지체장애인의 우울의 변화궤적과 예측요인

최희철 한국지체.중복.건강장애교육학회 2020 지체.중복.건강장애연구 Vol.63 No.1

Purpose: The purposes of this study were twofold: First, this study examined latent classes of trajectories in the longitudinal course of depression for people with physical disabilities. Second, this study examined the predictors of latent classes of trajectories in the longitudinal course of depression. Method: Data on depression and the predictors (gender, age, economic status, and self-esteem) came from the 9th to 13th wave in the Korean Social Welfare Panel Survey(KSWPS). The latent classes of depression were analyzed through latent class growth modeling. The predictors of the latent classes were analyzed through multinomial logistic regression analysis. Results: Three latent classes of trajectories were identified: the high increasing depression, the consistent moderate depression, and the consistent non-depressed class. The significant predictors in multinomial logistic regression analysis were gender, age, economic status, and self-esteem. Results indicated that women, higher age, and lower economic status had higher odds of the high increasing depression and the consistent moderate depression class than the consistent non-depressed class, and the higher self-esteem had lower odds of the high increasing depression and the consistent moderate depression class. Conclusion: The researcher discussed the implications of the results of alternative treatments for depression symptoms of physical disabilities. 연구목적: 본 연구의 목적은 다음의 두 가지와 같다. 첫째, 본 연구는 지체장애인의 우울의 종단적 궤적의 잠재계층을 알아보았다. 둘째, 본 연구는 우울의 종단적 궤적의 잠재계층의 예측요인들을 알아보았다. 연구방법: 우울과 예측요인들(성별, 연령, 경제적 지위, 자존감)은 '한국복지패널(Korean Social Welfare Panel Survey)'의 9~13차 조사에서 데이터를 추출하였다. 우울의 잠재계층은 잠재계층 성장 모형으로 분석되었다. 잠재계층의 예측요인들의 분석은 다항 로지스틱 회귀분석으로 이루어졌다. 연구결과: 우울의 잠재계층의 수는 3개로 확인되었다. 즉, (a) 높은 우울 상승 후 하강 집단, (b) 보통 우울 유지 집단, (c) 비우울 유지 집단. 다항 로지스틱 분석에서 유의한 예측변인들은 성별, 연령, 경제적 지위, 자존감이었다. 연구결과에 의하면, 남성보다 여성이, 나이가 많을수록, 경제적 지위가 낮을수록 비우울 유지 집단보다 높은 우울 상승 후 하강 집단, 보통 우울 유지 집단에 속할 확률이 높았다. 그리고 자존감이 높을수록 높은 우울 상승 후 하강 집단, 보통 우울 유지 집단에 속할 확률이 낮았다. 결론: 연구자는 연구결과가 지체장애인의 우울 증상들의 처치 대안들에 대해 갖는 함의들을 논의하였다.

BDI-Ⅱ에 의한 도시지역 노인의 우울 정도와 관련요인

양수,김남초 대한간호학회정신간호학회 2001 정신간호학회지 Vol.10 No.4

This study was conducted to measure the level of depression by BDI-Ⅱ which has not been used in Korea, and to identify factors influencing depression among the elderly. Data were collected from July to August 2000. Study participants were 301 elderly aged of 60 years or over who were recruited from 9 senior centers located in Seoul, Korea. The questionnaire consisted of demographics and BDI-Ⅱ by developed by Beck(1996). The data were analyzed byt-test, ANOVA. Stepwise multiple regression. The results were as follows: 1. The mean score of depression was 17.10±9.76, which means mild depression by Beck(1996). Of the sample, 116(38.5%) were nondepressed, 72(23.9%) were mildly depressed, 74(24.6%) were moderately depressed, and 39(13.0%) were severely depressed. 2. Regarding the sub-dimensions, depression score was highest in the item of Lost of Interest in Sex, whereas the item-score of Suicidal. Thoughts or Wishes was lowest. 3. With respect to the Changes in Sleeping Pattern item, 15.6% subjects reported that they were sleeping more, and 56.1% indicated that they were sleeping less. For changes in Appetite, 57.2% endorsed decreased appetite, whereas 10.4% reported increased appetite. 4. The mean score of depression showed significant differences in terms of following factors: gender, age, existence or absence of a spouse, family resident, education, provider of living expenses, number of going out, number of friends, perceived health status, ADL, knowledge of the cause of depression, thought of prognosis for depression. 5. In the multiple stepwise regression analysis on depression, significant predictors were existence or absence of a spouse, ADL, gender, thought of prognosis for depression, number of going out, family resident. These variables explained 24.9% of depression. In the light of these results, this study will be further used as a basic data to identify risk factors of depression and to realize the importance of care for depressed elderly. Also, these results showed that the education for the depressed elderly is very important. Therefore much attention has to be paid to elderly from the standpoint of mental health nursing. We would like to make following suggestions based on the findings of this study: * The development of intervention program to help the community-dwelling elderly seek treatment modalities are offered. * Further study research on a development of a model which comprehensive explains depression of the elderly should be needed. * It is necessary to study systematically the availability of BDI-Ⅱ with consideration of the cultural differences.

Depression after Subarachnoid Hemorrhage: A Systematic Review

Wai Kwong Tang,Lisha Wang,George Kwok Chu Wong,Gabor S. Ungvari,Fumihiko Yasuno,Kelvin K.F. Tsoi,Jong S. Kim 대한뇌졸중학회 2020 Journal of stroke Vol.22 No.1

Background and Purpose Depression is common and debilitating illness accompanying many neurological disorders including non-traumatic subarachnoid hemorrhage (SAH). The aim of this systematic review was to identify and critically appraise all published studies that have reported the frequency, severity and time course of depression after SAH, the factors associated with its development and the impact of depression on patients’ quality of life after SAH. Methods The PubMed database was searched for studies published in English that recruited at least 40 patients (>18 years old) after SAH who were also diagnosed with depression. Results Altogether 55 studies covering 6,327 patients met study entry criteria. The frequency of depression ranged from 0% to 61.7%, with a weighted proportion of 28.1%. Depression remained common even several years after the index SAH. Depression after SAH was associated with female sex, premorbid depression, anxiety, substance use disorders or any psychiatric disorders, and coping styles. Comorbid cognitive impairment, fatigue, and physical disability also increased the risk of depression. Aneurysmal SAH and infarction may be related to depression as well. Depression reduces the quality of life and life satisfaction in patients after SAH. Conclusions Depression is common after SAH and seems to persist. Further research is needed to clarify its time course and identify the neuroendocrine and neurochemical factors and brain circuits associated with the development of post-SAH depression. Randomized controlled treatment trials targeting SAH-related depression are warranted.

憂鬱症의 歸因 模型에 관한 硏究

金延 인제대학교 1985 仁濟醫學 Vol.6 No.3

憂鬱症의 歸因 模型을 檢證하기 위해 憂鬱症, 經憂鬱症, 正常 등 세 집단을 對象으로 하여 歸因 形態를 측정한 결과 憂鬱症 患者는 우울하지 않은 사람들보다 否定的 事件(朱敗)에 대해서 內的 歸因, 統制 不可能한 歸因, 持續的 歸因함을 확인했다. This study has attempted to prove attributional model of depression which was proposed as an alternative model of Beck's cognitive triad and Seligman's learned helplessness model of depression. It was hypothesized that, in the attributional model of depression, depressives compaired to nondepressives attribute negative life events (failure) to internal, uncontrollable, stable and global causes. Ninety six subjects, 46 males and 50 females participated in the experimental research. Their mean age was 21, and education 12 years. The subjects were classified as severe depression, mild depression, and nondepression according to the scores of Beck Depression Inventory as a subjective symptom criteria. Experimental design was 3(depression) x2 (reinforcement) x2 (suggestion) factorial design, and the dependent variables were the subjects' attribution of, and anagram performance after, the negative outcome experiences. The subjects were randomly assigned to 12 cells and treated on the experimental sitution which involved a discrimination problem task whcih is either soluble (100% reinforcement) or insoluble (20% reinforcement), thus providing success and failure outcome experiences. And then a suggestion was said that other people among his/her ages could solve either successfully or unsuccessfully the discrimination problem tasks. Next the subjects were handed an attributional rating scale in which they were supposed to check the degree of internality, controllability, stability and globality of attributional causes of success and failure outcome experiences. And then anagram task was ensued. The result largely upheld the attributional model of depression. Severe depressives compaired to mild depressives, and mild depressives, and mild depressives compaired to nondepressives attribute failure to internal, uncontrollable, and stable causes and attribute success to controllable and unstable causes. Accordingly depressives percepted the causes of negative life events as responsible, less controllable, and persistent, which supported the attributional model of depression. The learned helplessness model of depression was also supported by showing that, the more depressed, the more performance deficit in anagram solution tasks after success and failure outcome experiences, was revealed and the per son who experienced failure outcome manifested more lowered performance that those who experienced success outcome. The suggestion of success and failure(of other) was not effective on the attributional behavior of outcome experiences and it was discussed in light of the relationship between the attribution and the use of consensus information. Global dimension which was rejected in this research was also discussed in light of the characteristic of experimental situation and diagnostic categories of the depresed subjects. Three fouth of the attributional model of depression was supported in which depressives characteristically attribute negative outcomes to internal, uncontrollable, stable causes, accordingly Beck's cognitive model of depression also supported.

우울증에 따른 자살 예방을 위한 한국문학 콘텐츠 구축의 필요성과 방안

김수이 ( Su Yee Kim ) 한국언어문화학회 2010 한국언어문화 Vol.0 No.42

Depression, as a product of sociocultural experiences, shows a variety of differences according to races and culture. The cultural specific character of depression proposes two prerequisites in study on depression. First, a medical study should be carried out simultaneously with a cultural study for prevention and treatment of depression. Second, the cultural study on depression should be conducted with the culture and products of the relevant society as a text. For developing a method of treating depression fit for the reality of modern Koreans` lives, it is urgent to establish contents of modern Korean culture about depression and a suicide. This paper aims to develop a cultural program of preventing committing suicide from depression, and examined a methods of establishing modern about depression and a suicide. The suicide-preventing program proposed by this paper is a video of a multi-art type, formed by music, a video, recitation, theatrical elements, etc. being combined, which a depressive patient experiences a problem-solving process in an initiative and aesthetic process. As a concrete case of contents, this paper looked into 〈Laughter〉, Choi In-hun`s novel that written the process in which a woman who lost love goes a suicide trip and returns. This novel is a piece of work which dealt with and figured in detail the mental state of a suicide of a depressive patient and expected to be an effective text for depression treatment and suicide prevention.

An Acoustic Study of Fundamental Frequency and Pauses in Depressive Teenagers in Thailand: A Pilot Study

Phanintra Teeranon 세종대학교 언어연구소 2020 Journal of Universal Language Vol.21 No.1

Depression is a major public health problem among Thais. It has been reported that 30% of 70 million people living in Thailand suffer from depression. Suicide is a potential end result from mental illness, which normally involves depression. Diagnosis and treatment are key factors in the prevention of depression. In traditional diagnosis, there are two key methods of testing: (ⅰ) a screening test and interview and (ⅱ) a biomarker test. In recent years, detecting depression with speech—a kind of biomarker test— has gained high acceptance. Cues of suprasegments in speech, such as pauses, loudness, tones, rhythm, and phonation, have been scientifically proven using acoustic methods of being indicators of depression. This paper has two main objectives: (ⅰ) to conduct a review of the use of suprasegments as cues and an analysis of the cues capable of indicating depression in Thailand and (ⅱ) to analyze an acoustic study of pitch measured by the fundamental frequency and silent pause length in depressed and non-depressed participants. The method used in the study is the acoustic method of linguistics. Praat program version 6.2.09 was used to analyze the data. This is a pilot study of three depressed Thai students aged 20 compared with three non-depressed Thai participants. We propose a new perspective upon Thai language speech indicators that combines two or more cues in detecting depression (e.g. depression inventory with pause duration and word signs). Interestingly, it was found that the pitch of Thai tones may not be an appropriate cue for depression in Thais. This result conflicts with previous research conducted in other non-tonal languages. The results of this study lay the foundation for a Thai speech index for depression that can be further developed for the detection of depression.

작업기반 회상프로그램이 지역사회 노인의 우울과 회복탄력성에 미치는 영향 : 주관적 평가와 심박변이도 측정을 이용한 예비연구

홍서진,박치수,이재신 대한지역사회작업치료학회 2022 대한지역사회작업치료학회지 Vol.12 No.1

Objective : This study was to investigate the effect of Occupation based reminiscence program on depression and resilience of community elderly. Methods : Occupation based reminiscence program was provided to two elderly women. Baseline(A) of 3 sessions, intervention(B) of 11 sessions, and baseline regression(A') of 3 sessions were performed. Korean Form of Geriatric Depression Scale (KGDS) for depression and Korean Resilience Quotient Test-53 (KRQ-53) for resilience were measured for subjective evaluation at the last session of each period. QECG-3 was measured for heart rate variability, at each session to investigate physiological depression and physiological resilience. The amount of change in each period of subjective depression and subjective resilience was investigated for the analysis of results, and physiological depression and physiological resilience were visually analyzed to confirm the average and ±2 standard deviation band results for each period. Results : Depression decreased in both subjective and physiological depression. Subjective resilience decreased in subject 1 and increased in subject 2, and physiological resilience increased in all subjects. Conclusion : Occupation based reminiscence program was effective for subjective depression, physiological depression, and physiological resilience for elderly in community. Through this, the group study that applied Occupation based reminiscence program to prevent of depression and increase of physiological resilience of elderly in community could be considered. 목적 : 작업기반 회상프로그램이 지역사회 노인의 우울과 회복탄력성에 미치는 영향을 알아보기 위하여, 주관적 평가와 심박변이도 신호에 대한 생리적 변화를 비교하는 것이다. 연구방법 : 여성 노인 2명에게 단일사례 연구방법 중 ABA' 설계로 기초선(A) 3회, 중재기(B) 11회, 기초선 회귀(A') 3회 총 17회를 진행하였다. 중재 기간에는 작업기반 회상프로그램을 제공하였다. 주관적 평가를 위하여 우울은 Korean Form of Geriatric Depression Scale(KGDS), 회복탄력성은 Korean Resilience Quotient Test-53(KRQ-53)를 각 기간별 마지막 회기에 측정하였다. 심박변이도는 생리적 우울과 생리적 회복탄력성을 알아보고자 QECG-3를 매회기 반복 측정하였다. 결과 분석은 주관적 우울과 주관적 회복탄력성의 각 기간별 변화량을 알아보았고, 생리적 우울과 생리적 회복탄력성에 대한 측정결과는 시각적 분석으로 각 기간별 평균값과 ±2 표준편차 밴드(기준값) 결과를 확인하였다. 결과 : 작업기반 회상프로그램 결과에서 우울은 주관적 우울과 생리적 우울에서 모두 감소하는 것으로 나타났다. 주관적 회복탄력성은 대상자 1에서는 감소하고 대상자 2에서 증가하는 결과를 보였고, 생리적 회복탄력성에서는 대상자 모두 증가하여 작업기반 회상프로그램에 대한 긍정적인 변화를 확인하였다. 따라서, 주관성과 객관성 결과에 상반된 차이를 보인 회복탄력성에는 추가적인 재검증이 필요하다. 결론 : 지역사회 노인에게 작업기반 회상프로그램이 주관적 우울, 생리적 우울, 생리적 회복탄력성에 효과가 있음을 확인할 수 있었다. 이를 통해 지역사회 노인의 우울 예방과 생리적 회복탄력성 증가에 작업기반 회상프로그램을 적용한 집단 연구를 고려할 수 있을 것이다.

Psychosocial, Physical, and Autonomic Correlates of Depression in Korean Adults: Results from a County-Based Depression Screening Study

김기원,박선철,김석현,신진호,최보율,Junghyun Nam 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.4

Objective We aimed to investigate the prevalence and psychosocial and neurophysiological correlates of depression in a large county-based cohort of Korean adults. Methods We recruited 2355 adults from a rural county-based health promotion program. The following psychometric scales were used: the Center for Epidemiologic Studies Depression scale (CES-D) was used to assess depression, the General Health Questionnaire (GHQ) was used to evaluate stress, and the Medical Outcome Study Social Support Survey (MOS-SSS) was used to determine perceived social support. Heart rate variability (HRV) was used to assess neurophysiological properties. The psychosocial and neurophysiological variables of adults with depression (CES-D score ≥25) and without depression (CES-D score <25) were statistically compared. A logistic regression model was constructed to identify factors independently associated with depression. Results We estimated that 17.7% of the subjects had depression, which was associated with old age, being female, being single, less religious affiliation, high education, low body mass index (BMI), low levels of aerobic exercise, low social support, and a low HRV triangular index. The explanatory factors of depression included high education, less religious affiliation, low levels of current aerobic exercise, low BMI, and low social support. Conclusion Given the relatively high prevalence of overall depression, subsyndromal depression should also be regarded as an important issue in screening. The independent factors associated with depression suggest that practical psychosocial intervention, including brief psychotherapy, aerobic exercise, and other self-help methods should be considered. In addition, the HRV results suggest that further depression screening accompanied by neurophysiological features would require fine methodological modifications with proactive efforts to prevent depressive symptoms.

A comparative study on cardiovascular disease risk factors in Korean adults according to clinical depression status

Seo, Yuri,Je, Youjin Elsevier 2018 Psychiatry Research Vol.263 No.-

<P><B>Abstract</B></P> <P>This study was conducted to compare the association between depression and cardiovascular disease risk factors among Korean adults. This study was based on the data from the Korea National Health and Nutrition Examination Survey conducted in 2012–2014. Using a multivariable logistic regression model, we calculated odds ratios (ORs) and 95% confidence intervals (CIs). A total of 10,359 subjects aged 19–64 years were selected, and 432 subjects (74 men, 358 women) were included in the physician-diagnosed depression group. Several cardiovascular risk factors were associated with higher odds of clinical depression. For men, high waist circumference (≥91.3 cm) and body mass index (≥25.0 kg/m<SUP>2</SUP>) were significantly associated with increased odds of depression, and high physical activity (≥50 MET h/week) was associated with decreased odds of depression. Men with dyslipidemia and metabolic syndrome had 2.43-fold and 2.0-fold higher odds of depression than those without the diseases. For women, current smokers had 2.25-fold higher odds of depression than nonsmokers, and frequent alcohol drinkers (≥4 times/week) also had 2.88-fold higher odds of depression than nondrinkers. Korean adults with clinical depression had a higher prevalence of some risk factors for cardiovascular diseases than those without depression.</P> <P><B>Highlights</B></P> <P> <UL> <LI> There have been several studies on cardiovascular disease risk factors in relation to depression status. However, there are limited data on the association between depression and cardiovascular disease risk factors in Korean adults, especially for men. </LI> <LI> We investigated whether lifestyle factors, anthropometric and clinical measurements leading to cardiovascular disease were associated with the prevalence of depression in Korean adults, using a large nationally representative sample of Korean population, and confirmed that there are positive associations between depression and several cardiovascular disease risk factors among Korean adults. </LI> <LI> Our findings support early detection and management of depression among people with or at high risk of cardiovascular disease. </LI> <LI> Given the increasing importance of depression in many countries, the cardiovascular disease risk factors should be carefully monitored and adequate lifestyle changes could be advised. </LI> </UL> </P>

Longitudinal associations between glucocorticoid receptor methylation and late-life depression

Kang, Hee-Ju,Bae, Kyung-Yeol,Kim, Sung-Wan,Shin, Il-Seon,Kim, Hye-Ran,Shin, Myung-Geun,Yoon, Jin-Sang,Kim, Jae-Min Elsevier 2018 Progress in neuro-psychopharmacology & biological Vol.84 No.1

<P><B>Abstract</B></P> <P>It has been suggested that hypothalamus–pituitary–adrenal (HPA) axis dysregulation plays a role in the etiology of depression. HPA axis function is mediated by glucocorticoid receptors (GRs), which are influenced by epigenetic mechanisms (DNA methylation). The association between the DNA methylation of the GR gene (nuclear receptor subfamily 3, group C, member 1; <I>NR3C1</I>) and late-life depression as well as the role of <I>NR3C1</I> methylation in the prediction of the incidence of depression have not yet been investigated. Therefore, we examined the independent and longitudinal effects of the methylation of three CpG sites in exon 1<SUB>F</SUB> of <I>NR3C1</I> on late-life depression using peripheral blood. In total, 732 Korean community residents aged ≥65 years were assessed; 521 individuals in this group without depression at baseline were followed 2 years later. The Geriatric Mental State Schedule was used to identify depression, and demographic and clinical covariates were evaluated. The effects of <I>NR3C1</I> methylation (the individual methylation status of three CpG sites and their average values) on current and follow-up depression were calculated using a multivariate logistic regression model. Higher <I>NR3C1</I> methylation levels at CpG 2 and 3 and the average methylation value were independently associated with the prevalence of depression at baseline. Additionally, a higher <I>NR3C1</I> methylation level at CpG 2 was associated with depression incidence 2 years later in this population. These findings suggest an association between the methylation of <I>NR3C1</I> exon 1<SUB>F</SUB>, especially at CpG 2, and depression later in life.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Higher <I>NR3C1</I> exon 1<SUB>F</SUB> methylation, except at CpG 1, is related to prevalence of late life depression. </LI> <LI> Hypermethylation of <I>NR3C1</I> exon 1<SUB>F</SUB> at CpG 2 predicts depression incidence 2 years later. </LI> <LI> These associations were independent of potential covariates. </LI> <LI> Altered epigenetic regulation in the HPA axis in late-life depression was supported. </LI> </UL> </P>