韓國 精神障碍의 疫學的 調査 硏究(XIII) : Prevalence of Obsessive-Compulsive Disorder 强迫障碍의 有病率 = A National Epidemiological Study of Mental Disorders in Korea(XIII)

국문 초록 (Abstract)

過去의 韓國 精神障碍의 疫學的 硏究는 모두 問題點이 많아서 그 信賴度는 낮은 것이어서 著者는 이런 問題點을 補充하여 서울을 비롯하여 시골의 20個 地域을 무작위 선정하여 美國
國立精神保健院(NIMH)에서 개발한 DIS-III로부터 標準化한 韓國版 DIS-III를 面接道具로 하여 韓國最初로 제대로된 精神障碍의 疫學的 調査硏究를 全國에 걸쳐 施行하였고, 이를 美國, 푸엘토리코, 카나다, 獨逸, 뉴질랜드, 타이완의 6個國과 비교 考察하여 다음과 같은 結果를 얻었다.
1) 韓國 强迫障碍의 平生有病率은 2.15%이며, 서울은 2.29%, 시골 地域은 1.90%로 서울이 시골보다 높다.
2) 性別로 보면 男性이 2.03%, 女性이 2.37%이며, 서울은 남성 2.21%, 여성 2.38%, 시골은 男性 1.78%, 여성 2.00%로서 女性이 男性보다 높은 경향을 보였다.
3) 年齡群으로 보면 18~24세群은 2.54%, 25~44세群은 2.19%, 45~66세群은 1.77%로서 18~24세群이 높았다.
4) 韓國을 비롯한 7個國에서 平生有病率과 年間有病率은 푸엘토리코에서 2.5%로서 가장 높았고 타이완이 0.7%로서 가장 낮았다. 年間有病率도 비슷하고 푸엘토리코가 1.8%로서 가장 높고 韓國과 뉴질랜드는 1.1%였다.
5) 發病年齡은 20代 後半에서 30代 初半이고 가장 낮은 곳은 카나다의 21.9세에서 가장 낮고 푸엘토리코는 35.5세였다.
6) 性別로는 독일을 제외하고 女性에서 높았고, 뉴질랜드는 3.4%로서 가장 높다. 女性 對 男性의 此는 韓國 및 푸엘토리코에서 1.2, 카나다 1.3, 美國 1.6, 타이완 1.8이다.
7) 强迫障碍에서 obsession 또는 compulsion의 症狀을 가진 것을 비교해보면 美國, 카나다, 푸엘토리코 및 뉴질랜드는 obsession만 가진 것이 더 많고, 韓國은 compulsion이 더 많으며 獨逸과 타이완은 兩者가 비슷하다.
8) 독일은 obsession과 compulsion을 모두 가진 것이 가장 많아서 57%이고 나머지 國家는 13~26%이며, 푸엘토리코는 35%이다.
9) 强迫障碍의 Comorbidily에서 major depression과 모든 不安障碍를 가진 것이 다른 障碍에 비해서 더 많다. 또 모든 不安障碍가 major depression보다 더 많다. 그러나 독일의
結果는 그 反對의 소견을 보였다.

다국어 초록 (Multilingual Abstract)

A nationwide epidemiological of mental disorders including obsessive-compulsive disorder in Korea using DIS-Ⅲ Korean version was conducted in the Capital City of Korea(Seoul) and 20 rural areas and the results were compared with those of 6 other countries.
The results were as follows:
1) The lifetime prevalence rate of obsessive-compulsive disorder was 2.14%, 2.29% in seoul and 1.90% in rural areas.
2) As for sex, the lifetime prevalence rate was higher in females, than in males, 2.03% in male and 2.38% in female.
3) The most prevalent age group was 18-24yrs. old group(2.45%).
4) The lifetime prevalence rates of OCD of seven countries(Korea, USA, Canada, Puero Rico, New Zealand, Germany and Taiwan) were remarkably consistent across the cross-national sites. Most of the sites fall within the range of 1.9%(Korea) to 2.5% (Puerto Rico). The annual rate of OCD was also fairly consistent across sites, ranging from 1.8%(Puerto Rico) to 1.1%(Korea and New Zealand).
5) Mean age of onset of OCD was in the mid-to late twenties to early thirties, with the earliest mean age at Canada(21.9yrs) and the latest at Puerto Rico(35.5 years).
6) The lifetime rate by sex, was generally higher in females as compared to males, except for Germany where males had a higher rate than females. In New Zealand, females had the highest rate among all of the females(3.4%) and in Germany males had the highest rate among all of the males(2.5%). The female to male ratios were consistent for Korea(1.2), Puerto Rico(1.2), Canada(1.3), USA(1.6) and Taiwan(1.8).
7) Proportion of persons with only obsession, only compulsion and both were also compared. In USA, Canada, Puerto Rico and New Zealand there was a larger proportion of persons with only obsession as compared to only compulsion. In Germany and Taiwan the proportion were equal and in Korea there was a higher proportion of persons with compulsion only, just the opposite trend seen in most of the other sites.
8) Germany had the highest proportion of persons with both obsessions and compulsions. Most of the countries fall within the 13% to 26% range, with Puerto Rico slightly higher.
9) Comorbidity with major depression and any anxiety disorders(panic disorder or any phobia) in persons with and without OCD for the cross-national sites were compared. Persons with OCD were at a risk substantially greater than chance of also having comorbid major depression or any anxiety disorders as compared to persons without OCD across all sites, even though the comorbidity rates and the magnitude of risk vary by sites. The proportion of persons with OCD and any anxiety disorder were higher than that proportion with major depression. Persons with OCD at Munich(Germany) seemed to have higher proportion with major depression and anxiety disorder and are at greater risk than persons without OCD compared to the other sites.