• 대한불안의학회지
• /
• 제9권2호
• /
• pp.93-100
• /
• 2013

Major depressive disorder causes significant dysfunction and disability. Many of depressed patients tend to have cormobid anxiety disorders, substance use disorders and personality disorders, and so on. In this study, we reviewed researches about the effects of comorbid anxiety disorder, substance use disorder on depressive symptoms, progress, treatment, etc. In addition, the latest knowledges related to treatment was reviewed. If the symptoms of anxiety disorder coexist, They leads to the deterioration of the course and has an adverse effect on treatment response. Comorbid substance use disorder, such as alcohol dependence, causes worsening of symptoms and progression, and a loss of therapeutic response. Therapeutic clinical guidelines and instructions to comorbid psychiatric disorders on major depressive disorder was not established clearly, but consensus-based or evidence-based studies will be necessary for treatment for comorbid psychiatric disorders on major depressive disorder.

• 정신신체의학
• /
• 제2권1호
• /
• pp.59-68
• /
• 1994

본 연구는 정신신체장애, 불안장애 및 우울장애 환자들 간에 alexithymia의 정도를 비교하기 위해서 실시되었다. 연구대상은 정신과 외래에 내원 하였거나 타과에서 정신과에 자문의뢰된 정신신체장애 환자 100명(긴장성 두통환자 47명 포함), 불안장애환자 52명, 우울장애환자 50명으로 하였다. 조사방법은 반체계적 면담용 평가도구인 Alexithymia provoked Response Questionnaire(APRQ)를 사용하였다. 정신신체장애환자들은 불안장애 및 우울장애환자들보다 alexithymia의 정도가 더 낮았으나 세 군간에 유의한 차이는 없었다. 반면 긴장성 두통환자들은 불안장애 및 우울장애환자들에 비해 alexithymia의 정도가 각각 유의하게 더 높았다. 우울장애환자들이 불안장애환자들보다 aluithymia의 정도가 더 높았으나 양군간에 유의한 차이는 없었다. 성별, 연령, 교육수준, 종교 및 직업유무와 같은 인구학적 특징들은 조사대상 모든 군에서 alexithymia와 유의한 관계가 없었다. 이 결과들은 일반적으로 정신신체장애환자들이 alexithymia를 보인다는 기존 보고와 다르게 정신신체장애 중 긴장성 두통과 같은 특정 정신신체장애환자들에서 alexithymia가 현저함을 시사한다. 따라서 긴장성 두통환자들에서의 치료전략으로 감정표현을 유도하는 특수한 형태의 면담방법이 개발될 필요가 있다.

• 대한불안의학회지
• /
• 제3권1호
• /
• pp.46-51
• /
• 2007

Objectives : By comparing the prevalence rates of suicide-related behaviors (suicide ideation, plan and attempt) between depressive disorder and anxiety disorder patients, we tried to find the characteristics of suicide-related behaviors in these patients. Methods : Four hundred-three patients participated in the study and the prevalence rates of suicide-related behaviors were investigated using Korean version of Mini International Neuropsychiatric Interview plus. Pearson Chi-Square test was used to find the association between depressive or anxiety disorders and suiciderelated behaviors. Results : Statistically significant differences were found between depressive disorder group and anxiety disorder group in terms of suicide ideation ($X^2$=6.173, df=1, p=0.013) and suicide attempt ($X^2$=8.008, df=1, p=0.005). We also found that patients in depressive disorder group were more likely to have suicide ideation (Odds Ratio=2.049, 95% Confidence Interval=1.155-3.635), and attempt suicide (Odds Ratio=4.970, 95% Confidence Interval=1.466-16.845) than patients in anxiety disorder group. Conclusion : These findings suggest that suicide ideation and suicide attempt rates are higher in depressive disorders than in anxiety disorders.

• 생물정신의학
• /
• 제18권4호
• /
• pp.189-196
• /
• 2011

Major depressive disorder is characterized by cellular and molecular alterations resulting in the depressive behavioral phenotypes. Preclinical and clinical studies have demonstrated the deficits, including cell atrophy and loss, in limbic and cortical regions of patients with depression, which is restored with antidepressants by reestablishing proper molecular changes. These findings have implicated the involvement of relevant intracellular signaling pathways in the pathogenetic and therapeutic mechanisms of depressive disorders. This review summarizes the current knowledge of the signal transduction mechanisms related to depressive disorders, including cyclic-AMP, mitogen-activated protein kinase, Akt, and protein translation initiation signaling cascades. Understanding molecular components of signaling pathways regulating neurobiology of depressive disorders may provide the novel targets for the development of more efficacious treatment modalities.

• 우울조울병
• /
• 제15권3호
• /
• pp.123-129
• /
• 2017

Objective : To present effects of depression, optimism and gratitude on suicidal ideation of patients with depressive disorders. Methods : Using analyses of covariance (ANCOVA), scores on the Beck Depression Inventory (BDI), Life Orientation Test-Revised (LOT-R), and Gratitude Questionnaire (GQ-6) were compared between depressive disorder patients with higher and lower levels of suicidal ideations. A linear regression model was fitted to detect independent correlates for suicidal ideations. Results : Significantly greater level of depression and lower level of gratitude were characterized by depressive disorder patients with higher level of suicidal ideations. The fitted regression model presented that depression and gratitude were independent correlates for suicidal ideations in patients with depressive disorders. Conclusion : Our findings suggest that gratitude may be associated with lowering the level of suicidal ideation in patients with depression.

• 대한불안의학회지
• /
• 제7권1호
• /
• pp.16-21
• /
• 2011

Objective : Depressive symptoms often coexist with other anxiety disorder symptoms. Furthermore, an anxiety disorder that is comorbid with a depressive disorder results in more severe symptoms and a poorer outcome prognosis. To understand the construct of depressive symptoms in anxiety disorder, this study investigated the factor structure of the Beck Depression Inventory among outpatients with anxiety disorders. Methods : All data were from psychiatric department outpatients at a university-affiliated hospital. We conducted a principal component analysis using data from 194 outpatients with DSM-IV anxiety disorders and calculated goodness-of-fit-indices. Results : Exploratory factor analysis revealed a four factor structure--Cognitive-affective symptoms (Factor 1), Somatic symptoms (Factor 2), Self-reproach (Factor 3), and Hypochondriasis/indecisiveness (Factor 4)--and a 57% total variance. This four-factor model demonstrated an acceptable level of model fit, and it fit better than did a three-factor solution from the literature on depressive disorder. Conclusion : This study's results suggest a difference in the construct of self-reported depressive symptoms in anxiety disorders. These findings also support a dimensional approach to studying anxiety and depression. Further studies may benefit from including comorbid depressive disorder and its influence on anxiety disorders.

• 정신신체의학
• /
• 제7권1호
• /
• pp.79-86
• /
• 1999

본 연구는 신체형장애, 정신신체장애 및 우울장애 환자들 간의 가족지지도지각을 비교하기 위해서 시행되었다. 연구대상은 정신과 외래에 내원한 신체형장애 환자 49명, 정신신체장애 환자 43명, 우울장애 환자 50명이었다. 연구방법은 가족지지도 지각척도를 사용하였다. 신체형장애환자들은 정신신체장애환자들에 비해 가족지지도의 접수가 유의하게 더 낮았다. 그러나 신체형장애환자들과 우울장애환자들 간, 정신신체장애환자들과 우울장애환자들 간에 가족지지도점수는 각각 유의한 차이가 없었다. 이들 전체 환자들에서 연령이 많을수록 가족지지도점수가 유의하게 더 높았고, 기혼자들이 미혼자들보다 가족지지도점수가 유의하게 더 높았다. 결론적으로 신체형장애 환자들에서 낮은 가족지지도가 신체화의 원인 및 후유증일 가능성이 시사된다. 따라서 신체형장애 환자 들에 대한 평가 및 치료에 있어서 가족지지의 역할의 중요성이 강조된다. 앞으로 가족지지도가 신체화의 원인인지를 규명하기 위해서는 일정한 기간을 두고 종적인 연구를 시행해야 할 필요가 있다.

• 생물정신의학
• /
• 제18권4호
• /
• pp.176-180
• /
• 2011

Depressive disorders have strong genetic components. However, conventional linkage and association studies have not yielded definitive results. These might be due to the absence of objective diagnostic tests, the complex nature of human behavior or the incomplete penetrance of psychiatric traits. Imaging genetics explores the influences of genetic variation on the brain function or structure. This technique could provide a more sensitive assessment than traditional behavioral measures in psychiatric studies. Imaging genetics is a relatively new field of psychiatric researches, and may improve our understanding on neurobiology of psychiatric disorders. In this review, current understanding in neurobiology of depressive disorders, especially imaging genetic studies on serotonin transporter will be discussed.

• Journal of Yeungnam Medical Science
• /
• 제41권2호
• /
• pp.86-95
• /
• 2024

Background: This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on the development of major mental disorders in patients visiting a university hospital. Methods: The study participants were patients with COVID-19 (n=5,006) and those without COVID-19 (n=367,162) registered in the database of Keimyung University Dongsan Hospital and standardized with the Observational Medical Outcomes Partnership Common Data Model. Data on major mental disorders that developed in both groups over the 5-year follow-up period were extracted using the FeederNet computer program. A multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of major mental disorders. Results: The incidences of dementia and sleep, anxiety, and depressive disorders were significantly higher in the COVID-19 group than in the control group. The incidence rates per 1,000 patient years in the COVID-19 group vs. the control group were 12.71 vs. 3.76 for dementia, 17.42 vs. 7.91 for sleep disorders, 6.15 vs. 3.41 for anxiety disorders, and 8.30 vs. 5.78 for depressive disorders. There was no significant difference in the incidence of schizophrenia or bipolar disorder between the two groups. COVID-19 infection increased the risk of mental disorders in the following order: dementia (HR, 3.49; 95% CI, 2.45-4.98), sleep disorders (HR, 2.27; 95% CI, 1.76-2.91), anxiety disorders (HR, 1.90; 95% CI, 1.25-2.84), and depressive disorders (HR, 1.54; 95% CI, 1.09-2.15). Conclusion: This study showed that the major mental disorders associated with COVID-19 were dementia and sleep, anxiety, and depressive disorders.

• 생물정신의학
• /
• 제13권1호
• /
• pp.11-18
• /
• 2006

Depressive disorder is one of well-known major public health problems in Korea. The socioeconomic burden of depression is growing bigger and bigger. Therefore, the Korean government decided to establish the clinical research center for depression for better care of patients with depression. One of the major task of the center is the development of Korean clinical practice guideline for depressive disorders. This guideline should reflect the clinical situation in Korea and meet Korean physicians' needs. In addition, it should be feasible and easy to use. We reviewed the present status of the guideline development in Korea and other countries, and introduces the scope, method, and goals of Korean clinical practice guideline for depression.