범불안장애 환자와 일반인의 걱정 내용 및 심각도의 비교

Contents and Severity of Worries in Outpatients with Generalized Anxiety Disorder Compared to Normal Control

  • 김휘곤 (한양대학교 의과대학 정신건강의학과교실) ;
  • 김대호 (한양대학교 의과대학 정신건강의학과교실) ;
  • 오대영 (CHA의과학대학 분당차병원 정신건강의학교실) ;
  • 서호준 (가톨릭대학교 의과대학 정신과학교실) ;
  • 허휴정 (가톨릭대학교 의과대학 정신과학교실) ;
  • 채정호 (가톨릭대학교 의과대학 정신과학교실)
  • Kim, Hwigon (Department of Psychiatry, Hanyang University College of Medicine) ;
  • Kim, Daeho (Department of Psychiatry, Hanyang University College of Medicine) ;
  • Oh, Daeyoung (Department of Psychiatry, CHA Bundang Medical Center, CHA University) ;
  • Seo, Ho Jun (Department of Psychiatry, College of Medicine, The Catholic University of Korea) ;
  • Huh, Hyu Jung (Department of Psychiatry, College of Medicine, The Catholic University of Korea) ;
  • Chae, Jeong Ho (Department of Psychiatry, College of Medicine, The Catholic University of Korea)
  • 투고 : 2015.03.12
  • 심사 : 2015.04.20
  • 발행 : 2015.04.30

초록

Objective : Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by excessive worries and anxiety symptoms. To distinguish between pathological and normal worries, this study compared the contents and severity of worries among patients with GAD with those of matched non-psychiatric control Methods : Thirty outpatients with GAD receiving treatment at the psychiatric department of Hanyang University Guri Hospital were recruited. As a matched control group, we selected 30 adults without psychiatric history who participated in the Anxiety Disorder Survey, during the Mental Health Exposition held in Seoul in April, 2014. Matched demographic data were age, sex, education, and household income. Self-questionnaires included demographic data, contents of worry (10 categories of worries and each severity), and the Pennsylvania State Worry Questionnaire (PSWQ). Results : There was no statistical difference in the contents of worry between patient and control groups. However, the total PSWQ scores significantly higher in the GAD group. Conclusion : Our findings suggest that patients and non-patients worry about the similar contents and worries in GAD cannot be differentiated by what people worry about. Only the severity of worry was a distinguishable feature. Our finding supported inclusion of the diagnostic criterion of "excesslve wornes" in GAD.

키워드

참고문헌

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington DC: American Psychiatric Association;2013.
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text revision. Washington DC: American Psychiatric Association;2000.
  3. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005;62:617-627. https://doi.org/10.1001/archpsyc.62.6.617
  4. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005;62:593-602. https://doi.org/10.1001/archpsyc.62.6.593
  5. Maier W, Gansicke M, Freyberger HJ, Linz M, Heun R, Lecrubier Y. Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective: a valid diagnostic entity? Acta Psychiatrica Scandinavica 2000;101:29-36. https://doi.org/10.1034/j.1600-0447.2000.101001029.x
  6. Cho MJ, Ham BJ, Hong JP, Lee DW, Lee JY, Jeong IW, et al. The epidemiological survey of mental disorders in Korea. Seoul: Ministry of Health and Welfare;2011.
  7. Newman MG, Llera SJ, Erickson TM, Przeworski A, Castonguay LG. Worry and generalized anxiety disorder: a review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment. Annu Rev Psychol 2013;9:275-297. https://doi.org/10.1146/annurev-clinpsy-050212-185544
  8. Cramer V, Torgersen S, Kringlen E. Quality of life and anxiety disorders: a population study. J Nerv Ment Dis 2005;193:196-202. https://doi.org/10.1097/01.nmd.0000154836.22687.13
  9. Gordon D, Heimberg RG. Reliability and validity of DSM-IV generalized anxiety disorder features. J Anxiety Disord 2011;25:813-821. https://doi.org/10.1016/j.janxdis.2011.04.001
  10. Raster MJ, Wise TN, Cai J. Anxiety and anxiety disorders in medical settings In: Stein DJ, Hollander E. Textbook of Anxiety Disorders. Washington DC: American Psychiatric Publishing, Inc.;2002. p.449-460.
  11. Kim, KH, Guideline to diagnosis & assessment of generalized anxiety disorder. Proceedings of Annual Conference of the Korean Psychological Association; 2008, Seoul, South korea. The Korean Psychological Association;2008. p.520-521.
  12. Roemer L, Molina S, Borkovec TD. An investigation of worry content among generally anxious individuals. J Nerv Ment Dis 1997;185:314-319. https://doi.org/10.1097/00005053-199705000-00005
  13. Diefenbach GJ, Stanley MA, Beck JG. Worry content reported by older adults with and without generalized anxiety disorder. Aging Ment Health 2001;5:269-274. https://doi.org/10.1080/13607860120065069
  14. Choi KR, Kim DH, Seo HJ, Huh HJ, Lee DW, Chae JH. Results of anxiety disorder screening program at the 2013 mental health exposition in Seoul. Anxiety Mood 2013;9:1-7.
  15. Brown TA, Antony MM, Barlow DH. Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behav Res Ther 1992;30:33-37. https://doi.org/10.1016/0005-7967(92)90093-V
  16. Kim JW, Min BB. Intolerance of Uncertainty and Problem Orientation in Worry. Proceedings of Annual Conference of the Korean Psychological Association; 1998, Seoul, South Korea. Korean Psychological Association;1998. p.83-92.
  17. Becker ES, Goodwin R, Holting C, Hoyer J, Margraf J. Content of worry in the community: what do people with generalized anxiety disorder or other disorders worry about?. J Nerv Ment Dis 2003;191:688-691. https://doi.org/10.1097/01.nmd.0000092198.20420.fc
  18. Montorio I, Nuevo R, Marquez M, Izal M, Losada A. Characterization of worry according to severity of anxiety in elderly living in the community. Aging Ment Health 2003;7:334-341. https://doi.org/10.1080/1360786031000150694
  19. Hoyer J, Becker ES, Roth WI. Characteristics of worry in GAD patients, social phobics, and controls. Depress Anxiety 2001;13:89-96. https://doi.org/10.1002/da.1021
  20. Gould CE, Edelstein BA. Worry, emotion control, and anxiety control in older and young adults. J Anxiety Disord 2010;24:759-766. https://doi.org/10.1016/j.janxdis.2010.05.009
  21. Rios R, Zautra AJ. Socioeconomic disparities in pain: the role of economic hardship and daily financial worry. Health Psychol 2011;30:58. https://doi.org/10.1037/a0022025
  22. Scott EL, Eng W, Heimberg RG. Ethnic differences in worry in a nonclinical population. Depress Anxiety 2002;15:79-82. https://doi.org/10.1002/da.10027
  23. Dugas MJ, Freeston MH, Ladouceur R, Rheaume J, Provencher M, Boisvert JM. Worry themes in primary GAD, secondary GAD, and other anxiety disorders. J Anxiety Disord 1998;12:253-261. https://doi.org/10.1016/S0887-6185(98)00013-9
  24. Ruscio AM, Lane M, Roy-Byrne P, Stang PE, Stein DJ, Wittchen HU, et al. Should excessive worry be required for a diagnosis of generalized anxiety disorder? Results from the US National Comorbidity Survey Replication. Psychol Med 2005;35:1761-1772. https://doi.org/10.1017/S0033291705005908
  25. Park HJ, Kim JH, Lee JH, Heo JY, Yu BH. The usefulness of the Korean version of Penn state worry questionnaire for screening generalized anxiety disorder: A receiver operating characteristic analysis. Psychiatry Investig 2014;11:12-17. https://doi.org/10.4306/pi.2014.11.1.12
  26. Wittchen HU. Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety 2002;16:162-171. https://doi.org/10.1002/da.10065
  27. Tallis F, Eysenck M, Mathews A. A questionnaire for the measurement of non pathological worry. Pers Indiv Differ 1992;13:161-168. https://doi.org/10.1016/0191-8869(92)90038-Q