고혈압 환자에서 우울증상의 유병률과 심리사회적 관련 요인
The Prevalence and Psychosocial Correlates of Depressive Symptoms in Patients with Hypertension
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Objectives：This study investigated the prevalence and psychosocial correlates of depressive symptoms in patients with hypertension. Methods：The participants were 124 outpatients with hypertension who were treated at the Department of cardiology, Chosun University Hospital. Each subject was assessed concerning depressive symptom severity, state-trait anger, ego resilience, social conflict, and perceived stress using self-report questionnaires. A logistic regression model was constructed to examine the impact of psychosocial factors on depressive symptoms. Results：A total of 37.1% of participants were identified as having depressive symptoms. Depressive symptoms were positively correlated with perceived stress, trait anger, social conflict, and state anger. On the other hand, ego resilience was negatively correlated with depressive symptoms. Further, perceived stress and state anger were related to a higher risk of depressive symptoms whereas ego resilience were associated with a lower risk of depressive symptoms. Conclusion：This study demonstrated a high prevalence of depressive symptoms in patients with hypertension. Moreover, several possible risk and protective psychosocial factors of depressive symptoms were determined. Especially, our findings suggest that improving ego resilience as well as lowering perceived stress and state anger would be important in the prevention and management of depression in patients with hypertension.
Abstract
Objectives：This study investigated the prevalence and psychosocial correlates of depressive symptoms in patients with hypertension. Methods：The participants were 124 outpatients with hypertension who were treated at the Department of cardiology, Chosun University Hospital. Each subject was assessed concerning depressive symptom severity, state-trait anger, ego resilience, social conflict, and perceived stress using self-report questionnaires. A logistic regression model was constructed to examine the impact of psychosocial factors on depressive symptoms. Results：A total of 37.1% of participants were identified as having depressive symptoms. Depressive symptoms were positively correlated with perceived stress, trait anger, social conflict, and state anger. On the other hand, ego resilience was negatively correlated with depressive symptoms. Further, perceived stress and state anger were related to a higher risk of depressive symptoms whereas ego resilience were associated with a lower risk of depressive symptoms. Conclusion：This study demonstrated a high prevalence of depressive symptoms in patients with hypertension. Moreover, several possible risk and protective psychosocial factors of depressive symptoms were determined. Especially, our findings suggest that improving ego resilience as well as lowering perceived stress and state anger would be important in the prevention and management of depression in patients with hypertension.
참고문헌 (52)
- Mittal BV, "Hypertension in the developing world : Challenges and opportunities", Am J Kidney Dis, 55, pp.590~598 (2010)
- Faraco G, "Hypertension : a harbinger of stroke and dementia", Hypertension, 62, pp.810~817 (2013)
- Kretchy IA, "Mental health in hypertension : assessing symptoms of anxiety depression and stress on anti-hypertensive medication adherence", Int J Ment Health Syst, 8, pp.25~ (2014)
- Robins LN, "Psychiatric disorders in America: the epidemiologic catchment area study" (1991), The Free Press
- Kessler RC, "The epidemiology of major depressive disorder : results from the National Comorbidity Survey Replication(NCS-R)", JAMA, 289, pp.3095~3105 (2003)
- World Health Oraganization, "The global burden of disease:2004 update" (2008), WHO
- Moussavi S, "Depression, chronic diseases, and decrements in health: results from the World Health Surveys", Lancet, 370, pp.851~858 (2007)
- Musselman DL, "The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment", Arch Gen Psychiatry, 55, pp.580~592 (1998)
- Li Z, "Prevalence of depression in patients with hypertension: A systematic review and meta-analysis", Medicine(Baltimore), 94, pp.e1317~ (2015)
- Rabkin JG, "Hypertension and DSMIII depression in psychiatric outpatients", Am J Psychiatry, 140, pp.1072~1074 (1983)
- Jonas BS, "Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study", Arch Fam Med, 6, pp.43~49 (1997)
- Jonas BS, "Negative affect as a prospective risk factor for hypertension", Psychosom Med, 62, pp.188~196 (2000)
- Isaksson H, "The psychological and social condition of hypertensives resistant to pharmacological treatment", Soc Sci Med, 35, pp.869~875 (1992)
- Beers MH, "Antihypertensive medications and depression", Drugs, 40, pp.792~799 (1990)
- Liu MY, "Association between psychosocial stress and hypertension : a systematic review and meta-analysis", Neurol Res, 39, pp.573~580 (2017)
- Van der Kooy K, "Depression and the risk for cardiovascular disease : systematic review and meta analysis", Int J Geriatr Psychiatry, 22, pp.613~626 (2007)
- Barth J, "Depression as a risk factor for mortality in patients with coronary heart disease : a meta-analysis", Psychosom Med, 66, pp.802~813 (2004)
- Lesperance F, "Depression in patients with cardiac disease : a practical review", J Psychosom Res, 48, pp.379~391 (2000)
- Halaris A, "Comorbidity between depression and cardiovascular disease", Int Angiol, 28, pp.92~99 (2009)
- Hollon SD, "A review of empirically supported psychological therapies for mood disorders in adults", Depress Anxiety, 27, pp.891~932 (2010)
- Scalco AZ, "Hypertension and depression", Clinics, 60, pp.241~250 (2005)
- 오세만, "병원 불안-우울 척도에 관한표준화 연구", 대한신경정신의학회지, 38, pp.289~296 (1999)
- 전겸구, "한국판 상태-특성 분노 표현 척도(STAXI-K)개발연구 : IV", 미술치료연구, 7, pp.33~50 (2000)
- Block JH, "The role of ego-control and ego-resiliency in the organization of behavior", Minn Symp Child Psychol Ser, 13, pp.39~101 (1980)
- 유성경, "적응 유연한 청소년들의 심리적 보호요소 탐색", 교육심리연구, 16(4), pp.189~206 (2002), 한국교육심리학회
- 장연진, "도시 저소득층 기혼여성의 사회적 관계망에 관한 연구" (2001), 서울대학교 출판부
- 백영묘, "지각된 스트레스: 척도 표준화 및 기억 기능에 대한 영향 탐색" (2010), 서울대학교 출판부
- 최종원, "일개 대학병원에서 종합검진을 받은 직장인에서 우울증과 심혈관위험요인과의 관계", Korean Journal of Family Medicine, 29(09), pp.645~650 (2008), 대한가정의학회
- 김명희, "일 도시지역 노인의 고혈압과 우울간의 관계", Journal of Korean Biological Nursing Science, 12(3), pp.186~194 (2010), 한국기초간호학회
- Mahmood S, "Prevalence and predictors of depression amongst hypertensive individuals in Karachi, Pakistan", Cureus, 9, pp.e1397~ (2017)
- Ried LD, "Validating a self-report measure of global subjective well-being to predict adverse clinical outcomes", Qual Life Res, 15, pp.675~686 (2006)
- 김기원, "Psychosocial, Physical, and Autonomic Correlates of Depression in Korean Adults: Results from a County-Based Depression Screening Study", PSYCHIATRY INVESTIGATION, 11(4), pp.402~411 (2014), 대한신경정신의학회[DOI]
- "2016 정신질환실태조사" (2017)[URL]
- Benseñor IM, "Systemic arterial hypertension and psychiatric morbidity in the outpatient care setting of a tertiary hospital", Arq Neuropsiquiatr, 56, pp.406~411 (1998)
- Bromet E, "Cross-national epidemiology of DSM-IV major depressive episode", BMC Med, 9, pp.90~ (2011)
- 조맹제, "한국 주요정신장애의 유병률 및 관련요인：2006 전국정신질환역학조사", 신경정신의학, 48(3), pp.143~152 (2009), 대한신경정신의학회
- Coulter L, "Linking the psychosocial aetiology and neurobiology of unipolar depression", Psychiatr Danub, 29, pp.441~446 (2017)
- Light KC, "Psychosocial precursors of hypertension : experimental evidence", Circulation, 76, pp.67~76 (1987)
- Riley WT, "Anger and hostility in depression", J Nerv Ment Dis, 177, pp.668~674 (1989)
- Galambos NL, "The anger-depression connection : Between-persons and within-person associations from late adolescence to midlife", Dev Psychol, 54, pp.1940~1953 (2018)
- Schum JL, "Trait anger, anger expression, and ambulatory blood pressure: a meta-analytic review", J Behav Med, 26, pp.395~415 (2003)
- Everson SA, "Anger expression and incident hypertension", Psychosom Med, 60, pp.730~735 (1998)
- Markovitz JH, "Psychologic factors as precursors to hypertension", Curr Hypertens Rep, 3, pp.25~32 (2001)
- Stieglitz J, "Functional disability and social conflict increase risk of depression in older adulthood among bolivian foragerfarmers", J Gerontol B Psychol Sci Soc Sci, 70, pp.948~956 (2015)
- Guruge S, "Social support, social conflict, and immigrant women’s mental health in a Canadian context: a scoping review", J Psychiatr Ment Health Nurs, 22, pp.655~667 (2015)
- Lu X, "The association between perceived stress and hypertension among asian americans : Does social support and social network make a difference?", J Community Health, 44, pp.451~462 (2019)
- Elisei S, "Resilience and depressive disorders", Psychiatr Danub, 25, pp.263~267 (2013)
- Cha KS, "The effects of ego-resilience, social support, and depression on suicidal ideation among the elderly in South Korea", J Women Aging, 30, pp.444~459 (2018)
- 김상은, "청소년 자아탄력성 수준에 따른 정신심리학적 특성", 생물치료정신의학, 24(3), pp.156~162 (2018), 대한생물치료정신의학회[DOI]
- Liu X, "Prevalence and related factors of depressive symptoms in hemodialysis patients in northern China", BMC Psychiatry, 17, pp.128~ (2017)
- Desjardins E, "Promoting resilience", Q Rev Biol, 90, pp.147~165 (2015)
- Charney DS, "Psychobiological mechanisms of resilience and vulnerability : Implications for successful adaptation to extreme stress", Am J Psychiatry, 161, pp.195~216 (2004)