정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
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기능성 위장질환의 종류에 따른 정신사회적 특성 및 삶의 질의 차이에 관한 연구

A Study on the Difference of Psychosocial Characteristics and Quality of Life according to the Type of Functional Gastrointestinal Disorder

  • 박승규 (원광대학교 의과대학 정신건강의학교실) ;
  • 이상열 (원광대학교 의과대학 정신건강의학교실) ;
  • 류한승 (원광대학교 의과대학 내과학교실) ;
  • 최석채 (원광대학교 의과대학 내과학교실) ;
  • 양찬모 (원광대학교 의과대학 정신건강의학교실) ;
  • 장승호 (원광대학교 의과대학 정신건강의학교실) ;
  • 염동한 (원광대학교 의과대학 내과학교실) ;
  • 이귀행 (원광대학교 의과대학 정신건강의학교실)
  • Park, Seung-Kyu (Department of Psychiatry, School of Medicine, Wonkwang University) ;
  • Lee, Sang-Yeol (Department of Psychiatry, School of Medicine, Wonkwang University) ;
  • Ryu, Han-Seung (Department of Internal Medicine, School of Medicine, Wonkwang University) ;
  • Choi, Suck-Chei (Department of Internal Medicine, School of Medicine, Wonkwang University) ;
  • Yang, Chan-Mo (Department of Psychiatry, School of Medicine, Wonkwang University) ;
  • Jang, Seung-Ho (Department of Psychiatry, School of Medicine, Wonkwang University) ;
  • Yeom, Dong Han (Department of Internal Medicine, School of Medicine, Wonkwang University) ;
  • Lee, Kuy-Haeng (Department of Psychiatry, School of Medicine, Wonkwang University)
  • Received : 2021.05.07
  • Accepted : 2021.06.25
  • Published : 2021.06.30
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Abstract

연구목적 본 연구에서는 기능성위장질환 환자를 과민성 대장 증후군, 기능성 소화불량, 기능성 변비, 기능성 흉부 작열감, 중복집단(두 개 이상의 기능성 질환이 중복)으로 분류하여 정신사회적 특성을 비교하고, 기능성위장질환 환자의 삶의 질과 연관된 요인들을 알아보고자 하였다. 방 법 일 대학병원 소화기 내과 전문의에 의해 기능성 위장질환으로 진단받은 환자 144명을 기능성위장질환 환자 집단으로 선정하였다. 인구통계학적 요인을 조사하였으며 정신사회적 요인을 평가하기 위해 Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF)를 사용하였다. 결 과 중복집단이 다른 집단에 비해 BDI-II 점수(F=11.09, p<0.001)와 BAI 점수(F=8.93, p<0.001)가 유의하게 높았다. 아동기 외상에서 정서적 방임(F=2.54, p=0.04)은 IBS 환자집단이 FD 환자 집단에 비해 유의하였다. FGID 환자에서 삶의 질은 우울증상(r=-0.196, p<0.01), 불안(r=-0.235, p<0.01), 아동기 트라우마(r=-0.222, p<0.01)와 음의 상관관계를 보였고, 사회적 지지(r=0.512, p<0.01), 회복탄력성(r=0.581, p<0.01)과는 양의 상관관계를 나타냈다. 결 론 연구결과 중복 환자 집단에서 우울, 불안이 유의하게 높았으며 아동기 외상에서 IBS 환자 집단이 FD 환자 집단보다 정서적 방임이 유의하게 높았다. 따라서 추후 기능성 위장질환 환자의 치료에 있어 정신사회적 요인에 대한 적극적인 개입이 요구된다고 하겠다.

Objectives : The purpose of this study is to compare the psychosocial characteristics of patients diagnosed with functional gastrointestinal disorder (FGID) by classifying them into irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional heartburn (FH) groups, and overlap group (two or more functional diseases) and to examine the factors associated with the quality of life (QoL) of patients with FGID. Methods : A total of 144 patients who were diagnosed with FGID were selected as the subjects. The demographical factors were investigated; Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), and World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were used to evaluate the psychosocial factors. Results : TThe overlap group had a significantly higher K-BDI-II score (F=11.09, p<0.001) and K-BAI score (F=8.93, p<0.001) compared to other groups. In childhood trauma, the IBS patients had a difference in emotional neglect (F=2.54, p=0.04) than the FD patients. The QoL of FGID patients had a negative correlation with depression (r=-0.196, p<0.01), anxiety (r=-0.235, p<0.01), and childhood trauma (r=-0.222, p<0.01), and a positive correlation with social support (r=0.512, p<0.01) and resilience (r=0.581, p<0.01). Conclusions : Overlap group had a higher level of depression and anxiety, and the IBS patient group had a higher level of emotional neglect than the FD patient group in terms of childhood trauma.

Keywords

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