주요우울장애 환자에서 일 년 이내 재입원에 영향을 미치는 임상 요인 : 일 대학병원 후향적 조사

Clinical Characteristics of Patients with Major Depressive Disorder That Affect One-Year Rehospitalization Rate: A Retrospective Study in a University Hospital

흔히 정신건강의학과 진료 중에 만날 수 있는 주요우울장애 환자들 중 입원 환자들을 대상으로 재입원을 하는 환자들의 특징을 파악하고자 하였다. 본 연구에서 1년 이내 재입원을 한 환자들은 그렇지 않은 환자들에 비해 이전의 정신과적 입원횟수가 유의하게 높았다. 또한 항우울제의 종류와 약물치료의 종류에 따른 차이점을 비교하였으나 여러 대상군들 사이에 유의한 차이는 없었다. 또한 항우울제 중단을 할 경우 그렇지 않은 경우에 비해 재입원을 하는 경우가 유의하게 높았다. 이러한 결과들을 종합하였을 때 정신과적 입원의 과거력과 항우울제의 중단은 재입원을 예측하는 인자로서 임상적인 의의가 있고, 이외의 다른 요소들에 대한 추가적인 연구가 필요할 것으로 사료 된다.

Objective This study was designed to investigate the clinical characteristics of patients with major depressive disorder who were rehospitalized within a year in a naturalistic setting at a university hospital. Methods Inpatients with major depressive disorder patients were retrospectively investigated. Data on patients’ demographic factors, clinical variables-age, sex, education year, socioeconomic state, marital state, illness duration, length of stay, severity of illness, presence of psychotic features, number of past depressive episodes and hospitalization, family history, comorbidity-were collected. Use of antidepressants, antipsychotics, mood stabilizers and hypnotics were investigated. Results A total of 238 patients participated in the study. No significant differences were observed between one-year rehospitalized group and the non-rehospitalized group in demographic factors and clinical variables except for the number of previous psychiatric hospitalizations. The mean number of previous psychiatric hospitalization was significantly higher in the one-year rehospitalized group than the non-rehospitalized group (0.41±0.83 times vs. 0.23±0.83 times) (p=0.048). No significant differences in rehospitalized rates were observed among the disparate treatment types. One-year rehospitalization rate was significantly higher in patients who discontinued antidepressants than the patients who continued the antidepressants (15.9% vs. 0%) (p=0.002). Conclusion The present data suggest that the number of previous psychiatric hospitalizations is higher in patients who were rehospitalized within a year and the discontinuation of antidepressant might be an influencing factor. Further controlled studies are recommended to confirm our findings.