정신보건관련시설 입원(소)자의 주요 정신장애 유병률 : 전국 20개 시설의 입원(소)자를 대상으로

조성진,조맹제,서동우,함봉진,홍진표,배재남,이준영,이동우,박종익,전홍진,김성주,김용익 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of Psy-chiatric diagnoses using the results of this study. Methods : The study subjects, aged from 181o 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, Psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. Results : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence · withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%,female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. Conclusion : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.

한국 주요정신장애의 유병률 및 관련요인 : 2006 전국정신질환역학조사

조맹제,장성만,함봉진,정인원,배안,이영문,안준호,원승희,손정우,홍진표,배재남,이동우,조성진,박종익,이준영,김진영,전홍진,이해우 大韓神經精神醫學會 2009 신경정신의학 Vol.48 No.3

Objectives The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. Methods The Korean Epidemiologic Catchment Area study Replication (KECA-R) was Conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target Population included all eligible residents aged 181o 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). Results A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of Specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nicotine use disorder, 9.0% and 6.0% ; 3) specific phobia, 3.8% and 3.4% ; 4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. Conclusion The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

정신종양학의 역사와 현황

함봉진,심은정,김하경,김종흔 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

Cancer statistics shows a high risk and increasing incidence of cancer among Koreans. Considerable burdens related to cancer and its treatment causes significant psychosocial distress among cancer patients and their family. Due to early detection and progress in cancer treatments, cancer is becoming a chronic illness and the quality of life and long-term impact of cancer is receiving increasing attention. Psycho-oncology is a subspecialty of oncology that addresses a psychosocial dimension of cancer throughout 'the continuum of cancer care', viz. from prevention and early detection to palliative and end-of-life care. This paper reviews the development of psycho-oncology and its current status in international and national context so as to promote efforts toward an integrative cancer care in Korea.

중·고등학교 청소년의 자살사고 및 자살시도의 유병률과 자살시도의 위험요인에 관한 연구

조성진,전홍진,김장규,서동우,김선욱,함봉진,서동혁,정선주,조맹제 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 지역사회에 거주하고 있는 중·고등학교 청소년들을 대상으로 자살 사고 및 자살시도의 빈도, 성별과 연령(13∼15세 vs 16∼18세)에 따른 자살사고 및 시도의 빈도에 차이가 있는지 여부, 자살사고 및 자살시도가 있는 청소년의 특징, 그리고 자살시도의 위험요인을 알아보고자 하였다. 방 법 : 부천시에 소재하고 있는 중학교 24개교 및 고등학교 20개교의 청소년 71,102명중에서 무작위 집락 표본 추출범으로 청소년 2,203명(남자 1,105명, 여자 1,098명)을 조사대상으로 선정하였다. 자살시도 및 자살사고의 정의에 관한 항목은 Moscicki가 사용한 자살행동에 관한 4항목 중 2항목을 사용하였다. 우울증에 대한 조사도구는 the Center for Epidemiologic Studies Depression Scale, 알코올 의존에 대한 조사도구는 Composite International Diagnostic Interview의 알코올 의존 관련 항목을 사용하였다. 조사자료 통계는 빈도, 백분율, chi-square test, 단변인 및 다변인 로지스틱 회귀분석을 사용하였다. 결 과 : 본 조사연구의 분석결과를 통계적으로 유의한 차이를 보인 항목으로 살펴보면 다음과 같다. 1) 전체 대상자의 자살 사고률은 30.7%, 자살 시도률은 5.3%인 것으로 조사되었다. 남자 대상자의 자살 사고률과 시도률은 26.9%, 3.4%이었고, 여자 대상자의 자살 사고률과 시도률은 34.9%, 7.3%인 것으로 조사되었다. 성별에 따라 자살 사고률과 시도률에 통계적으로 유의한 차이가 있었다. 2) 연령(학년)을 13∼15세(중학교)와 16∼18세(고등학교)의 두 연령층으로 조사하였을 때, 중학생의 자살 사고률과 시도률은 30.1%, 4.3%이었고, 고등학생의 자살 사고률과 시도률은 31.6%, 6.4%인 것으로 조사되었다. 연령에 따른 자살 사고률에는 통계적으로 유의한 차이가 없으나 자살 시도률에는 유의한 차이가 있었다. 3) 전체 조사 대상자를 대상으로 시행한 다변인 로지스틱 회귀 분석 결과에 의하면, 자살 시도의 위험요인이 여자, 알코올 의존, 중등도 및 중증 우울 증상인 것으로 조사되었다. 남녀별로 시행한 단변인 로지스틱 회귀 분석 결과에 의하면, 남자는 알코올 의존이 있을 때, 여자는 알코올 의존, 중등도 및 중증의 우울 증상이 있을 때 자살시도의 위험성이 높았다. 결 론 : 본 연구에서 자살 사고률 및 자살 시도률이 각각 29.6%(남자 25.6%, 여자 33.7%)와 5.31%(남자 3.3%, 여자 7.3%)인 점과 자살시도의 위험요인이 우울 증상의 정도, 알코올 의존인 점을 고려할 때 알코올 의존 및 우울 증상의 조기발견과 치료, 그리고 자살 사고자 및 자살 시도자에 대한 정신의학적 접근과 추적관찰에 대한 방안이 강구되어야 할 것으로 생각된다. Objectives : Aims of this study were 1) to estimate prevalence rates of suicidal ideation and suicide attempt, 2) to find out whether the gender difference and age difference(13-15 years vs 16-18 years) for suicide behaviors exist, 3) to analyse correlates of suicide attempts among junior and high school adolescents aged 13-18 years old. Methods : A self-administered questionnaire was used in a cluster random sample of 2,203 school adolescents(male 1,105, female 1,098). Data were obtained on a wide range of constructs including suicidal ideation and attempts during past 2 weeks, depressive symptoms, symptoms of DSM-IV alcohol dependence, family structure, socioeconomic status, smoking, satisfaction with school achievements, and subjective health status. Chi-square test were done for analysing gender difference and age difference of suicide behaviors. Statistical analyses including uni-variate and multi-variate logistic regression analysis were done for each sex, respectively. Results : 1) The prevalence of suicide ideation during past 2 week was 30.7% in the total sample. The prevalence rates of male and female ideators were 26.9% and 34.9% respectively. The prevalence of suicide attempt during past 2 week was 5.3% in the total sample. The prevalence of suicide attempt in males was 3.4% and 7.3% in females. 2) Gender difference was significant. That is, female respondents showed higher rate of suicidal ideation and suicide attempt. In our study age difference was found only at the rate of suicide attempt. That is, older adolescents(16-18 years) showed only statistically significant higher rate of suicide attempt than younger adolescents(13-15 years). 3) Multi-variate logistic regression analysis revealed that the correlates for suicide attempt were female, moderate to severe depressive symptoms, alcohol dependence in the total sample. In males the correlate for suicide attempt was alcohol dependence. In females, were moderate to severe depressive symptoms, and alcohol dependence. Conclusion : Depressive symptoms, alcohol dependence, presence of suicidal ideation were strong predictors for suicide attempts. This suggest that early detection of treatment of depression and alcohol dependence is important and psychiatric approach and follow-up be needed for the prevention of suicide.

도시 거주 노인 수면 습관 및 불면증상의 요인 : 인구학적,질병 및 정신증상의 관련성

홍진표,안준호,윤영국,박종익,이소영,함봉진,김장규,한오수,조맹제 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 본 연구는 국내 노인의 습관을 조사하고 불면 증상과 연관 있는 인구학적, 질병학적 요인을 알고자 했다. 방 법 : 1997년 12월부터 1998년 1월까지 약 1개월에 걸쳐 2단계 층화집락표본추출의 역학조사법을 통해 선정된 3개 4개동 거주의 만 65세 이상 노인을 대상으로 수행되었다. 대상자 중 723명에서 등답을 받았으며 응답률은 73.8였다. 대학생인 설문조사요원들을 훈련시킨 뒤, 이들로 하여금 대상지역의 노인거주가정을 방문하여 개개 노인을 대상으로 반구조화된 면담으로 수면습관 및 불면증상 설문을 실시하였으며 그 외 한국어판 노인정신장애평가척도, 삶의 질 척도를 이용한 설문조사와 과거 질병력을 청취조사하게 하였다. 결 과 : 국내 노인들은 평균 오후 10시 16분에 자리에 누워 오전 5시22분에 일어나서 총 7시간 6분의 수면시간을 보였다. 노인의 11.7%가 거의 매일 밤 불면증을 14.8%가 간헐적 불면증을 호소하였다. 남자에서는 연령이 증가할수록 침상에 누워있는 시간이 증가하고, 또, 입면시까지 소요되는 시간과 수면 중의 각성회수가 증가되었으나 여성에서는 명확하지 않았다. 단변수 분석에서 요통, 중풍 병력의 환자에서 불면증상이 심했다. 다변량분석 결과 불면 증상과 관련 깊은 요인으로 남자에게서는 고령과 우울증상이 여자에게서는 남자의 위험요인에다 신체통증과 피부병력이 추가로 관련이 있었다. 결 론 : 지역 거주 노인에서 불면 증상은 매우 흔한 증상이며 우울증상과 명확한 상관관계를 보이고 있었다. 불면증을 극복하기 위해 불면증 위험요인의 인과관계에 대한 추후 연구가 필요하다. Objectives : The purpose of this study is to analyze sleep habit and investigate the association between insomnia and demographic, health and psycho-behavioral symptomatology in Korean urban elderly Method : A total of 723 community residents aged 65 years or older were surveyed by two stage, random cluster sampling method. The response rate was 76.2%. Interviewers performed door to door visits and administered a questionnaire about sleep, past medical history, and several scales as the Psychogeriatric Assessment Scale(PAS), the short form Quality of Life Scale (SF-36) and etc. Results : The mean scores are as follows : retiring time was ten-sixteen p.m., wake-up time was five twenty two a.m., duration of sleep was seven hours and six minutes. Among the elderly, 11.6% and 14.8% of the subjects reported chronic and intermittent difficulty in sleeping, respectively. The patients with back pain and history of stroke complained of more insomnia symptoms in univariate analysis. In ANCOVA analysis, insomnia symptoms were associated with an old age, depressive symptoms in male. Bodily pain and history of dermatologic disease were additional risk factors in female. Conclusions : The data suggest insomnia is one of most common health problems among elderly Koreans living in the community. Strong positive relationship between depressive symptoms and insomnia were found. Further research is needed to explore the causal relationship between insomnia and risk factors.

명상에 의한 뇌파의 변화 : 스펙트럼 분석 및 시각적 고찰

권준수,함봉진,이부영 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

목적 : 본 연구는 한국의 전통적인 명상법의 하나인 단학수행에 의한 뇌파의 변화를 조사하기 위한 것이다. 방법 : 명상수행자 16명과 대조군 9명을 모집하였다. 명상 및 이완상태에서 측정한 뇌파에 대한 스펙트럼 분석을 시행하여 각 주파수 구간의 절대력(absolute power)과 양반구간 동시성(interhemispheric coherence)을 구하였다. 명상수행군과 대조군의 뇌파변화를 비교하기 위하여, 절대력과 양반구간 동시성의 변화율을 계산하였다. 아울러, 스펙트럼 분석으로 발견되지 않는 뇌파의 특징을 조사하기 위하여 모든 뇌파를 시각적으로 관찰하였다. 결과 : 11명의 명상수행자와 4명의 대조군이 졸음 또는 순응도 불량으로 분석에서 제외되었고, 명상 수행자 5명과 대조군 5명이 실제 분석에 포함되었다. 명상수행군과 대조군 모두 다양한 뇌파의 변화를 보였고, 그 변화의 정도는 대조군에 비해 명상수행군에서 현저하였다. 이러한 차이는 전두엽부위의 알파와 쎄타의 절대력과 베타의 양반구간 동시성 그리고 후두엽부위의 쎄타의 양반구간 동시성에서 현저하였다. 대조군에 비해 명상수행군에서 전두엽부위의 알파와 쎄타의 절대력과 후두엽 부위의 쎄타의 양반구간 동시성이 증가하는 경향이 있었다. 뇌파의 시각적 관찰에서 5명의 명상수행군 중 3명에서 많은 theta burst가 발견되었고, 대조군에서는 1명에서 1개의 theta burst가 나타났다. 결론 : 이상의 결과는 뇌파변화의 다양성과 theta burst의 출현이 대조군과 구별되는 명상수행군의 특징이고, 명상의 상태가 단순한 이완상태에 비해 매우 다양하고 역동적이라는 것을 시사한다. 0bjectives : This study was to investigate the EEG changes induced by Danhak which is one of the Korean traditional meditation. Methods : Sixteen meditators and 9 controls were recruited. Spectral analysis and visual inspection of EEG during meditation(meditators) and relaxation(controls) were performed. The absolute power and interhemispheric coherence in each frequency band were obtained. Ratio of change in absolute power and interhemispheric coherence was calculated to compare the EEG changes between meditators and controls. To evaluate episodic changes of EEG with time, all recorded EEGs were reviewed by visual inspection. Results : Eleven meditators and 4 controls were excluded from the analysis due to drowsiness or poor compliance. Both meditators and controls showed various EEG changes and the degree of variability was more prominent in meditators than in controls. These differences were evident in absolute power of alpha and theta and coherence of beta at frontal, and coherence of theta at occipital. Meditators showed the increase in absolute power of alpha and theta at frontal, and interhemispheric coherence of theta at occipital. In visual inspection, a number of theta bursts were observed in three of 5 meditators and only one theta burst appeared in one control. Conclusion : These results suggest that great variability of EEG change and the appearance of the bursts is the characteristics of EEG change and the appearance of theta bursts is the characteristics of EEG changes of meditators and that th state of meditation is more diverse and than that of relaxation.

한국어판 Composite International Dianostic Interview(K-CIDI)의 개발

조맹제,함봉진,서동우,홍진표,배재남,김장규,이동우,조성진 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.1

연구목적 : 본 연구는 국제적인 정신장애 진단도구인 Composite International Diagnostic Interview(CIDI)를 한국의 사회문화적 상황에 적합하게 번역하고 신뢰도 및 타당도를 평가하여 한국어판으로 개발하기 위한 것이다. 방 법 : CIDI는 정신장애를 평가하고 진단할 수 있는 포괄적이고, 완전히 표준화된 진단도구로 훈련받은 일반인들이 적용할 수 있기 때문에 대규모 역학조사에 적합하다. 세계보건기구에서 제공하는 CIDI 번역 지침에 따라 한국어판 CIDI(K-CIDI)를 제작하였다. 영어권과 한국의 언어 및 사회문화적 차이를 고려하여 번역 및 개정을 하였고 역번역을 통하여 원본의 의미와 일치하는지를 확인하였다. 임상환자를 135명과 일반인 5명을 대상으로 신뢰도와 타당도 검사를 실시하였다. 두 명의 평가자가 K-CIDI를 이용하여 동일한 대상자를 동시에 면담하고 일주일 뒤에 재검사를 실시하였다. K-CIDI로 검사를 받은 대상자들을 정신과 전공의와 임상심리사가 한국어판 Structured Clinical Interview for DSM-Ⅳ를 이용하여 진단을 내렸다. 두 가지 진단의 일치도에 대한 kappa값을 산출하였다. 결 과 : CIDI의 번역에서 한국어 표현이 복잡하고 긴 문항은 두 개의 문장으로 분리하였고, 성과 관련된 표현과 의료체계 및 의료추구행태에서 사회문화적 차이를 반영하였다. 공포장애의 대상과 알코올 및 물질의 종류도 한국의 실정에 맞게 조정하였다. 현장 검사와 역번역 과정에서 K-CIDI가 적절하게 제작된 것으로 평가되었다. K-CIDI의 평가자간 신뢰도 검사는 140명에 대하여 이루어졌고 kappa값은 진단에 따라 0.86∼1.00범위였다. 검사/재검사 신뢰도 검사는 47명에 대해 이루어졌고 kappa값은 진단에 따라 0.42∼0.89였다. K-CIDI의 타당도 검사는 50명에 대해 이루어졌고 kappa값이 진단에 따라 0.50∼1.00의 범위였다. 결 론 : K-CIDI는 한국의 사회 문화적 배경에 적합하게 제작되었고 신뢰도 및 타당도 검사에서 역학연구에 적절한 진단도구로 평가되었다. Objectives : This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). Methods : The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-Ⅳ. Results : Notable modifications were done on sex-related expression, health system and help seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. Conclusion : The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.

Alzheimer병의 역학

조맹제,함봉진 啓明大學校 醫科大學 1997 계명의대학술지 Vol.16 No.3

Alzheimer's disease(AD) is emerging as a major trouble for the patients and their families as well as community. Epidemiology of AD is the study of the distribution of AD and those factors that influence this distribution. Several findings were derived from reviewing the various epidemiologic studies of AD. Prevalence estimates of AD rise exponentially with age. Typical estimates for the age groups 60-69 years, 70-79 years, and 80-89 years are about 0.5%,3%, and 10%, respectively. All studies showed an exponentially increase in the incidence rate with age and several studies found that the proportion of incident dementias is attributable to AD increased with age. Except for age and family history of dementia, no definite risk factors for AD have yet been proven. Survival of AD patients is worse in early-onset cases and in men, and it appears to be related to the initial severity of the disease. Improvement of prognosis through intervention has been unsuccessful until now. It was shown that methodological variables such as definition of dementia, the design of the study, the characteristics of the sample and methods of assessment and diagnosis might have a significant effect on the results. New epidemiologic approaches to AD should be well designed prospective follow-up studies to provide more accurate information. Epidemiologic studies combined with pathophysiologic findings could be helpful in improvement of prevention and treatment of the AD.

일 장기 수용시설 노인들의 인지기능장애와 우울증상의 유병율

조맹제,함봉진,이부영,김성윤,신영민,이창인 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 본 연구는 수용시설의 노인들에서 인지기능장애와 우울증상의 유병율을 조사하기 위한 것이다. 방 법 : 한국의 한 수용시설인 꽃동네에 거주하는 60세 이상 노인 169명을 대상으로 한국판 Mini-Mental State Examination(MMSE-K). Short Portable Mental State Questionnaire(SPMSQ), 축약판 Geriatric Depression Scale(SGDS). 그리고 the Center for Epidemiologic Studies Depression (CES-D)을 적용하였다. 결 과 : 전체 169명중 153명(남자=72명, 여자=79명, 그리고 누락=2명)이 검사를 완성하였다. 연령의 범위는 60에서 102세였고, 평균연령은 74.17±8.27(남자71.76±8.14. 여자76.14±7.78)세였다. 교육기간의 범위는 무학에서 16년이었고, 평균교육기간은 3.04±3.93(남자 4.13±4.23, 여자 2.01±3.38)년이었다. 인지기능장애의 유병율은 MMSE-K≤23의 기준으로 56.2%, SPMSQ≤6의 기준으로 26.1% 로 평가되었다. 비교적 분명한 인지기능장애의 기준으로 MMSE-K≤19를 적용하였을 경우 유병율은 25.5%로 이는 SPMSQ≤6을 기준으로 하여 얻은 결과와 유사한 수준이었다. 우울증상의 유병율은 SGDS≥10의 기준으로 19%, CES-D≥25의 기준으로 23.5%로 평가되었다. 비교적 가벼운 우울증상까지 선별하기 위하여 SGDS≥8을 기준으로 할 경우 유병율은 39.2%로 이는 CES-D≥20을 기준으로 하여 얻은 결과와 일치하는 수준이었다. MMSE-K와 SPMSQ, SGDS와 CES-D, MMES-K와CES-D, MMES-K와 SGDS, 그리 고·SPMSQ와 SGDS 사이에 의미있는 상관관계가 관찰되었다. 결 론 : 수용시설 노인들에서 인지기능장애와 우울증상의 유병율은 매우 높은 수준이며, 이러한 결과는 수용시설 노인들에 대한 보다 집중적의 의료서비스가 필요함을 시사한다. Objectives : This study was to investigate the prevalence of cognitive impairment and depressive symptomatology among the long-term institutionalized elderly people. Methods : Mini-Mental State Examination-Korean version(MMSE-K), Short Portable Mental State Questionnaire(SPMSQ), Short version of Geriatric Depression Scale(SGDS), and the Center for Epidemiologic Studies Depression(CES-D) were administerd to 169 elderly residents in an institution, 'Got Dong Rae'. Results : One hundred fifty-three(males=72, females=79, and missing=2) completed the entire examination. Age ranged from 60 to 102 years and the mean of age was 74.17±8.27(males 71.76±8.14, females 76.14±7.78) years. Duration of education ranged from 0 to 16 years and the mean of duration of education was 3.04±3.93(males 4.13±4.23, females 2.01±3.38) years. The prevalence of cognitive impairment was estimated as 56.2% by MMSE-K≤23 and 26.1% by SPMSQ≤6. The prevalence of relatively definite cognitive impairment defined by MMSE-K≤19 was 25.5%, which was similar to the result achieved by using SPMSQ≤6. The prevalence of depressive symptomatology was estimated as 19% by SGDS≥10 and 23.5% by CES-D≥25. In the case of using SGDS≥8 as cutoff-point to screen mild as well as severe depressive symptomatology, the prevalence was 39.2%. It was identical to the result achieved by using CES-D≥20. Significant correlations were observed between MMSE-K and SPMSQ, between SGDS and CES-D, between MMSE-K and CES-D, between MMSE-K and SGDS, and between SPMSQ and SGDS. Conclusion : The prevalencies of cognitive impairment and depressive symptomatology were high in institutionalized elderly people. This results suggests that more intensive mental health care is needed for long-term institutionalized elderly people.

대학생들의 우울장애에 관한 연구 : 유병율, 위험요인, 자살행동 및 기능장애

노명선,전홍진,이해우,이효정,한성구,함봉진 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.5

Objectives : The purpose of this study was to investigate the prevalence and correlates of major and minor depressive disorders in college students. Methods : A cross-sectional study was completed on a sample of 906 students (507 men and 399 women) with the self-administered form of Korean version of Mini International Neuropsychiatric Interview (K-MINI). Results : Estimated 12-month prevalence of major depressive disorder was 4.2% in men and 9.5% in women, and that of minor depressive disorder was 15.4% in men and 23.2% in women. The factors, 'female gender' and 'age of 20-21', were significantly associated with major depressive disorder. 'Poor adaptation to school' was significantly associated with major depressive disorder both in men and women, but 'poor interpersonal relationship' and 'history of school withdrawal' were associated only in men. Idea of self-injury and suicidal behaviors (suicidal ideation, plan and attempt) were significantly associated with major depressive disorder in women, but were not associated with minor depressive disorder. Conclusion : Major and minor depressive disorders are highly prevalent in the college students. Major depressive disorder was more associated with dysfunctions and suicidal behaviors than minor depressive disorder. Campus-based mental health service is needed for the high-risk students.