정신과 외래 환자에서 우울증상과 무감동의 관계 = Relationship between Depression and Apathy in Outpatients with Depressive Disorder

다국어 초록 (Multilingual Abstract)

Introduction: Apathy was found in patients with disorders seemingly unrelated with depression such as dementias, stroke, Parkinson`s disease, Alzheimer`s disease, and schizophrenia. As apathy is common in depressive patients and depressive patients with apathy have poorer prognosis than depressive patients without apathy, it might be important that we evaluate the relationship between apathy and depressive symptoms in clinical practice. Therefore, we evaluated the relationship between apathy and depressive symptoms in patients using Hamilton Rating Scale for depression(HRSD), Beck depression inventory(BDI), and apathy evaluation scale-clinician version(AES). Method: This study was performed in Korea university medical center, Guro hospital. Outpatients diagnosed as currently having depressive disorders or have achieved state of remission were enrolled (n=70). We translated AES into Korean and performed a cross-sectional assessment using HRSD, BDI and AES. Results: There was a positive correlation between total score of HRSD and the total score of AES (R=0.757, p<0.001). The AES score was higher correlated with subtotal scores of the four apathyrelated items from HRSD; loss of interest, psychomotor retardation, loss of energy, and loss of insight (R=0.827, p<0.001). Moreover, there was a positive correlation between total score of BDI and the total score of AES(R=0.552, p<0.001). In high BDI score group(n=33), 32 patients showed apathy syndrome. However, there was not a positive correlation between total score of BDI and the total score of AES. In low BDI group(n=37), 21 patients showed apathy syndrome. There was not a positive correlation between total score of BDI and the total score of AES. In high HRSD group(n=21), all patients had clinically meaningful apathy syndrome. There was not a positive correlation between total score of HRSD and the total score of AES. On the other hand, in low HRSD group(n=49), 32 patients had apathy syndrome. There was a statistically significant positive correlation between total score of HRSD and the total score of AES(R=0.720, p<0.001). Moreover, there was also a significant correlation between subtotal scores of the four apathy-related items from HRSD and the total score of AES(R=0.793, p<0.001). Conclusion: This cross-sectional study shows that apathy symptoms are different from the depression. However, apathy symptoms frequently coexist with depression. Even if the depressive patients scored below cut-off value in HRSD or BDI as they are in clinically remission state, we should consider the possibility of apathy syndrome.