본문 바로가기
KERD
논문KCI 등재

PHQ-15를 이용한 우울증의 신체증상에 대한 연구 : 일 대학병원 외래 초진환자 대상

A Research Using PHQ-15 on the Somatic Symptoms of the First Visiting Patients with Depressive Disorder at a University Hospital

백종우|송지영|김경훈|이재진
대한노인정신의학회 (Korean Association For Geriatric Psychiatry)|2012.06|노인정신의학 (Journal of Korean Geriatric Psychiatry)|제16권 제1호|pp. 44-51|DOI http://dx.doi.org/

0

조회

0

다운로드

4

인용

0

참고문헌

키워드

주요우울장애Major depressive disorder신체증상Patient Health Questionnare-15Somatic symptom

초록

Objectives:Somatic symptoms are mostly accompanied with depression and the evaluation about the aspect of somatic symp- toms of depressive patients helps diagnose, treat and the prognosis. This clinical study was performed to acquire the characteristics of somatic symptoms of depression and their relations with other factors. Methods:The PHQ-15 was administered to analyze the aspect and the frequency of somatic symptoms among depressive pa- tients. In addition, the associations between the PHQ-15 score and BDI score, GARS score, sociodemographic factors and clinical characteristics were analyzed. Results:Of 201 patients, fatigue (93.6%) and sleep difficulty (81.7%) included in DSM-IV depression diagnosis category showed the most frequency. A headache (68.4%), gastrointestinal symptoms (79.8%) and unspecific pain (91.6%) were highly re- ported. PHQ-15 total score was significantly associated with female patients, blue-collar workers and unemployed state, higher GARS score, and the case consulted by other physicians. However, it was not significantly associated with the age. Conclusion:In this study, headaches were significantly more common than gastrointestinal symptoms among patients with depression, and these findings suggest changes of somatic symptoms tendency of depressive patients in South Korea. A severity of somatic symptoms were associated with the female, high GARS score, blue-collar workers and at the case consulted by other phy- sicians. In conclusion, the materials from PHQ-15 in somatic symptoms are valuable to diagnose and treat depressive patients.

Abstract

Objectives:Somatic symptoms are mostly accompanied with depression and the evaluation about the aspect of somatic symp- toms of depressive patients helps diagnose, treat and the prognosis. This clinical study was performed to acquire the characteristics of somatic symptoms of depression and their relations with other factors. Methods:The PHQ-15 was administered to analyze the aspect and the frequency of somatic symptoms among depressive pa- tients. In addition, the associations between the PHQ-15 score and BDI score, GARS score, sociodemographic factors and clinical characteristics were analyzed. Results:Of 201 patients, fatigue (93.6%) and sleep difficulty (81.7%) included in DSM-IV depression diagnosis category showed the most frequency. A headache (68.4%), gastrointestinal symptoms (79.8%) and unspecific pain (91.6%) were highly re- ported. PHQ-15 total score was significantly associated with female patients, blue-collar workers and unemployed state, higher GARS score, and the case consulted by other physicians. However, it was not significantly associated with the age. Conclusion:In this study, headaches were significantly more common than gastrointestinal symptoms among patients with depression, and these findings suggest changes of somatic symptoms tendency of depressive patients in South Korea. A severity of somatic symptoms were associated with the female, high GARS score, blue-collar workers and at the case consulted by other phy- sicians. In conclusion, the materials from PHQ-15 in somatic symptoms are valuable to diagnose and treat depressive patients.

참고문헌 (36)

  1. Burden of mental and behavior disorders in World Health Report, "WHO", WHO, 19~46 (2001)
  2. Robert EH, "Textbook of psychiatry, 5th ed" (2008), American psychiatric publishing, Inc
  3. 조맹제, "한국 주요정신장애의 유병률 및 관련요인：2006 전국정신질환역학조사", 신경정신의학, 48(3), pp.143~152 (2009), 대한신경정신의학회
  4. Kessler RC, "The epidemiology of major depressive disorder: results from the national comorbidity survey replication (NCS =R)", JAMA, 289, pp.3095~3105 (2003)
  5. 정신질환실태 역학조사: 보건복지부 용역연구보고서, "이충경", 국립서울병원, 서울의대 정신과, ~ (2001)
  6. Anthony LV, "Prevalence and association of somatic symptoms in patients with major depressive disorder", J Affect Disord, 110, pp.270~276 (2008)
  7. Schappert SM, "National ambulatory medical care survey: 1991 summary", Vital Health Stat, 116, pp.1~110 (1994)
  8. Fava M, "Somatic symptoms, depression, and antidepressant treatment", J Clin Psychiatry, 63, pp.305~307 (2002)
  9. 노성원, "한국에서 우울증의 특징과 비약물학적 치료", 생물정신의학, 13(4), pp.226~233 (2006), 대한생물정신의학회
  10. Gerber PD, "The relationship of presenting physical complaints to depressive symptoms in primary care patients", J Gen Intern Med, 7, pp.170~173 (1992)
  11. George JP, "Somatic symptoms in treatment-resistant depression", Psychiatry Res, 118, pp.39~45 (2003)
  12. Karp JF, "Pain predicts longer time to remission during treatment of recurrent depression", J Clin Psychiatry, 66, pp.591~597 (2005)
  13. Javier GC, "Relationship of somatic symptoms with depression severity, quality of life, and health resources utilization in patients with major depressive disorder seeking primary health care in spain", Prim Care Companion J Clin Psychiatry, 10, pp.355~362 (2008)
  14. Kroenke K, "The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms", Psychosom Med, 64, pp.258~266 (2002)
  15. Interian A, "Somatic complaints in primary care: further examining the validity of the PHQ-15", Psychosomatics, 47, pp.392~398 (2006)
  16. Charlson ME, "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation", J Chronic Dis, 40, pp.373~383 (1987)
  17. Lee YH, "A study of the reliability and the validity of the BDI, SDS, and MMPI-D Scales", J Korean Clinical Psychology, 10, pp.98~113 (1991)
  18. Han C, "PHQ-15 for measuring the somatic symptoms of psychiatric outpatients", Psychosomatics, 50, pp.580~585 (2009)
  19. Linn MW, "A Global Assessment of Recent Stress (GARS) Scale", Int J Psychiatry Med, 15, pp.47~59 (1985)
  20. Koh KB, "Development of the stress response inventory", J Korean Neuropsychiatr Assoc, 39, pp.707~719 (2000)
  21. Madhukar HT, "Symptom clusters as predictors of late response to antidepressant treatment", J Clin Psychiatry, 66, pp.1064~1070 (2005)
  22. Stoeckle JD, "Bodily complaints and other symptoms of depressive reactions", JAMA, 180, pp.134~139 (1962)
  23. Park JS, "Somatic discomforts among depressed women", J Korean Neuropsychiatr Assoc, 20, pp.382~391 (1981)
  24. Jung HS, "Somatic complaints of the depressives", J Korean Neuropsychiatr Assoc, 16, pp.358~365 (1977)
  25. Kim KI, "Clinical study of primary depressive symptom. Part II: Symptom pattern of Korean depressive", J Korean Neuropsychiatr Assoc, 16, pp.46~52 (1977)
  26. 서호준, "신체증상을 동반한 주요 우울장애 환자에서 Venlafaxine ER의 치료 유지 기간", 대한정신약물학회지, 18(5), pp.329~337 (2007), 대한정신약물학회
  27. Choi YK, "An investigation of somatic symptoms in depressed patients", J of Kor Soc for Dep and Bip Disorders, 2, pp.245~251 (2004)
  28. Min Soo Lee, "Association between Painful Physical Symptoms and Clinical Outcomes in Korean Patients with Major Depressive Disorder: A Three-Month Observational Study", PSYCHIATRY INVESTIGATION, 6(4), pp.255~263 (2009), 대한신경정신의학회
  29. Mussell M, "Gastrointestinal symptoms in primary care: Prevalence and association with depression and anxiety", J Psychosom Res, 64, pp.605~612 (2008)
  30. Barsky AJ, "Somatic symptom reporting in women and men", J Gen Intern Med, 16, pp.266~275 (2001)
  31. Levine FM, "The effects of experimenter gender on pain report in male and female subjects. Pain 1991;44:69-72. 32) Kim SB. Clinical studies on depressive equivalents", J Korean Neuropsychiatr Assoc, 17, pp.139~148 (1978)
  32. 연규월, "우울증 여성에서 생활스트레스가 우울증 정도와 신체증상에 미치는 영향", 신경정신의학, 49(3), pp.306~313 (2010), 대한신경정신의학회
  33. Regier DA, "One month prevalence of mental disorders in the United States and socioeconomic characteristics: the Epidemiologic Catchment Area Project", Acta Psychiatr Scand, 88, pp.35~47 (1993)
  34. Kirmayer LJ, "Somatization and the recognition of depression and anxiety in primary care", Am J Psychiatry, 150, pp.734~741 (1993)
  35. Kirmayer LJ, "Three forms of somatization in primary care: Prevalence, co-occurrence, and sociodemographic characteristics", J Nerv Ment Dis, 179, pp.647~655 (1991)
  36. Nakao M, "Somatic symptoms for predicting depression: one-year follow-up study in annual health examinations", Psychiaty Clin Neurosci, 60, pp.219~225 (2006)

이 간행물의 다른 논문 (7건)

알츠하이머병의 진단 기준연병길, 홍나래pp. 3-6새로운 알츠하이머병 임상진단기준 : NIA-AA 진단가이드라인을 중심으로이동영, 손보경pp. 7-12ADNI 연구에서 알츠하이머병 및 경도인지장애의 뇌영상 표지자이준영pp. 13-16뇌척수액과 말초혈액 내 알츠하이머병의 생화학적 생체표지자김어수, 이영민, 최원정, 박민선pp. 17-23갈란타민(Galantamine) 투여 후 순수 알츠하이머병 치매와 혼합성 치매 환자의 주의력, 일상생활능력 및 신경정신행동 증상에 대한 효과 평가황태영, 김도관, 이영민, 김혜란, 윤지혜, 문유진, 안인숙, 강효신pp. 24-30
원문 보기