THE DEGREE OF EGO IMPAIRMENT IN ADOLESCENT PSYCHIATRIC PATIENT GROUPS

청소년 정신과 환자군을 대상으로 한 자아기능의 장애정도 비교 - Rorschach검사의 자아손상지표를 중심으로 -

Objective：This study was designed to examine the validity of the Ego Impairment Index(EII) in adolescent psychiatric patients(depression, depressive-conduct disorder, schizophrenia), and to explore the validity of the depressive-conduct disorder as a diagnostic entity. Method：19 depressives, 13 depressive-conduct disordered, and 10 schizophrenics with the age from 12 to 18 were selected based on DSM-IV and ICD-10 criteria, and their responses of the Rorschach and MMPI were analyzed. The EII was empirically developed by Perry and Viglione(1991) in order to assess the degree of ego impairment, and was derived from the Rorschach test. Results：It was founded that a single factor, ego impairment, was derived from the principal component analysis and explained 57.18% of total variances. The degree of ego impairment was grater in schizophrenics than in the other two groups, but there were no difference between depressives and depressive-conducts. Conclusions：These results offered support for the use EII as an empirical means of assessing the degree of ego impairment in adolescent patients. And these results suggest that depressive-conduct disorder group is more similar to the depressive group, implying that depressive-conduct disorder might correspond to so called masked depression. The clinical implication and limitation of present study were discussed.

본 연구에서는 청소년 정신과 환자군중에서 우울증 집단(n=19), 우울증적 품행장애 집단(n=13), 정신분열증 집단(n=10)을 대상으로 자아기능의 장애정도를 비교하였다. Rorschach검사를 통해 자아손상지표(EII)를 도출하였고, 요인분석 결과 선행연구와 마찬가지로 자아손상의 단일요인을 얻었으며 전체 변량의 57.18%를 설명하였다. EII를 진단별로 비교했을 때, 정신분열증 집단이 다른 두 집단에 비하여 유의미하게 높은 EII 점수를 나타냈지만, 우울증 집단과 우울증적 품행집단간의 차이는 발견되지 않았다. 이상의 결과는 자아기능 장애정도에 대한 측정도구로서 EII가 청소년정신장애집단에서 사용하는데 유용하다는 것을 제시함과 동시에, 청소년기 우울증적 품행장애가 이른바 위장된 우울증에 해당될 가능성을 시사해주었다.