국내 대학병원 공황장애 환자들의 임상적 특징에 대한 연구 : 다기관, 후향적 연구
Clinical Characteristics of Panic Disorder Patients in Korean University Hospital : A Multi-Center, Retrospective Study
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was 41.3±12.7 years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was 4.5±1.0 at the first visit, reflecting a ‘marked’ level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After 17.7±0.5 months of mean follow up period, the mean score of PSR scale at the last visit was reduced into 2.1±0.9, reflecting a ‘residual’ severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.
Abstract
Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was 41.3±12.7 years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was 4.5±1.0 at the first visit, reflecting a ‘marked’ level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After 17.7±0.5 months of mean follow up period, the mean score of PSR scale at the last visit was reduced into 2.1±0.9, reflecting a ‘residual’ severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.
참고문헌 (31)
- "Diagnositc and statistical manual of mental disorder: DSM-IV-R" (2000), American Psychiatric Association
- 2011년도 정신질환실태 역학조사: 보건복지부 학술연구 용역사업 보고서, "조맹제", 서울대학교 의과대학, ~
- Lepine JP, "The Epidemiology of Anxiety disorders: Prevalence and Societal Costs", J Clin Psychiatry, 63(14), pp.4~8 (2002)
- Kessler RC, "Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication", Arch Gen Psychiatry, 62, pp.593~602 (2005)
- Kessler RC, "Wang PS The descriptive epidemiology of commonly occurring mental disorders in the United States", Annual Review of Public Health, 29, pp.115~129 (2008)
- Rubin HC, "Quality of well being in panic disorder: The assessment of psychiatric and general disability", Journal of Affective Disorders, 57, pp.217~221 (2000)
- Waghorn G, "Disability, employment and work performance among people with ICD-10 anxiety disorders", Aust N Z J Psychiatry, 39, pp.55~66 (2005)
- Cramer V, "Quality of life and anxiety disorders : a population study", J Nerv Ment Dis, 193, pp.196~202 (2005)
- Saarni SI, "Impact of psychiatric disorders on health-related quality of life : General population survey", British Journal of Psychiatry, 190, pp.326~332 (2007)
- Davidoff J, "Quality of life in panic disorder : Looking beyond symptom remission", Qual Life Res, 21, pp.945~959 (2012)
- Roy-Byrne PP, "Course and outcome in panic disorder : a review of recent follow-up studies", Anxiety, 1, pp.151~160 (1994)
- Noyes R Jr, "Environmental factors related to the outcome of panic disorder. A seven-year follow-up study", J Nerv Ment Dis, 181, pp.529~538 (1993)
- Bruce SE, "Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study", Am J Psychiatry, 162, pp.1179~1187 (2005)
- Albus M, "Panic disorder with or without concomitant depression 5 years after treatment : a prospective follow-up", J Affect Disord, 34, pp.109~115 (1995)
- Keller MB, "Remission and relapse in subjects with panic disorder and panic with agoraphobia : a prospective short-interval naturalistic follow-up", J Nerv Ment Dis, 182, pp.290~296 (1994)
- Barlow DH, "Cognitive-behavioral therapy, imipramine, or their combination for panic disorder : A randomized controlled trial", JAMA, 283, pp.2529~2536 (2000)
- Hirschfeld RM, "Panic disorder: diagnosis, epidemiology, and clinical course", J Clin Psychiatry, 10, pp.3~8 (1996)
- Pollack MH, "Long-term course and outcome of panic disorder", J Clin Psychiatry, 58(2), pp.57~60 (1997)
- Gelernter J, "Population studies of polymorphisms of the serotonin transporter protein gene", Am J Med Genet, 88, pp.61~66 (1999)
- Roy-Byrne PP, "Paroxetine response and tolerability among ethnic minority patients with mood or anxiety disorders : a pooled analysis", J Clin Psychiatry, 66, pp.1228~1233 (2005)
- Warshaw MG, "Reliability and validity of the longitudinal interval follow-up evaluation for assessing outcome of anxiety disorders", J Psychiatr Res, 28, pp.531~545 (1994)
- Leucht S, "Clinical implications of Brief Psychiatric Rating Scale scores", Br J Psychiatry, 187, pp.366~371 (2005)
- Weissman MM, "The cross-national epidemiology of panic disorder", Arch Gen Psychiatry, 54, pp.305~309 (1997)
- Sheikh JI, "Aging and panic disorder : phenomenology, comorbidity, and risk factors", Am J Geriatr Psychiatry, 12, pp.102~109 (2004)
- Kessler RC, "The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication", Arch Gen Psychiatry, 63, pp.415~424 (2006)
- Keller MB, "The clinical course of panic disorder and depression", J Clin Psychiatry, 53(Suppl), pp.5~8 (1992)
- Gardos G, "Long-term treatment of panic disorder with agoraphobia in private practice", J Psychiatr Pract, 6, pp.140~146 (2000)
- Kim MH, "One Year Naturalistic Outcome Study of Panic Disorder Patients", Anxiety and Mood, 2, pp.108~114 (2006)
- Segui J, "Differential clinical features of early-onset panic disorder", J Affect Disord, 54, pp.109~117 (1999)
- Katon WJ, "Clinical practice. Panic disorder", N Engl J Med, 354, pp.2360~2367 (2006)
- 조맹제, "한국 주요정신장애의 유병률 및 관련요인：2006 전국정신질환역학조사", 신경정신의학, 48(3), pp.143~152 (2009), 대한신경정신의학회