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주요우울증에서 자살경향성 : 공존질환의 영향

Suicidality in Major Depressive Disorder : The Impact of Psychiatric Comorbidity

김희철|이은정|사공정규|성형모|김정범|정성원|신임희|정지원
대한신경정신의학회 (Korean Neuropsychiatric Association)|2012.03|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제51권 제2호|pp. 85-92

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참고문헌

키워드

Major depressive disorderComorbidity공존질환Suicidal riskSuicidality주요우울증자살경향성자살위험도
주제분류정신과학

초록

Mini-International Neuropsychiatric Interview-Plus를통해 주요우울증으로 진단받은 288명의 환자들 중에서 공존질환이 있는 주요우울증 환자군이 공존질환이 없는 주요우울증 군에 비해 자살경향성과 자살위험도가 유의하게 높았다. 불안장애가 동반된 군에서는 공존질환이 없는 주요우울증 환자군에 비해 자살경향성 및 자살위험도가 유의하게 높았다. 전체 공존질환의 개수가 많을수록 자살경향성이 높게나타났고 공존질환 개수에 따라 자살위험도의 유의한 차이를 보였으며 공존질환이 3개 이상인 군에서 자살위험도가 가장 높았다. 임상현장에서 주요우울증 환자를 진료할 때, 공존질환이 있는 환자에서 자살사고 및 행동에 대해 좀 더 세심하게 평가하고 이에 대한 적극적인 치료적 개입이 필요할것이다.

Abstract

Objectives Generally, major depressive disorder (MDD) with psychiatric comorbidities is associated with a high suicide rate. However, this relationship has not been studied much in Korea. In this study, we evaluated the suicidality in MDD with psychiatric comorbidities. Methods This study was performed on patients who visited the psychiatric department of three university hospitals in the Gyeongbuk area from March 2008 to September 2011. In total, 776 patients were ev aluated with the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus), and 288 with MDD were recruited for the study. Suicidality and suicidal risks were evaluated in the MINI-Plus questionnaire. Results MDD patients with comorbidities had a significantly higher suicidality and suicidal risk than patients with pure MDD. Suicidality was significantly higher in an anxiety disorder group with comorbidity than in the pure MDD group. As the total number of comorbidities got higher, the suicidality increased, and suicidal risks had significant differences depending on the total number of comorbidities Conclusion These results suggest that an MDD patient with comorbidities has a higher suicidality and suicidal risk. In clinical settings, comorbid MDD patients should be approached with more aggressive psychiatric intervention of their suicidal thoughts and actions

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