공황장애 환자에서 공존 주요 우울증과 연관된 임상요인들
Clinical Factors Associated with Comorbid Major Depressive Disorder in Patients with Panic Disorder
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of “fear of losing control or going crazy” were associated with MDD in patients with panic disorder. In female patients, the “chills or hot flushes” symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.
Abstract
Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of “fear of losing control or going crazy” were associated with MDD in patients with panic disorder. In female patients, the “chills or hot flushes” symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.
참고문헌 (37)
- Kessler RC, "Lifetime and 12-month prevalence of dsm-iii-r psychiatric disorders in the united states. Results from the national comorbidity survey", Arch Gen Psychiatry, 51, pp.8~19 (1994)
- Spitzer RL, "Health-related quality of life in primary care patients with mental disorders. Results from the prime-md 1000 study", JA-MA, 274, pp.1511~1517 (1995)
- Leon AC, "Prevalence of mental disorders in primary care. Implications for screening", Arch Fam Med, 4, pp.857~861 (1995)
- Hasin DS, "Epidemiology of major depressive disorder: Results from the national epidemiologic survey on alcoholism and related conditions", Arch Gen Psychiatry, 62, pp.1097~1106 (2005)
- The world health report 2001: Mental health- new understanding, new hope, "World Health Organization", World Health Organization, ~ (2001)
- 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)
- Leckman JF, "Panic disorder and major depression. Increased risk of depression, alcoholism, panic, and phobic disorders in families of depressed probands with panic disorder", Arch Gen Psychiatry, 40, pp.1055~1060 (1983)
- Biederman J, "A high risk study of young children of parents with panic disorder and agoraphobia with and without comorbid major depression", Psychiatry Res, 37, pp.333~348 (1991)
- Weissman MM, "The relationship between panic disorder and major depression. A new family study", Arch Gen Psychiatry, 50, pp.767~780 (1993)
- Roy-Byrne PP, "Lifetime panic-depression comorbidity in the national comorbidity survey. Association with symptoms, impairment, course and help-seeking", Br J Psychiatry, 176, pp.229~235 (2000)
- Vollrath M, "Outcome of panic and depression in a seven-year follow-up: Results of the zurich study", Acta Psychiatr Scand, 80, pp.591~596 (1989)
- Cassano GB, "The panic-agoraphobic spectrum: A descriptive approach to the assessment and treatment of subtle symptoms", Am J Psychiatry, 154, pp.27~38 (1997)
- Choi YH, "Clinical characteristics and heart rate variability in patients with comorbid panic disorder and major depressive disorder", Sleep Med Psychophysiol, 12, pp.50~57 (2005)
- Dube S, "Interface of panic and depression : Clinical and sleep eeg correlates", Psychiatry Res, 19, pp.119~133 (1986)
- 안주연, "우울장애의 동반 유무에 따른 공황장애 환자의 임상적 특성", 우울조울병, 6(2), pp.109~113 (2008), 대한우울∙조울병학회
- Meuret AE, "Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder", J Psychiatr Res, 40, pp.520~527 (2006)
- Yaseen ZS, "Fear of dying in panic attacks predicts suicide attempt in comorbid depressive illness: Prospective evidence from the national epidemiological survey on alcohol and related conditions", Depress Anxiety, 30, pp.930~939 (2013)
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- Hamilton M, "Hamilton anxiety scale" (1959)
- Kim JB, "Development of the korean version of the panic disorder severity scale", Korean J Psychopathol, 10, pp.140~151 (2001)
- Sheehan DV, "The mini-international neuropsychiatric interview (m.I.N. I.): The development and validation of a structured diagnostic psychiatric interview for dsm-iv and icd-10", J Clin Psychiatry, 59(20), pp.22~33 (1998)
- Yoo SW, "Validity of korean version of the mini international neuropsychiatric interview", Anxiety Mood, 2, pp.50~55 (2006)
- Maser JD, "Comorbidity of anxiety and mood disorders: Introduction and overview. In: Maser JD, Cloninger CR, editors. Comorbidity of anxiety and mood disorders", pp.1~12 (1990), American Psychiatric Press
- Breier A, "Major depression in patients with agoraphobia and panic disorder", Arch Gen Psychiatry, 41, pp.1129~1135 (1984)
- Dealy RS, "Secondary depression in anxiety disorders", Compr Psychiatry, 22, pp.612~618 (1981)
- "Facts about panic disorder", National institute of mental health, ~ (2006)
- Kuehner C, "Gender differences in unipolar depression: An update of epidemiological findings and possible explanations", Acta Psychiatr Scand, 108, pp.163~174 (2003)
- Bruch MA, "Social phobia: Diagnosis, assessment, and treatment", pp.163~182 (1995), Guilford Press
- Rapee RM., "Social phobia: Diagnosis, assessment, and treatment", pp.41~66 (1995), Guilford Press
- Kikuchi M, "Panic disorder with and without agoraphobia: Comorbidity within a half-year of the onset of panic disorder", Psychiatry Clin Neurosci, 59, pp.639~643 (2005)
- Kessler RC, "The epidemiology of major depressive disorder: Results from the national comorbidity survey replication (ncs-r)", JAMA, 289, pp.3095~3105 (2003)
- Arnstein P, "Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients", Pain, 80, pp.483~491 (1999)
- Berendsen HH., "The role of serotonin in hot flushes", Maturitas, 36, pp.155~164 (2000)
- Plouffe L Jr, "An open trial of sertraline for menopausal hot flushes: Potential involvement of serotonin in vasomotor instability", Del Med J, 69, pp.481~482 (1997)
- Roth AJ, "Sertraline relieves hot flashes secondary to medical castration as treatment of advanced prostate cancer", Psychooncology, 7, pp.129~132 (1998)
- Loprinzi CL, "Pilot evaluation of venlafaxine hydrochloride for the therapy of hot flashes in cancer survivors", J Clin Oncol, 16, pp.2377~2381 (1998)
- Murphy DL, "Comparative anxiogenic, neuroendocrine, and other physiologic effects of m-chlorophenylpiperazine given intravenously or orally to healthy volunteers", Psychopharmacology (Berl), 98, pp.275~282 (1989)
