유방암 환자의 우울장애 예측변인 = Biopsychosocial Predictors of Depressive Disorder in Breast Cancer Patients

다국어 초록 (Multilingual Abstract)

The purpose of this study was to examine the prevalence and analyze the various predictors of depressive disorder in women with breast cancer on the basis of biopsychosocial model. A total of 128 breast cancer patients were recruited, and they were assessed on the basis of cancer-related variables, sociodemopraphic variables, symptoms of depression, cancer-related somatic symptoms, and psychosocial variables (optimism, self esteem, husband support). The results showed that 31% of the patients exhibited a high level of depressive symptoms, and 14% of the patients were classified as having depressive disorder. The 4-step hierarchical binary logistic regression analysis was significant, and the rate of correct prediction was 94.9%. Before entering the psychosocial variables, none of the cancer-related variables, sociodemographic variables or cancer-related somatic symptoms was significant. The high risk of depressive disorder in breast cancer patients was associated with a personality trait. The results supported that depressive symptomatology in breast cancer patients is not associated with objective variables, but rather that it is very strongly linked with psychological variables. Finally, the implications for the identification of and psychosocial intervention for depressive disorder in breast cancer patients were discussed.

참고문헌 (Reference)

1 박영신, "한국인의 부모자녀 관계" 교육과학사 2004

2 신승철, "한국에서의 the Center for Epidemiological Studies Depression Scale (CES-D)의 사용" 30 (30): 752-767, 1991

3 김은정, "임상적 우울집단과 준 임상 우울집단의 심리 사회적 특성 비교" 18 (18): 95-104, 1999

4 한영인, "유방암환자의 통증과 우울의 관계" 5 (5): 22-32, 2005

5 김종남, "유방암 환자를 위한 집단치료의 효과: 예비연구" 한국임상심리학회 24 (24): 1-18, 2005

6 채영란, "유방암 절제술을 받은 여성의 지각된 건강상태, 우울 및 삶의 질의 관계" 성인간호학회 17 (17): 119-127, 2005

7 한숙정, "암환자가족의 가족기능에 대한 조사연구*" 대한종양간호학회 3 (3): 155-163, 2003

8 보건복지부, "암 발생 통계" 보건복지부 2005

9 이영자, "스트레스,사회적 지지,자아존중감과 우울 및 불안과의 관계" 서울여자대학교 1996

10 조현주, "산후우울증의 위험요인 탐색과 예방 개입의 효과" 고려대학교 대학원 2003

11 한국보건사회연구원, "보건복지동향" 한국보건사회연구원 2006

12 박현숙, "만성요통환자가 지각하는 낙관성과 우울에 관한 연구" 10 (10): 125-136, 2001

13 House,J.S., "Work Stress and Social Support, Reading Massachisette" Addison- Wesley, In Sisca Lentjes 1981

14 Yun,Y.H., "Validation of the Korean version of the EORTC QLQ-C30" 13 : 863-868, 2004

15 Graham,J., "Stressful life experiences and risk of relapse of breast cancer: Observational cohort study" 324 : 1420-1423, 2002

16 Rosenberg,M., "Society and the adolescent self-image.Princeton" NJ: Princeton University Press. 1965

17 Scheier,M.F., "Really, disease doesn't matter A commentary on correlates of depressive symptoms in women treated for early-stage breast cancer" 24 : 2407-2408, 2006

18 Yen,J.Y., "Quality of life, depression, and stress in breast cancer women outpatients receiving active therapy in Taiwan" 60 : 147-53, 2006

19 Casso,D., "Quality of life of 5-10 years breast cancer survivors diagnosed between age 40 and 49" 18 : 25-33, 2004

20 Leedham,B., "Psychosocial concerns and quality of life in breast cancer survivors" 17 : 342-348, 1999

21 Yoe,W., "Psycho-social impact of breast cancer surgeries in Chinese Patients and their spouses" 13 : 132-139, 2004

22 Kim,M.J., "Pruefungsangst und andere psycholsoziale Merkmale: ein Beitrag zur interkulturellen Diagnostik" Dissertation der Philosophischen Fatultaet der Universitaet Duesseldorf 1998

23 Green,B.l., "Prevalence of posttraumatic stress disorder in woman with breast cancer" 39 : 102-111, 1998

24 Scheider,M.F., "Optimism, coping, and health: Assessment and implication of generalized outcome expectancies" 5 : 2219-2247, 1985

25 Dodd,M.J., "Occurrence of symptom clusters" 32 : 76-78, 2004

26 Bardwell,W.A., "Objective cancer-related variables are associated with depressive symptoms in women treated for early-stage breast cancer" 2006

27 McLay,R.N., "Nulliparity and late menopause are associated with decreased cognitive decline" 15 : 161-167, 2003

28 Fann,J.R., "Major depression after breast cancer: a review of epidemiology and treatment" 30 : 112-126, 2008

29 Barraclough,J., "Life events and breast cancer prognosis" 304 : 1078-1081, 1992

30 Byar,K.L., "Impact of adjuvant breast cancer chemotherapy on fatigue, other symptoms, and quality of life" 33 (33): E18-E26, 2006

31 Cardova,M.J., "Frequency and correlates of posttraumatic stress disorder-like symptoms after treatment for breast cancer" 1995

32 Kim,S.H., "Fatigue and Depression in Disease-Free Breast Cancer Survivors: Prevalence, Correlates, and Association with Quality of Life" 35 (35): 2008

33 Sherwin,B.B., "Estrogen effects on cognition in menopausal women" 48 : S21-S26, 1997

34 Roscoe,J.A., "Effect of paroxetine hydrochloride(Paxil) on fatigue and depression in breast cancer patients receiving chemotherapy" 89 : 2-, 2005

35 Golden-Kreutz,D.M., "Depressive symptoms after breast cancer surgery: Relationship with global, cancer -related, and life event stress" 13 : 211-220, 2004

36 McDaniel,J.S., "Depression in patients with cancer. Diagnosis, biology, and treatment" 52 : 89-99, 1995

37 Burgess,C., "Depression and anxiety in women with early breast cancer: five year observational cohort study" 330 : 702-705, 2005

38 Spiegel,D., "Depression and Cancer: Mechanisms and Disease Progression" 54 : 269-282, 2003

39 Schagen,S.B., "Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma" 85 : 640-650, 1999

40 Somerset,W., "Breast Cancer and Depression" 18 (18): 1021-1034, 2004

41 Bower,J.E., "Behavioral Symptoms in Patients With Breast Cancer and Survivors\" 26 (26): 768-777, 2008

42 Cohen,J., "Applied multiple regression and correlation analysis for the behavioral sciences" Mahwah, New Jersey: Lawrence Erlbaum Associates 2003