정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
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암과 우울증상 네트워크 구조의 연관성

The Association Between Cancer and Network Structure of Depressive Symptoms

  • 황휘진 (단국대학교병원 정신건강의학과) ;
  • 이경규 (단국대학교병원 정신건강의학과) ;
  • 이석범 (단국대학교병원 정신건강의학과) ;
  • 이정재 (단국대학교병원 정신건강의학과) ;
  • 김경민 (단국대학교병원 정신건강의학과) ;
  • 김도현 (단국대학교병원 정신건강의학과)
  • Hwang, Hwijin (Department of Psychiatry, Dankook University Hospital) ;
  • Lee, Kyung Kyu (Department of Psychiatry, Dankook University Hospital) ;
  • Lee, Seok Bum (Department of Psychiatry, Dankook University Hospital) ;
  • Lee, Jung Jae (Department of Psychiatry, Dankook University Hospital) ;
  • Kim, Kyoung Min (Department of Psychiatry, Dankook University Hospital) ;
  • Kim, Dohyun (Department of Psychiatry, Dankook University Hospital)
  • 투고 : 2021.06.15
  • 심사 : 2021.09.04
  • 발행 : 2021.12.31
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초록

연구목적 우울증은 감정, 생장증상, 자살 사고 등 다양한 증상들이 혼재되어 있으나 암 환자에서개별 우울증상간의 연관성에 대해서는 잘 알려져 있지 않다. 본 연구에서는 암 진단군과 대조군에서의 우울증상 네트워크 구조의 차이를 밝히고자 했다. 방 법 제7기 국민건강영양조사 데이터를 활용하여 진행하였다. 599명의 암 진단군과 연령 성별을 맞춘 599명의 대조군을 선정하였다. 우울증 선별도구인 PHQ-9을 활용하여 우울증상을 평가하였고, 각 증상에 대해 Ising fit 모델을 활용하여 네트워크 구조를 도출하였다. 결 과 두 군에서 개별 PHQ-9의 점수 차이는 유의하지 않았고, 두 군 모두에서 집중력저하-정신운동성 변화, 흥미의감소-우울한 기분, 우울한기분-자살사고 간에 강한 연결성을 보였다. 그러나 무가치함의 중심연결성은 암 진단군에서 대조군에 비해 유의하게 높았다. 결 론 암 진단군에서 무가치함과 다른 우울증상들 간의 연결성이 강했음을 의미한다. 이러한 점은 암 환자의 우울증상에서 무가치함이 치료목표가 되는 중요한 증상이 될 수 있음을 시사한다.

Objectives : The characteristics of depressive symptoms in patients with cancer is different from those in control group. However, few research has focused on the association between depressive symptoms in cancer patients. The aim of this study was to compare the network structure of depressive symptoms between patients with cancer and normal control. Methods : This study was based on cohort data from Korea National Health and Nutrition Examination Survey in 2016-2018. The Patient health Quetionnaire-9 (PHQ-9) was used to assess depressive symptoms in 599 patients with cancer and 599 age-sex matched controls. We estimated network structure of depressive symptom using Isingfit model. Results : There was no significant difference of each PHQ-9 item score. There were strong associations between symptoms were concentration problem-psychomotor activity, anhedonia-depressed mood, and depressed mood-suicidal ideation in both groups. Strength centrality of worthlessness was significantly higher in patients with cancer. Conclusions : These results suggest that worthless is associated with other depressive symptoms more tightly in patients with cancer. Worthless can serve as important treatment targets for intervention of depression in patients with cancer.

키워드

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