삼출성 나이관련황반변성 노인 환자들의 우울증, 불안증, 신체화장애 그리고 적응장애
Depression, Anxiety, Somatization Disorder, and Adjustment Disorder in Older Patients with Exudative Age-related Macular Degeneration
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목적: 삼출성 나이관련황반변성 환자에서 우울증, 불안증, 신체화장애, 적응장애의 동반 유병률을 알아보고, 삼출성 나이관련황반변성이 이들 질환의 유의한 연관성이 있는지 알아보고자 하였다. 대상과 방법: 건강보험심사평가원에서 제공된 2016년 고령환자 데이터(Health Insurance Review and Assessment Service-Aged Patient Sample)를 분석에 사용하였다. 전체 대상자를 두 군으로 분류하여, 나이관련황반변성을 진단받고, 유리체내주입술을 시행받은 환자를 삼출성 나이관련황반변성군으로 정의하였고, 그 외 환자들을 대조군으로 정의하였다. 동반질환의 정도는 찰슨 동반 상병지수를 이용하여 평가하였다. 결과: 전체 1,319,052명의 대상자 중 유리체강내 주사를 시행 받고 있는 삼출성 나이관련황반변성 환자군은 3,134명이었다. 대상자의 평균 연령은 74.7 ± 6.7세였으며, 이 중 41.8%는 남자였다. 삼출성 나이관련황반변성군에서 우울증, 불안증, 신체화장애, 적응장애의유병률은 각각 16%, 20%, 0.5%, 그리고 0.4%였다. 특히 우울증과 적응장애의 유병률은 대조군에 비해 삼출성 나이관련황반변성군에서 유의하게 높았다. 다변량 회귀분석에서, 삼출성 나이관련황반변성은 우울증을 1.2배(95% 신뢰구간 1.08-1.31, p<0.001), 적응장애를 2.47배(95% 신뢰구간 1.47-4.18, p<0.001) 높였으며, 이는 통계적으로도 유의하였다. 반면, 삼출성 나이관련황반변성과 불안증, 신체화장애 사이에는 유의한 연관성이 관찰되지 않았다. 결론: 삼출성 나이관련황반변성은 우울증 및 적응장애와 유의한 연관성이 있으며, 이에 임상적 관심과 주의가 필요하다.
Abstract
Purpose: The aim of this study was to analyze the prevalence of depression, anxiety, somatization disorder, and adjustment disorder in older patients diagnosed with exudative age-related macular degeneration (AMD) and to evaluate the relationship between exudative AMD and psychological disease. Methods: The 2016 Health Insurance Review and Assessment Service-Aged Patient Sample was applied in this study. The subjects were divided into two groups: AMD patients undergoing intravitreal injection treatment and a control group. Comorbidities were evaluated using the Charlson Comorbidity Index. Results: A total of 1,319,052 subjects were selected, of which 3,134 were in the exudative AMD group receiving intravitreal injections. The average age of the subjects was 74.7 ± 6.7 years, and 41.8% were male. In patients with exudative AMD, the prevalence of depression, anxiety, somatization disorder, and adjustment disorder were 16%, 20%, 0.5%, and 0.4%, respectively; in particular, the prevalence of depression and adjustment disorder were significantly higher than in the control group. In multivariate regression analysis, exudative AMD was a significant factor of depression (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.08-1.31, p < 0.001) and adjustment disorder (OR 2.47, 95% CI 1.47-4.18, p < 0.001). However, the association between AMD and anxiety or somatization disorder was not statistically significant. Conclusions: Exudative AMD showed a significant association with psychiatric disease, such as depression, and requires close clinical attention.
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