성별에 따른 주요우울증의 DSM-IV 증상 연구- 한국판 정신장애 진단선별질문지(Korean Psychiatric Diagnostic Screening Questionnaire; K-PDSQ)를 중심으로 -
Gender Differences in DSM-IV Major Depression Symptoms: Based on Korean Psychiatric Diagnostic Screening Questionnaire; (K-PDSQ)
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초록
본 연구에서는 DSM-IV의 축 1진단을 선별하기 위해 고안된 한국판 PDSQ(Psychiatric Diagnostic Screening Questionnaire)의 주요우울증(Major Depression Disorder; MDD) 항목을 통해 DSM-IV 진단체계에서 명시한 주요우울증 증상의 성별에 따른 차이를 알아보았다. 연구대상은 2008년 3월부터 2013년 10월까지 대구경북지역의 3개 대학병원 정신건강의학과를 방문한 외래 초진환자 및 입원환자 873명 중 PDSQ의 주요우울증 하위척도(총 21개 문항)에서 9개 문항 이상을 보고하여 MDD로 진단된(Kwak, Kim, Choi, Kim, Jung, Lee et al., 2012) 466명이다. 성별에 따른 우울증상의 차이를 알아보기 위하여 t-test를 통해 MDD 21개 문항 총점에서의 차이를 살펴보았으며, 필수 증상(우울감 및 흥미/관심의 저하)을 측정하는 MDD 1, 2, 3, 4번 문항의 차이를 알아보았고, 다음으로 MDD 21개 개별 문항에서의 빈도 및 성별의 차이를 알아보았다. 또한 주요우울증 환자의 성별에 따라 사회인구학적 변인들(연령, 직업, 종교, 결혼, 교육정도)에서의 빈도차이를 알아보기 위해 교차분석을 실시하였다. 연구결과, 여성 환자가 남성 환자보다 MDD 21개 문항 총점에서 유의하게 더 높은 것으로 나타났다. 또한 여성 환자가 남성 환자에 비해 DSM-IV의 주요우울증 진단에서 필수증상을 비롯하여, 2, 3, 4, 5, 10번 문항에서 유의하게 더 높은 것으로 나타나, 여성 환자가 ‘우울감’, ‘흥미/관심의 저하’, ‘식욕저하’와 ‘피로감’을 더 많이 경험하는 것으로 나타났다. 성별에 따라 연령, 직업, 종교, 결혼여부, 교육정도 모두에서 유의미한 빈도 차이가 있는 것으로 나타났다. 남녀 모두 무직, 무교, 고졸의 경우에서 우울증상의 빈도가 높았으며, 남성의 경우 20대, 미혼일수록, 여성의 경우 50대, 기혼일수록 우울증상의 빈도가 더 높았다. 연구결과에 따른 의의 및 시사점이 제시되었다.
Abstract
The purpose of this study was to investigate gender differences in major depression symptoms based on a subscale of major depressive disorder(MDD) of K-PDSQ reflecting DSM-IV diagnostic criteria. Subjects were recruited from March 2008 through October 2013 from psychiatric departments of three University hospitals located in areas of East Southern parts of Korea as part of stduy of Clinical Research Center for Depression. Among 873 patients, data sizing in 466 patients were analyzed, who were diagnosed as MDD according to the results of a study providing an optimal cutoff score of K-PDSQ(Kwak, Kim, Choi, Kim, Jung, Lee et al., 2012). Results of this study were as follows. First, the means of 21 total items of MDD displayed higher scores in females than those of males. On the items(1,2,3,4) measuring essential symptoms for MDD, the means of “depressive mood” and “loss of interest/pleasure” symptoms also displayed higher scores in females than those of males. Additionally, there were significant gender differences in 5 individual items(item 2, 3, 4, 5, 10) out of 21 items, displaying higher scores in females. Finally, in the frequency analyses for SES variables(age, marital status, job, religion, education) by gender, males showed higher MDD symptoms in twenties and unmarried status while females showed higher MDD symptoms in fifties and married status. Both males and females showed higher MDD symptoms in such status as unemployed, not having religion, and graduating high school. Based on the these results, the discussions and implications are provided.
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