해녀 우울장애 환자의 임상적 특징 = Clinical Characteristics of Haenyeo with Depressive Disorders

다국어 초록 (Multilingual Abstract)

Objectives Haenyeo are Korean professional women breath-hold divers in Jeju island. The aim of this study was to investigate the clinical characteristics of depressed Haenyeo group, compared to non-Haenyeo depressed group. Methods This study included 75 Haenyeo and 340 non-Haenyeo with depressive disorders recruited from the Dementia Early Detection Program in Jeju island. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview. All patients completed the questionnaires, including the Subjective Memory Complaints Questionnaire (SMCQ), the Patient Health Questionnaire-15 (PHQ-15), and the Blessed dementia scale. Depression was evaluated by the Korean version of short form the Geriatric Depression Scale (K-SGDS) and cognition was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment packet. Results Although the mean scores of the K-SGDS were similar between Haenyeo and non-Haenyeo depressed groups, the Haenyeo group showed a higher mean score on the PSQ-15 (p < 0.001, ANCOVA adjusting for age, the K-SGDS and education). The Haenyeo group showed poorer performance on the Korean Version of Frontal Assessment Batter (p < 0.001), the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (p < 0.018), the word fluency test (p < 0.001), and the word list memory test (p = 0.012) in ANCOVA adjusting for age and education. The mean SMCQ score was higher in the Haenyeo depressed group than in the non-Haenyeo depressed group. Conclusions The Haenyeo depressed group shows cognitive dysfunction, especially frontal lobe dysfunction, compared to the non-Haenyeo depressed group, indicating the Haenyeo depressed group may have more severe frontolimbic dysfunction due to chronic exposure to hypoxia. The Haenyeo depressed group suffers more somatic symptoms than the non-Haenyeo depressed group.

참고문헌 (Reference)

• 1 이동영, "치매 선별용 정보 제공자 보고형 설문지 Seoul Informant Report Questionnaire for Dementia (SIRQD)의 개발" 대한신경정신의학회 43 (43): 209-218, 2004
• 2 Alexopoulos GS, "“The depression-executive dysfunction syndrome of late life”: a specific target for D3 agonists?" 9 : 22-29, 2001
• 3 Alexopoulos GS, "‘Vascular depression’ hypothesis" 54 : 915-922, 1997
• 4 Paranthaman R, "Vascular function in older adults with depressive disorder" 68 : 133-139, 2010
• 5 Yoo SW, "Validity of Korean version of the Mini-International Neuropsychiatric Interview" 2 : 50-55, 2006
• 6 Cho MJ, "Validation of Geriatric Depression Scale, Korean Version (GDS) in the Assessment of DSM-III-R Major Depression" 38 : 48-63, 1999
• 7 Taylor WD, "The vascular depression hypothesis: mechanisms linking vascular disease with depression" 18 : 963-974, 2013
• 8 Blessed G, "The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects" 114 : 797-811, 1968
• 9 Yokoyama O, "Right frontopolar cortex activity correlates with reliability of retrospective rating of confidence in short-term recognition memory performance" 68 : 199-206, 2010
• 10 Paranthaman R, "Relationship of endothelial function and atherosclerosis to treatment response in late-life depression" 27 : 967-973, 2012
• 11 Markus HS, "Reduced cerebral blood flow in white matter in ischaemic leukoaraiosis demonstrated using quantitative exogenous contrast based perfusion MRI" 69 : 48-53, 2000
• 12 Kim HT, "Pulmonary Function Test and Diving Capacity of Woman Divers in Cheju Island" 36 : 68-74, 1989
• 13 Han C, "Psychometricproperties of the Patient Health Questionnaire-15 (PHQ-15) for measuring thesomatic symptoms of psychiatric outpatients" 50 : 580-585, 2009
• 14 Lewin DS, "Preliminary evidence of behavioral and cognitive sequelae of obstructive sleep apnea in children" 3 : 5-13, 2002
• 15 Nagata R, "Olmesartan, an angiotensin II receptor blocker, restores cerebral hypoperfusion in elderly patients with hypertension" 19 : 236-240, 2010
• 16 Iadecola C, "Neurovascular regulation in the normal brain and in Alzheimer’s disease" 5 : 347-360, 2004
• 17 Krishnan KR, "MRI-defined vascular depression" 154 : 497-501, 1997
• 18 Martin KC, "Local protein synthesis and its role in synapse-specific plasticity" 10 : 587-592, 2000
• 19 Metternich B, "How are memory complaints in functional memory disorder related to measures of affect, metamemory and cognition?" 66 : 435-444, 2009
• 20 김재림, "High Altitude Remains Associated with Elevated Suicide Rates after Adjusting for Socioeconomic Status: A Study from South Korea" 대한신경정신의학회 11 (11): 492-494, 2014
• 21 Kleim JA, "Functional organization of adult motor cortex is dependent upon continued protein synthesis" 40 : 167-176, 2003
• 22 Alexopoulos GS, "Frontostriatal and limbic dysfunction in late-life depression" 10 : 687-695, 2002
• 23 Moody DM, "Features of the cerebral vascular pattern that predict vulnerability to perfusion or oxygenation deficiency:an anatomic study" 11 : 431-439, 1990
• 24 Alexopoulos GS, "Executive dysfunction and the course of geriatric depression" 58 : 204-210, 2005
• 25 Ghiadoni L, "Effect of the angiotensin II type 1 receptor blocker candesartan on endothelial function in patients with essential hypertension" 35 (35): 501-506, 2000
• 26 American Psychiatric Association, "Diagnostic and statistical manual of mental disorders: DSM-IV" American Psychiatric Association 1994
• 27 Youn JC, "Development of the Subjective Memory Complaints Questionnaire" 27 : 310-317, 2009
• 28 Lee JH, "Development of the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries" 57 : P47-P53, 2002
• 29 Rey de Castro J, "Depressive symptoms in patients with obstructive sleep apnea/hypopnea syndrome" 17 : 615-620, 2013
• 30 Pamidi S, "Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population" 12 : 827-831, 2011
• 31 Maes M, "Depression is an inflammatory disease, but cell-mediated immune activation is the key component of depression" 35 : 664-675, 2011
• 32 Wilson I, "Depression in the patient with COPD" 1 : 61-64, 2006
• 33 Stage KB, "Depression in COPD--management and quality of life considerations" 1 : 315-320, 2006
• 34 Asmaro D, "Cognition at altitude: impairment in executive and memory processes under hypoxic conditions" 84 : 1159-1165, 2013
• 35 Alexopoulos GS, "Clinically defined vascular depression" 154 : 562-565, 1997
• 36 Choi JC, "Chronic daily headache with analgesics overuse in professional women breath-hold divers" 48 : 1037-1043, 2008
• 37 Greenstein AS, "Cerebrovascular damage in late-life depression is associated with structural and functional abnormalities of subcutaneous small arteries" 56 : 734-740, 2010
• 38 Direk N, "Cerebral hemodynamics and incident depression: the Rotterdam Study" 72 : 318-323, 2012
• 39 Tiemeier H, "Cerebral haemodynamics and depression in the elderly" 73 : 34-39, 2002
• 40 Debiec J, "Cellular and systems reconsolidation in the hippocampus" 36 : 527-538, 2002
• 41 Gozal D, "Behavioral and anatomical correlates of chronic episodic hypoxia during sleep in the rat" 21 : 2442-2450, 2001
• 42 Di Marco F, "Anxiety and depression in COPD patients: the roles of gender and disease severity" 100 : 1767-1774, 2006
• 43 Godbout JP, "Age and neuroinflammation: a lifetime of psychoneuroimmune consequences" 24 : 521-538, 2006
• 44 Fregly MJ, "Activity of the hypothalamic-pituitary-thyroid axis during exposure to cold" 41 : 85-142, 1989