憂徽病의 發病前 社會環境的 要因에 대한 考察

A CLINICAL STUDY ON SOCIO-ENVIRONMENTAL STRESSORS WHICH PRECEDE THE ONSET OF SEVERE DEPRESSION

This clinical study was made to investigate the socio-environmental stressors occurring prior to the onset of severe depression in 85 patients who were hospitalized in the N euro-Psychiatric Department of Chosun University Hospital from September, 1976 until December, 1979. The result were as follows： 1. According to the diagnostic distribution, 54 were cases of “nonendogenous” depression and 31 were cases of “endogenous” depression. Among them , 71% of the endogenous depressives and 28% of the nonendogenous depressives had a past history of depression. 2. Frequency of the socio-environmental stressors prior to the onset of depressive illness were (1) financial problem s(55.3%) (2) conflict among family members(42.4%) (3) failure of patients children to meet parental expectations(27.1%) (4) failure in job perform ance or increased responsibities(27.1%) (5) made to face denied reality (25.9%) (6) threat to sexual identity (23.596) (7) physical illness(22.4% ) (8) change in marital relationship(22.4%) (9) damage to social status (12.9%) (10) death of important person(12. 9%). 3. Of the patient, 27 cases were male and 58 were fomale. Most of the cases were distributed in the late adulthood range. The more frequent stressors in male patients were financial problems aned failure in job performance or increased responsibilities. In female patients, jfinancial problems, conflict among family members and failure of patient’s children to meet parental expectations were the most frequent stressors. 4. The frequency and type of socio-environmental stressors were similar in both the endogenous and nonendogenous groups. Frequency of stressors in the endogenous group was in the order of financial problem s(58.0% ), failurein job perform ance or increased responsibilities (38.7%), made to face denied reality (35. 5% ), conflict among family members(25.896)t failure of patient s children to meet parental expectations(25.8% ), physical . illness(25.8%), threat to sexual identity (25.8%). The frequency of stressors in the nonendogenous group was in the order of finanrcial proplems(53.7% ), conflict among family members(51.8%), failure of patien t’s children to meet parental expectations(29.4%), threat to sexual identity (22. 2% )t change in marital relationship (22. 2% ). 5. Internal psychological reactions to socio-environmental exteranl events seemed to be determined by individual psychopathology and internally underlying psychological conflict.