseases Eleventh Revision (ICD-11)", World Health Organization, ~ (2022)
- Yaffe, K., "Posttraumatic stress disorder and risk of dementia among US veterans", Archives of General Psychiatry, 67(6), pp.608~613 (2010)
- Yehuda, R., "Vulnerability to posttraumatic stress disorder in adult off spring of Holocaust survivors", American Journal of Psychiatry, 155(9), pp.1163~1171 (1998)
- Yesavage, J., "Development and validation of a geriatric depression screening scale", Journal of Psychiatric Research, 17, pp.37~49 (1983)
