종합병원 입원환자의 불안과 우울에 관한 연구 = The Studies on Anxiety and Depression in General Hospital Inpatients

국문 초록 (Abstract)

저자는 1987년 12월부터 88년 5월까지 부산대학교 병원과 부산 메리놀 병원에 입원중인 환자 317명을 대상으로 Zung의 Self-Rating Anxiety Scale(SAS)과 Self-Rating Depression Scale(SDS)을 이용하여 불안과 우울의 정도 및 빈도를 구하고 이를 건강대조군, 정신과 불안장해 환자군 및 우울장애 환자군과 비교하여 불안과 우울의 특성을 구하고 또한 인구통계학적인 변인과 질병에 관계되는 변인에 따른 불안과 우울정도를 조사하여 다음과 같은 결과를 얻었다.
1) 입원환자군의 SAS 및 SDS평균점수는 각각 38.5, 44.6으로서 그 불안과 우울의 정도는 모두 건강대조군보다는 유의하게 높았으나(p<0.05) 정신과 환자군보다는 유의하게 낮았다.(p<0.05)
2) 불안장애와 우울장애를 구분해 주는 SAS 및 SDS상의 기준점은 예민도가 84.4%, 88.0% 특이도가 81.1%, 85.8% 전반적 진단력이 82.1%, 86.5%로 나타나는 42점, 49점으로 잡는 것이 가장 타당할 것으로 판단된다. 이 때 입원환자의 36.0%가 불안장애, 37.2%가 우울장애에 속했다.
3) 입원환자군에서는 불안의 특성은 불안정서나 감각증상의 불안요인은 적고(P<0.05) 과민성과 부분적인 자율신경계 증상의 불안요인은 높은 것이었고(p<0.05) 우울의 특성은 초조감을 동반한 우울이나 관념적 우울요인은 유의하게 적고(p<0.05) 지체성우울과 식물성 증상의 우울요인은 유의하게 높은 것이다(p<0.05).
4) 남자보다 여자환자군에서 불안과 우울의 정도가 모두 유의하게 높았고(p<0.01) 저 소득층에서는 우울의 정도만 유의하게 높았다. (p<0.05). 그리고 회복에 대해 부정적 전망을 가진 환자군이 다른 환자군보다 불안과 우울의 정도가 모두 유의하게 높았다(p<0.001).

다국어 초록 (Multilingual Abstract)

This study aimed to evaluate the severity and tile frequency of depressive and anxiety disorders observed in 317 inpatients who were admitted to two general hospitals in Pusan, Pusan National University Hospital and Markynoll Hospital from December, 1987 to May, 1988. The evaluation was done by using the method of Zung's Self-Rating Anxiety Scale and Self-Rating Depression Scale. The characteristics of anxiety and deprssion in general hosptial inpatients were compared with those of the healthy subjects and psychiatric patients with anxiety and depressive disorders. The changes of severity in anxiety and depression according to the demographic and other related factors which might influence on the emotional status of these patients were analyzed.
The results were as follow ;
1) The mean score of SAS in inpatients was 38.5 which was significantly higher than that of healthy subjects and lower than that of anxiety disorders. The mean score of SDS in inpatients was 44.6 and it was significantly higher than that of healthy subjects and lower than that of depressive disorders.
2) The authors suggests the score of 42 in SAS and 49 in SDS as the cut off score which distinguish clinical anxiety or depressive disorders from normal condition when considering the sensitivity(84.4%, 88.0%) and specificity(81.1%, 85.8%) and overall diagnostic power(82.1%, 86.5%). In that case, the 36.5% and 37.2% of inpatients were included in anxiety and depressive disorders.
3) The characteristic feature of anxiety in inpatients was the more frequent occurrence of vigilance and scanning and of some of the autonomic symptoms and rarer occurrence of anxious mood and sensory symptoms. In the case of depression, the feature of retarded depression and vegetative symptoms were more frequent and the depressed affect with agitation and ideational depression were rarer.
4) The severity of anxiety and depression was significantly higher in the female than male and in the group who have the negative prospect to recovery to their own illness than other groups. The severity of depression was also significantly higher in the lower income group than other groups.