흉통 환자에서의 정서, 자존감 및 삶의 질에 대한 예비 연구 = A Preliminary Study on Emotion, Self-Esteem and Quality of Life in the Patients with Chest Pain

다국어 초록 (Multilingual Abstract)

Objectives : The objective of this study is to measure and to compare the rate of depression, anxiety, self-es-teem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. Methods : Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). Results : 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. Conclusions : The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.

참고문헌 (Reference)

• 1 이훈진, "한국판 자아존중감 척도, 편집증적 경향, 자기개념, 자의식간의 관계에 대한 탐색적 연구" 277-290, 1995
• 2 "통계청"
• 3 Lumley MA, "The relationship of alexithymia to subjective and biomedical measures of disease" 38 : 497-502, 1997
• 4 Osler W, "The principle and practice of medicine" J Portland Young 1892
• 5 Dunbar GC, "The development of SBQOL-A unique scale for measuring quality of life" 2 : 65-74, 1992
• 6 Kisely SR, "The course of psychiatric disorder associated with non-specific chest pain" 36 : 329-335, 1992
• 7 Stoker MJ, "The SmithKlein Beecham ‘quality of life’ scale: A validation and reliability study inpatients with affective disorder" 1 : 385-395, 1992
• 8 Rosenberg M, "Society and Adolescent self-image" Princeton University Press 1965
• 9 Dammen T, "Psyhological factors, pain attibution and medical morbidity in chest-pain patietns with and without coronary artery disease" 26 : 463-469, 2004
• 10 Beck AT, "Psychometric Properties of the Beck Depression Inventory-25 Years of Evaluation" 8 : 77-100, 1988
• 11 Papanicolaou MN, "Prognostic implication of angiographically normal and insignificantly narrowed coronary arteries" 58 : 1181-1187, 1986
• 12 Carter C, "Panic disorder and chest pain in the coronary care unit" 33 : 302-309, 1992
• 13 Alexander PJ, "Mental disorders in patients with noncardiac chest pain" 89 : 291-293, 1994
• 14 Spielberger CD, "Manual for the State-Trait Anxiety Inventory" Consulting Psychologist Press 1970
• 15 Costa PT, "Influence of the normal personality dimension of neuroticism on chest pain symptoms and coronary artery disease" 60 : 20J-26J, 1987
• 16 Roll M, "Five-year follow up of young adults visiting an emergency unit because of atypical chest pain" 231 : 59-65, 1992
• 17 McCroskery JH, "Differntiating angina patients with coronary artery disease from those with normal coronary arteries using psychological measures" 67 : 645-646, 1991
• 18 García-Campayo J, "Different Psychological Profiles in Non-Cardiac Chest Pain and Coronary Artery Disease: a Controlled Study" 63 : 357-361, 2010
• 19 Beck AT, "Depression-Clinical, experimental, and theoretical aspects -New York" Harper & Low 1967
• 20 Fagring AJ, "Depression, anxiety, stress, social interaction and health-related quality of life in men and women with unexplained chest pain" 8 : 165-, 2008
• 21 Broadhead WE, "Depression, Disability Days, and Days Lost from Work in a Prospective Epidemiologic Survey" 264 : 2524-2528, 1990
• 22 Dickens CM, "Contribution of depression and anxiety to impaired health-related quality of life following first myocardial infarction" 189 : 367-372, 2006
• 23 Kroenkc K, "Common symptoms in ambulatory care incidence, evaluation, therapy and outcome" 86 : 262-266, 1987
• 24 Katon W, "Chest pain: relationship of psychiatric illness to coronary arteriographic results" 84 : 1-9, 1988
• 25 Katon W, "Chest pain, cardiac disease, and panic disorder" 51 : 27-30, 1990
• 26 Bass C, "Chest pain with normal coronary arteries: a comparative study of psychiatric and social morbidity" 14 : 51-61, 1984
• 27 Cormier LE, "Chest pain with negative cardiac diagnostic studies. Relationship to psychiatric illness" 176 : 351-358, 1988
• 28 Cormier LE, "Chest pain with negative cardiac diagnostic studies. Relationship to psychiatric illness" 176 : 351-358, 1988
• 29 Bass C, "Chest pain and breathlessness: relationship to psychiatric illness" 92 : 127S-17S, 1992
• 30 이영호, "BDI, SDS, MMPI-D 척도의 신뢰도 및 타당도에 대한 연구" 10 : 98-113, 1991
• 31 Channer KS, "Anxiety and depression in patients with chest pain referred for exercising testing" 2 : 820-823, 1985
• 32 Colgan SM, "Angina-like chest pain: a joint medical and psychiatric investigation" 64 : 743-746, 1988
• 33 Yoon JS, "A preliminary study on Korean version of the SmithKlein Beecham ‘Quality of Life’ Scale(Kv- SBQOL)" 37 : 280-294, 1998
• 34 Tew R, "A long-term follow-up study of patients with ischemic heart disease versus patients with nonspecific chest pain" 39 : 977-985, 1995
• 35 이영호, "A Study of the Reliability and the Validity of the BDI , SDS, and MMPI-D Scales" 10 : 98-113, 1991