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반응성 우울과 내인성 우울의 현대적 재개념화

Review of Reactive Depression and Endogenous Depression Concepts

서동기|이순묵|김종남|채정민|최윤경|최승원
한국임상심리학회 (Korean Clinical Psychology Association)|2018.05|Korean Journal of Clinical Psychology|제37권 제2호|pp. 211-224

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참고문헌

키워드

depression우울증반응성 우울내인성 우울reactive depressionendogenous depression
주제분류심리과학

초록

우울증을 증상 심각도라는 단일 차원에서 이해할 것인지, 아니면 여러 이질적 속성을 가지는 하위 집단으로 보아야 할 것인지는 오랫동안이분야전문가들의논쟁거리였다. 이중우울증을그원인의 명확성에따라구분하는반응성우울과내인성 우울의개념은오랫동안임상가들이 환자들의 진단과 치료결정에서 중요하게 다루어졌다. 하지만 이런 다원론적 개념은 DSM-5로 대표되는 최근의 진단기준들이 원인에 따른 우울증 분류보다는 증상의 심각도라는 단일 차원에서의 이해를 채택함으로써 그 지위를 위협받고 있다. 본 연구는 지금까지 진행된 우울증의 일원론과 다원론에 대한 논란을 현대적 관점에서 재조명하는 데 목적을 가지고 있다. 그간 축적된 우울증의 임상과 기초연구들을 종합하여 두 모형 중 어떤 관점을 채택하는 것이 우울증의 평가 및 치료방법을 연구하는 심리학자들에게 유용한지와 이를 통합한 새로운이해를도출할수있는지에대해논의하였다.

Abstract

Whether to perceive depression as a unit of symptom severity or as a subgroup with multiple heterogeneous attributes has long been a topic of debate among experts in the field. Among these, the concepts of reactive depression and endogenous depression, which have been distinguished by the clarity of external cause, have long been regarded by clinicians as important in the diagnosis and treatment decisions for patients. However, this pluralistic understanding has been threatened by a recent diagnostic approach represented by the DSM-5, which have adopted a phenomenological understanding rather than an etiological perspective. This study aimed to review the controversy over the monism and pluralism of depression. We discussed which perspective could be beneficial for psychologists whose role is to evaluate and treat depression and whether we could generate more comprehensive view on the issue.

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