우울 경험, 진단 및 치료에 영향을 미치는 요인
Factors Associated with Self-Reported Depression, Diagnosis, and Treatment among Korean Adults
1
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
배경: 우울에 영향을 미치는 요인과 특히 우울의 진단및 치료에 영향을 미치는 사회인구학적, 건강행태, 건강상태 요인을 규명하여 비교 분석하고자 하였다. 방법: 2010년 및 2011년 국민건강영양조사 원시자료를이용하여 만 19세 이상 성인 13,306명을 분석대상으로 하였다. 교차분석 및 다중 로지스틱 회귀분석을 실시하였다. 결과: 다중 로지스틱 회귀분석 결과, 여성(여 vs. 남, OR(odds ratio)=3.35), 50대 연령(50-59 vs. 60+, OR=1.45),낮은 소득수준(하 vs. 상, OR=1.35; 중하 vs. 상, OR=1.29),무직(무 vs. 유, OR=1.23), 낮은 교육수준(초졸 vs. 대졸,OR=1.26; 중졸 vs. 대졸, OR=1.27; 고졸 vs. 대졸, OR=1.18),흡연(유 vs. 무, OR=1.19), 고위험음주(유 vs. 무, OR=2.28),낮은 주관적 건강(중 vs. 상, OR=1.52; 하 vs. 상, OR=2.65),만성질환(유 vs. 무, OR=1.255), 활동제한(유 vs. 무, OR=1.744),와병(유 vs. 무, OR=1.69) 등이 우울경험에 영향을 미치는 요인들이었다. 우울진단에 영향을 미치는 변수로는 거주지(대도시 vs. 군지역, OR=1.40)가 유일하였고, 남자일수록(여vs. 남, OR=0.501), 만성질환이 있을수록(OR=1.73), 활동제한이 있을수록(OR=2.05), 와병이 있을수록(OR=1.88) 우울치료를 받은 것으로 나타났다. 결론: 정책결정자는 우울증 진단율의 지역적 차이를 줄이기 위해 대도시 이외 지역에서의 우울진단율을 높이는한편 여성의 치료율을 향상시킬 수 있도록 노력해야 할것이다.
Abstract
Background: We compared factors associated with self‐reported depression and, in particular, diagnosis andtreatment of depressive symptoms in Korean adults. Methods: The sample included 13,306 adults aged 19 years or older from the 2010 and 2011 Korea NationalHealth and Nutrition Examination Survey (KNHANES Ⅴ). Data were applied to the χ 2 test and multivariate logisticregression analysis. Results: The following characteristics of individuals are significantly associated with self-reported depression:female (vs. male, OR [odds ratio]=3.35), ages 50-59 years (vs. 60+, OR=1.45), economic status (low vs. high,OR=1.35; middle-low vs. high OR=1.29), unemployed (vs. employed, OR=1.23), education (elementary vs. college, OR=1.18; middle school vs. college, OR=1.27; vs. high school vs. college, OR=1.18), current smoking (vs. no, OR=1.19), high-risk alcohol consumption (vs. no, OR=1.18), perceived health (good vs. very good/excellent,OR=1.156; poor/fair vs. very good/excellent, OR=2.65), chronic disease (vs. no, OR=1.26), activity limitation dueto health problems (vs. no, OR=1.74), and being in a sickbed during the past month (vs. not in a sickbed, OR=1.69). Living in a metropolitan area (vs. rural, OR=1.40) is significantly associated with greater odds of being diagnosedwith depression. The odds of being treated for depression are lower for female (vs. male, OR=0.53). Greater oddsof being treated for depression was seen for those with chronic conditions (vs. no, OR=1.73) and activity limitationdue to health problems (vs. no, OR=2.05), as well as, those in a sickbed (vs. not, OR=1.88). Conclusions: Applying our findings, policy makers should address the lower rates of depression diagnosed innon-metropolitan areas to reduce regional variations, and also promote treatment in females.
참고문헌 (26)
- "Public health action for the prevention of suicide: a framework" (2012)[URL]
- "2011 Korean national health and nutrition examination survey" (2012)[URL]
- "2011 The epidemiological survey of mental disorders in Korea" (2011)[URL]
- 김지미, "노인의 우울과 건강수준과의 관련성", 한국노년학, 30(4), pp.1311~1327 (2010), 한국노년학회
- Chiang HH, "Prevalence and correlates of depression among chronic kidney disease patients in Taiwan", BMC Nephrol, 14, pp.78~ (2013)
- "Mental illness surveillance among adults in the United States" (2011)[URL]
- 김영주, "남녀별 독거노인과 동거노인의 건강습관, 스트레스, 우울, 자살생각 비교", 기본간호학회지, 16(3), pp.333~344 (2009), 기본간호학회
- Grammatikopoulos L, "Social activity and participation as determinants of anxiety and depression among elderly in primary care", Annals of General Psychiatry, 9(Suppl 1), pp.S137~ (2010)
- Al-Nsour M, "Frequent mental distress, chronic conditions, and adverse health behaviors in the behavioral risk factor surveillance survey, Jordan, 2007", Prev Chronic Dis, 10, pp.130030~ (2013)
- 김록범, "우울증상에 관련된 요인과 우울증상이 지각된 건강수준, 외래의료이용, 삶의 질에 미치는 영향", 보건교육건강증진학회지, 28(1), pp.81~92 (2011), 한국보건교육건강증진학회
- Yoon J, "The role of adverse physical health events on the utilization of mental health services", Health Serv Res, 48(1), pp.175~194 (2013)
- Wells KB, "Functioning and utility for current health of patients with depression or chronic medical conditions in managed, primary care practices", Arch Gen Psychiatry, 56(10), pp.897~904 (1999)
- Hirschfeld RA, "Social functioning in depression:a review", J Clin Psychiatry, 61(4), pp.268~275 (2000)
- Spitzer RL, "Health-related quality of life in primary care patients with mental disorders: results from the PRIMEMD 1000 study", JAMA, 274(19), pp.1511~1517 (1995)
- Wells KB, "The functioning and well-being of depressed patients: results from the medical outcomes study", JAMA, 262(7), pp.914~919 (1989)
- "2001 The Epidemiological survey of mental disorders in Korea" (2002)[URL]
- Regier DA, "The de facto US mental and addictive disorders service system: epidemiologic catchment area prospective 1-year prevalence rates of disorders and services", Arch Gen Psychiatry, 50(2), pp.85~94 (1993)
- Kessler RC, "Past-year use of outpatient services for psychiatric problems in the national comorbidity survey", Am J Psychiatry, 156(1), pp.115~123 (1999)
- Narrow WE, "Use of services by persons with mental and addictive disorders:findings from the national institute of mental health epidemiologic catchment area program", Arch Gen Psychiatry, 50(2), pp.95~107 (1993)
- "Mental Health: a report of the Surgeon General. Washington" (1999)[URL]
- Olfson M, "Continuity of antidepressant treatment for adults with depression in the United States", Am J Psychiatry, 163(1), pp.101~108 (2006)
- 이경욱, "항우울제를 복용 중인 주요 우울증 환자에서 조기 치료 중단율과 위험 요인", 대한정신약물학회지, 17(6), pp.550~556 (2006), 대한정신약물학회
- "Mental health resources in Korea" (2012)[URL]
- Zuckerbrot RA, "Improving recognition of adolescent depression in primary care", Arch Pediatr Adolesc Med, 160(7), pp.694~704 (2006)
- Cepoiu M, "Recognition of depression by non-psychiatric physicians-a systematic literature review and meta-analysis", J Gen Intern Med, 23(1), pp.25~36 (2008)
- "Mental Health Atlas 2011" (2011)[URL]