憂戀症의 社會精神醫學的 硏究 一特히 憂變症 發病前 狀況을 中心으로 一

A SOCIOPSYCHIATRIC STUDY OF SEVERE DEPRESSION

1. In this clinical study, it was intended to reveal the socin-environmental events occurring prior to the onset of severs depressions in 12Mendogenous” depressives and 26 “nonendogenous” depressies who were hospitalized in the Department of Neuropsychiatry, Chosun University Hospital from April 1974 to August 1976. Among the 38 depressed patients, 11 cases were males and 27 were females. 2. Twenty stressful socio-environmental events were empirically selected according to the frequency of occurrence in the recorded material. Of these 20,14 events that occurred more frequently were then subjected to a more intensive analysis. The more frequent socio-environmental events were defined as follows： 1. Financial affairs 2. Change in family relationship 3. Failure of children to meet parent’s expectation 4. Beieg forced to encounter negative reality 5. Failure inj ob performance and increased resgonsijbility 6. Threat to sexual identity 7. Damage to social status 8. Change in marital relationship 9. Death of important person 10. Moving residence 11. Unemployment and transfer of job 12. Physical illeness 13. Iatrogenic factor 14. Parturition 3. More than 90% of them reported one or more socioenvironmental events； most of them reported multiple stressful events prior to the onset. The male patients tended to report predominantly social factors in contrast to the female patients who reported familial and social events. Frequently reported social events were financial affairs,，failure of children to meet parent’s expectations, fail urein job performahce, increased job resporsibility encountering negative social realities and damage to the social status. Relatively infrequent were moving residence, house problems, unemployment and transfer of job. Frequent familial affairs were conflict among extended family members and threat to sexual identity. Disease, death or parting of the family members were infrequently associated with the onset. 4. Patients with repeated history of depression presented similar stressful events prior to each onset. The author noted in each patient a consistent interaction between external events and internal psychological reactions to these events which seemed to be determined by a core conflict and underlying psychopathology.