한국의 노인우울증 환자에서 조발성 우울증과 만발성 우울증의 임상증상의 비교 = Comparison of Clinical Symptoms between Early and Late Onset Depression in Elderly Depressive Patients in Korea

다국어 초록 (Multilingual Abstract)

Objectives : Clinical differences between elderly patients with early and late onset depression have been described although these have been inconsistent. We aimed to compare differences of clinical symptoms using the 17 items Hamilton Rating Scale for Depression(HAM-D-17) between two groups. Methods : Data of 175 elderly patients with a diagnosis of major depressive disorder according to DSM-IV from January 2005 to November 2009 were collected. Seventy five patients were early onset depression and one hundred patients were late onset depression. Depressive symptoms were assessed by the 17-item Hamilton Rating Scale for depression. Results : There were some differences in HAM-D-17 scores between early and late onset depression. Early onset depression patients scored significantly higher in retardation(t = 2.41, p = 0.017) and somatic symptoms( general)(t = 2.37, p = 0.019) than late onset depression patients. Conclusion : We concluded that early onset depression patients have more severe psychomotor retardation and general somatic symptoms than late onset depression patients in Korea. Because of some limitations of this study, further investigations will be needed to validate this study results.

참고문헌 (Reference)

1 김문두, "조발성 우울증과 만발성 우울증의 임상적, 생물학적인 차이" 대한생물치료정신의학회 8 (8): 164-175, 2002

2 Baldwin RC, "vascular depression a distinct sub-type of depressive disorder? A review of causal evidence" 20 : 1-11, 2005

3 World Health Organization, "World Health Report 2001: Mental Health: New understanding, New Hope. Geneva"

4 Teper E, "Vascular factors and depression" 23 : 993-1000, 2008

5 Baldwin RC, "Vascular basis of late-onset depressive disorder" 180 : 157-160, 2002

6 Kozel FA, "Treatment outcomes for older depressed patients with earlier versus late onset of first depressive episode" 16 : 58-64, 2008

7 Marin RS, "The sources of convergence between measures of apathy and depression" 28 : 7-14, 1993

8 Sheehan DV, "The Mini-International Neuropsychiatric Interview(M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10" 59 : 22-33, 1998

9 Sadock BJ, "Synopsis of psychiatry" Lippincott Williams & Wilkins 552-553, 2003

10 Division of brain disease of the Korea c, "Risk factors for depression in older Koreans: Community-Based Geriafic Cohort Study"

11 Alexopoulos GS, "Research advances in geriatric depression" 8 : 140-149, 2009

12 Alexopoulos GS, "Remission in depressed geriatric primary care patients: a report from the PROSPECT study" 162 : 718-724, 2005

13 Avery D, "Psychomotor retardation and agitation in depression. Relationship to age, sex, and response to treatment" 7 : 67-76, 1984

14 Baldwin R, "Neurological findings in late-onset depressive disorder: comparison of individuals with and without depression" 186 : 308-313, 2005

15 Koenig HG, "Mood disorder in Textbook of geriatric psychiatry" American Psychiatric Publishing 241-268, 2004

16 Krishnan KR, "MRI-defined vascular depression" 154 : 497-501, 1997

17 Greenwald BS, "MRI signal hyperintensities in geriatric depression" 153 : 1212-1215, 1996

18 Salloway S, "MRI and neuropsychological differences in early-and late-life-onset geriatric depression" 46 : 1567-1574, 1996

19 Janssen J, "Late-life depression: the differences between earlyand late-onset illness in a community-based sample" 21 : 86-93, 2006

20 Benazzi F, "Late-life depression in private practice depressed outpatients: a 203-case study" 13 : 145-148, 1998

21 Dillon C, "Late- versus early-onset geriatric depression in a memory research center" 5 : 517-526, 2009

22 Devanand DP, "Late onset dysthymic disorder and major depression differ from early onset dysthymic disorder and major depression in elderly outpatients" 78 : 259-267, 2004

23 Gallagher D, "Late life depression: a comparion of risk factors and symptoms according to age of onset in community dwelling older adults" 2009

24 Brown RP, "Involutional melancholia revisited" 141 : 24-28, 1984

25 Alexopoulos GS, "Geriatric depression in primary care" 11 : 397-400, 1996

26 Brodaty H, "Early and late onset depression in old age: different aetiologies, same phenomenology" 66 : 225-236, 2001

27 Heun R, "Distinction of early-and late-onset depression in the elderly by their lifetime symptomatology" 15 : 1138-1142, 2000

28 Holroyd S, "Differences in geriatric psychiatry outpatients with early- vs late-onset depression" 12 : 1100-1106, 1997

29 Alexopoulos GS, "Depression in the elderly" 365 : 1961-1970, 2005

30 Baldwin RC, "Depression in later life in A comparison of symptoms and risk factors in early and late onset cases" 167 : 649-652, 1995

31 Conwell Y, "Depression in late life: age of onset as marker of a subtype" 17 : 189-195, 1989

32 Alexopoulos GS, "Clinically defined vascular depression" 154 : 562-565, 1997

33 Alexopoulos GS, "Clinical presentation of the “depression-executive dysfunction syndrome” of late life" 10 : 98-106, 2002

34 Bella R, "Clinical presentation and outcome of geriatric depression in subcortical ischemic vascular disease" 56 : 298-302, 2010

35 Yamashita H, "Clinical features and treatment response of patients with major depression and silent cerebral infarction" 44 : 176-182, 2001

36 Krishnan KR, "Clinical and Phenomenological comparisons of lateonset and early-onset depression" 152 : 785-788, 1995

37 de Groot JC, "Cerebral white matter lesions and depressive symptoms in elderly adults" 57 : 1071-1076, 2000

38 Corruble E, "Association between age of onset and symptom profiles of late-life depression" 118 : 389-394, 2008

39 Hamilton M, "A rating scale for depression" 23 : 56-62, 1960

40 Burvill PW, "A comparison of early-onset and late-onset depressive illness in the elderly" 155 : 673-679, 1989

41 Simpson SW, "1997 IPA/Bayer Research Awards in Psychogeriatrics. Subcortical hypertensities in late-life depression: acute response to treatment and neuropsychological impairment" 9 : 257-275, 1997