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COPD 환자에서 우울증 선별검사

Screening for Depression in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review

정기석|이상도|김현정|오연목|원왕연|조준성|황용일
대한내과학회 (The Korean Association Of Internal Medicine)|2012.10|대한내과학회지 (The Korean Journal of Medicine)|제83권 제4호|pp. 468-475|DOI http://dx.doi.org/10.3904/kjm.2012.83.4.468

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참고문헌

키워드

Depression우울증선별 검사Screening만성폐쇄성폐질환COPD
주제분류내과학

초록

목적:우울증은 COPD 환자들에게 흔하게 동반되는 질환이다. 하지만 현재 COPD 환자들에게 우울증의 선별 검사의 효과와 선별 검사를 무슨 도구로 시행해야 하는지 알려진 바가 전혀 없는 실정이다. 이에 체계적 문헌고찰을 통해 COPD 환자의 우울증 선별 검사 효과와 도구에 대해서 알아 보고자 하였다. 방법:COPD 환자에서 우울증 선별 검사 효과와 우울증 진단 도구로 일차 진료의가 선별 검사 목적으로 사용할 수 있는 것이 어느 것인지 알아보기 위해 “COPD 환자에게 우울증 선별 검사를 하는 것이 필요한가?” 와 “우울증 진단 도구 중, 일선 진료의의 선별 검사 목적으로 권장할 만한 것은 무엇인가?” 라는 두 가지 핵심 질문을 선정하고 이에 대한 답을 구하고자 하였다. 문헌 검색을 위한 데이터베이스로는 국내의 경우 국내의학학술지초록검색(kmbase.medric.or.kr), 학술연구정보서비스(www.riss.kr), 코리아메드(www.koreamed.org)를 이용하였고 국외의 경우는 Medline, Embase, Cochrane Library를 이용하였다. 결과:COPD가 있을 경우 우울증의 발생 또한 높아진다. 우울증이 동반이 될 경우 COPD 환자들이 삶의 질에 나쁜 영향을 받았다. 우울증 선별 검사 도구 중 한글화되어 있는 도구는 8가지가 있으며 각 도구는 비슷한 정도의 신뢰도와 타당도를 가진다. 결론:COPD 환자에서 우울증의 선별 검사는 필요하며 우울증 선별을 위해서 한글화된 8가지 도구 사용이 모두 가능하다. 그중에서 문항수가 적고 환자의 자가 기입이 가능한 도구가 현재의 진료 현실에서는 적합할 것으로 생각된다.

Abstract

Background/Aims:Chronic obstructive pulmonary disease (COPD) often coexists with co-morbid conditions that significantly affect the prognosis. Although depression frequently coexists with COPD, little about how to screen for depression in COPD patients is known. We report the effectiveness of depression screening in patients with COPD and of the instruments used for this purpose. Methods:We performed a systematic literature review of the domestic (Research Information Sharing Service, KoreaMed, and Kmbase) and international (Medline, Embase, Cochrane library) databases using “COPD AND depression AND screening tools” as key words. Results:No study directly evaluated the effectiveness of screening for depression in COPD patients. However, depression was present more frequently in patients with COPD. COPD patients with depression were also more likely to be in poor health. A total of eight screening instruments for depression were translated into Korean. All had similar reliabilities and internal consistencies. Conclusions:Screening of COPD patients for depression is necessary because individuals with this condition are more likely to suffer from depression, which has a negative impact on health. The choice of depression screening instruments may need to be based on considerations of simplicity. (Korean J Med 2012;83:468-475)

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