주요우울증，정신분열증 및 조증환자들이 호소하는 신체증상에 따른 자기보고척도 간의 비교

Comparision of Various Self-Rating Scale Scores by Somatic Symptoms in Major Depressive, Schizophrenic and Manic Patients

This study was designed to examine and compare the various self-rating scale scores of m ajor depressives, schizophrenics and manics according to the somatic symptoms. The subjects consisted o f 78 psychiatric inpatients (m ajor depressives, 35 ; schizophrenics, 30 ; manics, 13) who were admitted to the Departm ent o f Psychiatry in the Kang N am S t M ary，s Hospital, TaeJon St. M ary，s Hospital, S t Vincent，s Hospital, and S t Andrew，s N europsychiatric Hospital from September 1990 to June 1991. For the purpose of the assessment of somatic symptoms, the patients completed the questionaire that comprised 31 questions about somatic symptoms derived from somatization disorder by DSM-III-R diagnostic criteria. The patients were classified into two groups with higher scores or lower scores of somatic symptoms according to the cut-off point of the median number. A nd the patients also completed the self-rating scales such as Self-Rating Anxiety Scale, Self- Rating Depression Scale, Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale. The self-rating scale scores were compared between the two groups by somatic symptoms. The results were as follows • 1) W hen the scores of Self-Rating Anxiety Scale and Self-Rating Depression Scale were com pared am ong the groups of major depressives, Schizophrenics and manics, the group of m ajor depressives significantly rated themselves as most depressed, and the groups of anxious and manics significantly rated themselves as least depressed and anxious. A nd in Schalling-Sifneos Personality Scale and Toronoto Alexithymia Scale, manics rated the factor o f “day dreaming” as significantly lower and the factor “ability to describe feelings” as significantly higher than m ajor depressives. And, the factor “ability to identify and distinguish between feelings and bodily sensation” was rated less both in m ajor depressives and schizophrenics than in manics. 2) Generally, the more somatic group rated themselves as higher in Self-Rating Anxiety Scale scores and Self-Rating Depression Scale scores than the less somatic group, but the two groups did not show significant difference in Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale. This might suggest that somatic symptoms of the patients were attributable to their depressive and anxiety equivalents rather than alexithymic trait 3) For the major depressives and schizophrenics, the more somatic group rated themselves as higher than the less somatic group in Self-Rating Anxiety and Self-Rating Depression Scale, but the two groups did not show significant difference in Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale. 4) F or the manics, two groups didn’ t show significant difference in any o f the scales. The above results suggest that Self-Rating Anxiety Scale and Self-Rating Depression Scale would be more useful for evaluation of somatic symptoms o f psychiatric inpatients than Schalling- Sifneos Personality Scale and Toronto Alexithymia Scale.