투석 환자에서 연령에 따른 우울, 불안 및 긍정사고의 차이

The Differences of Depression, Anxiety and Positive Thinking between Adult and Elderly Hemodialysis Patients

  • 노기원 (성균관대학교 의과대학 강북삼성병원 정신건강의학교실) ;
  • 하주원 (성균관대학교 의과대학 강북삼성병원 정신건강의학교실) ;
  • 임세원 (성균관대학교 의과대학 강북삼성병원 정신건강의학교실) ;
  • 이재은 (성균관대학교 의과대학 강북삼성병원 신장내과학교실) ;
  • 이규백 (성균관대학교 의과대학 강북삼성병원 신장내과학교실) ;
  • 김향 (성균관대학교 의과대학 강북삼성병원 신장내과학교실) ;
  • 오강섭 (성균관대학교 의과대학 강북삼성병원 정신건강의학교실)
  • Noh, Ki-Won (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Ha, Juwon (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lim, Se-Won (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Jae-Eun (Divison of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Kyu-Beck (Divison of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Hyang (Divison of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Oh, Kang-Seob (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2013.03.10
  • 심사 : 2013.04.18
  • 발행 : 2013.04.30

초록

본 연구는 혈액 투석 중인 성인 환자 집단과 노인 환자 집단 간의 우울, 불안 및 자율신경기능의 차이를 비교해 보고자 하였다. 정신의학적 특징들과 자율신경기능을 비교해보았을 때 만성질환에 견디어 내는 능력에 있어서 노인 환자 집단이 성인 환자 집단에 비해 취약하지 않은 결과를 보였다. 이는 만성질환을 앓고 있는 동일한 상황에서 노인들이 보다 긍정적 사고 경향을 가지고 있는 것과 관련되어 있을 것으로 생각된다.

Objective : The end-stage renal disease patients who shared fear of death, functional impairment due to hemodialysis are vulnerable to depression, anxiety and other mental problems. It is possible that their psychiatric characteristics and related autonomic nervous functions have some differences depending on their age. We purpose to find the differences of psychiatric characteristics and related autonomic nervous functions between adult and elderly hemodialysis patients. Methods : Our subjects are end-stage renal disease hemodialysis patients composed of 39 adults (<65 years) and 24 seniors (${\geq}65$ years). Outcome measures included the 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale and Mini-International Neuropsychiatric Interview by clinician. And subjects fulfilled self-report scale, The Positive thinking scale and The Snaith-Hamilton Pleasure Scale. The autonomic nervous functions are measured by heart rate variability. Results : There are no significant differences in demographic factors between two groups. The 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale, The Snaith-Hamilton Pleasure Scale and autonomic nervous functions are also not different. But only positive thinking scale is higher in adult hemodialysis group than the elderly (F=5.395, p=0.024). Conclusion : This study compared depression, anxiety and autonomic nervous functions between adult and senior hemodialysis patients. There are no significant differences in psychiatric characteristics and autonomic nervous functions between two groups except positive thinking traits. Senior patients endured their chronic disease similar to adult patients did in spite of their old age. This result suggests that elderly's higher positive thinking traits affect their endurances about the negative situations.

키워드

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