만성폐쇄성폐질환 환자에서 삶의 질과 우울 및 불안과의 관계
The Relationship between Quality of Life and Comorbid Depression or Anxiety in Patients with Chronic Obstructive Pulmonary Disease
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초록
연구배경: 만성폐쇄성폐질환(chronic obstructive pulmonary disease, COPD) 환자들은 다른 만성질환이나 일반 인구에 비해 우울과 불안증상을 많이 가지고 있는 것으로 알려져 있다. 본 연구는 우울 및 불안증상이 COPD 환자의 삶의 질에 미치는 영향을 분석하기 위해 시행되었다. 방법: 저자는 광주광역시 지역 1개 종합병원 외래진료를 하는 129명의 COPD 환자를 대상으로 삶의 질을 평가하기 위해 Short Form-36 (SF-36)설문을, 우울 및 불안증상을 평가하기 위해 Primary Care Evaluation of Mental Disorder Patient Health Questionnaire (PRIME-MD PHQ)를 사용하였다. 우울 및 불안증상과 SF-36 점수와의 관련성을 평가하기 위해 Pearson 상관분석을 시행하였으며 영향의 정도를 평가하기 위해 다중회귀분석을 시행하였다. 결과: PRIME-MD PHQ를 사용한 검사에서 대상자의 48.8%가 주요우울증후군, 18.6%가 기타 우울증후군, 23.3%가 공황 증후군, 30.3%가 기타 불안증후군을 가지고 있는 것으로 조사되었다. SF-36의 신체요소 요약점수에는 우울증상, 호흡곤란정도 순으로 영향을 미치고, 정신요소 요약점수에는 우울증상만이 영향이 있는 것으로 판명되었다(P<0.05). 결론: 우울 및 불안증상은 COPD 환자에서 높은 유병률을 보이며 이 중 우울증상은 환자의 삶의 질을 유의하게 저하시키므로 COPD를 진료하는 의사들은 환자의 우울 및 불안증상에 관심을 가지고 적극적으로 치료하려는 태도가 필요하다.
Abstract
Background: It is well known that patients with chronic obstructive pulmonary disease (COPD) show symptoms of depression and anxiety more often than patients with other chronic illnesses or the general population. This study was designed to evaluate the effects of depression and anxiety on quality of life in patients with COPD. Methods: Quality of life was assessed using the Short Form-36 (SF-36) questionnaire and depression and anxiety symptoms were assessed using the Primary Care Evaluation of Mental Disorder Patient Health Questionnaire (PRIME-MD PHQ) in 129 patients with COPD visiting an outpatient clinic. We examined the correlations between the SF-36 scores and clinico-demographic features by Pearson's correlation analysis and the influence of depression and anxiety symptoms on the SF-36 scores by multiple regression analysis. Results: Of the 129 patients, 48.8% were diagnosed as having major depressive syndrome, 18.6% other depressive syndromes, 23.3% panic syndrome, and 30.3% other anxiety syndrome by the PRIME-MD PHQ. The physical component summary was affected the most by depressive symptoms followed by dyspnea (P<0.05). The mental component summary was only affected by depressive symptoms (P<0.05). Conclusions: The prevalence of depression and anxiety symptoms in COPD patients is markedly increased, and depressive symptoms decrease the quality of life in these patients. Thus, there is a need for physicians to assess for and recognize such symptoms and promptly administer appropriate interventions.
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