Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prevalence and Risk Factors of Depression in Patients with Chronic Obstructive Pulmonary Disease

폐쇄성폐질환에서 우울증상의 빈도 및 위험 인자

  • Chin, Hyun Jung (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Lee, Kwan Ho (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Park, Chan Soh (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Son, Chang Woo (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Lee, Hi-young (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Yu, Sung Ken (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Shin, Kyeong Cheol (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Chung, Jin Hong (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Kim, Jung Youp (Elderly Welfare Department, Daegu Haany University)
  • 진현정 (영남대학교 의과대학 내과학교실) ;
  • 이관호 (영남대학교 의과대학 내과학교실) ;
  • 박찬서 (영남대학교 의과대학 내과학교실) ;
  • 손창우 (영남대학교 의과대학 내과학교실) ;
  • 이하영 (영남대학교 의과대학 내과학교실) ;
  • 유성근 (영남대학교 의과대학 내과학교실) ;
  • 신경철 (영남대학교 의과대학 내과학교실) ;
  • 정진홍 (영남대학교 의과대학 내과학교실) ;
  • 김정엽 (대구한의대학교 노인복지학과)
  • Received : 2008.07.28
  • Accepted : 2008.09.01
  • Published : 2008.09.30
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Abstract

Background: Due to the irreversible nature of chronic obstructive pulmonary disease (COPD), the treatment aim in patients with COPD is not to cure but to reduce the symptoms, increase lung function, and improve the quality of life. It has been suggested that depression is a common emotional disturbance in patients with COPD who are faced with a major physical impairment and embarrassing symptoms. This study evaluated the prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease. Methods: A total of 59 patients with a registered diagnosis of chronic obstructive pulmonary disease were selected. Depression was assessed using the Centers for Epidemiologic Studies Depression (CES-D) scale. The quality of life was assessed using the Korean version of the St. George's Respiratory Questionnaire. Results: The prevalence of depression was 17.0%. In the correlation model, the interaction of the $FEV_1%$ over predicted value and SGRQ score(symptom, activity, impact, overall score) was statistically significant. The interaction of the $FEV_1%$ over predicted value and depression scale(CES-D) was also statistically significant. There was a positive correlation between the SGRQ scores(symptom, activity, impact, overall score) and the depression scale. Conclusion: The prevalence of depression in patients with chronic obstructive pulmonary disease is relatively high. The pulmonary function and the living standards were found to be significant risk factors for depression.

연구배경: 만성폐쇄성폐질환에서 점진적인 폐기능의 악화 및 치료의 장기화는 환자의 삶의 질을 저하시키며 우울증의 발생 가능성을 높인다. 만성폐쇄성폐질환에서 우울증의 빈도, 호흡기 증상과 관련된 삶의 질 정도와 우울증과의 관계 및 관련 인자에 관해 알아보았다. 방 법: 대상은 2007년 3월부터 9월까지 영남대학교 의료원 호흡기내과 외래를 방문한 59명의 만성폐쇄성폐질환환자로 하였으며, 이들에서 폐기능 검사 및 해당 설문조사를 시행하였다. 호흡기 증상과 관련된 삶의 질에 대한 평가는 SGRQ (St. George's Respiratory Questionnaire), 우울증은 우울척도인 CES-D (Center for Epidermiological Studies-Depression Scale)를 사용하였다. 결 과: 연구 결과 만성폐쇄성폐질환자에서 우울증의 유병율은 17.0%로 일반인들의 우울증 유병률보다 높았다.SGRQ 결과 증상, 활동 제한, 영향력 제한, 총 점수 모두 우울증상과 양의 상관관계를 보였다(p=0.010, 0.001, 0.000, 0.046). 폐기능 검사에서 $FEV_1$은 SGRQ 및 우울증상과 음의상관관계를 보였다(p=0.001, 0.000, 0.000, 0.002, 0.006). 만성폐쇄성폐질환 환자에서 생활수준이 낮을수록 우울증상은 증가하였고 삶의 질도 저하되었으나 교육 수준, 신뢰도 정도 등과는 통계적으로 유의한 차이가 없었다. 결 론: 만성폐쇄성폐질환 환자는 일반인들에 비해 우울증의 유병률이 높았으며 우울증상에 관여하는 의미있는 인자는 폐기능의 감소와 경제적 수준이었다.

Keywords

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