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항우울제의 복약 순응도

Treatment compliance of antidepressants

고영훈|조숙행|이문수
대한생물정신의학회 (The Korean Society Of Biological Psychiatry)|2010.02|생물정신의학 (Journal of Korean Society of Biological Psychiatry)|제17권 제1호|pp. 5-14

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참고문헌

키워드

depression우울장애약물치료순응도pharmacotherapytreatment compliance
주제분류정신과학

초록

우울장애는 만성적이고 재발이 잦은 질환으로, 적절한 치료를 위하여서는 항우울제의 복약 순응도를 높이는 것이 중요하다. 그러나 일차 의료 환경에서의 재발의 위험성을 낮추기에 치료기간이 충분하지 못한 경우가 많으면서 동시에 치료 탈락율은 상당히 높은 것으로 보고되고 있다. 순응도의 평가 방법으로는 혈중 약물농도 또는 약리학적 표식자 측정법, 알약 수 계수 법, 전자적 모니터 방법 및 환자 면담에 의한 측정법 등이 있다. 이러한 순응도에 영향을 미치는 요인들은 우울장애 자체의 특성, 항우울제의 특성, 환자 각 개인의 역학적, 인격적 및 정신역동상의 특성, 치료진 측면의 특성 및 환자-의사 사이의 치료적 관계 등의 인자들로 나누어 볼 수 있다. 항우울제에 대한 순응도를 높이기 위한 각기 다양한 기법들이 사용되어 왔으며, 이 기법들을 적용할 때에는 동시에 정신치료적인 관점에서의 고려가 함께 필요하다.

Abstract

Depressive disorder is a chronic disabling condition with recurrent episodes. Medication noncompliance is a significant problem for effective management of depressive disorder. However, compliance with antidepressant medication is poor. There are difficulties in assessing compliance accurately. Various methods for assessing compliance are in use. A patient’s compliance with antidepressant may be affected by many factors including the clinical characteristics of depression, pharmacologic properties of antidepressants, patients’ characteristics, accessibility treatment, and doctor-patient relationships. For enhancing the treatment compliance, psychotherapeutic considerations in patient-therapist relationship are needed.

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