한국인 주요우울장애 환자에서 혈중 ACTH, Cortisol 농도와 해밀턴 우울 평가 척도의 신체증상 항목과의 상관관계
Association between Somatic Component of the Hamilton Depression Rating Scale and the Plasma ACTH & Serum Cortisol Level in Korean Patients with Major Depressive Disorder
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초록
여러 제한 점에도 불구하고 본 연구는 해밀턴 우울증 평가척도, Plasma ACTH, Cortisol 등 객관적이고 임상실제에서 비교적 쉽게 접할 수 있는 방법을 통하여 진행된 연구라는 점에서 장점을 찾을 수 있다. 또한 이번 연구에서는 3차 대학병원 한곳에서만 수행되었다는 한계는 존재하지만 정신과적인 입원이 필요할 정도의(HAMDscale : 17점 이상)중증도를 가진 환자들만을 대상으로 진행된 연구라는 점에서 그 의의를 찾을 수 있다.
Abstract
Objectives：Hypothalamic-Pituitary-Adrenocortical(HPA) system dysregulation plays an important role in the pathophysiology of major depressive disorder. Medically unexplained somatic symptoms comprised the predominant complaints of korean patients with major depressive disorder. It might be related to dysregulation of HPA system and somatic symptoms. The aim of this study was to investigate the association between Hamilton Depression Rating Scale severity and the Plasma Adrenocorticotropic Hormone(ACTH) & Serum Cortisol level in Korean patients with major depressive disorder. Methods：Our study design was prospective. A total 111 hospitalized patients with major depressive disorder (DSM-IV) at Anam Hospital, Korea University Medical Center between Jan 2009 and May 2011 were selected. Hamilton Depression Rating Scale was measured by psychiatrist. Plasma ACTH, Serum Cortisol levels were analyzed at the time of admission. Results：There are significant correlations(p＜0.05) between Hamilton Depression Rating Scale of somatic component(HAM-D 11-15 item) and Plasma ACTH and Serum Cortisol level. However, other HAM-D sub items were not significantly correlated with Plasma ACTH and Serum Cortisol level except somatic component. Conclusion：Our Study results suggest that hyperactivity of HPA axis might be correlation with somatic symptoms in korean patients with major depressive disorder.
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