우울증 센터 내원 초진 환자에서 혈중 코티솔 농도와 해밀턴 우울 평가 척도의 우울증상 항목과의 관계

Association between the Daytime Plasma Cortisol Level and Depression Component of Hamilton Depression Rating Scale in Korean Depression Clinic Outpatients

ObjectivesZZThere is evidence that Hypothalamic-Pituitary-Adrenocortical (HPA) system dysregulation plays a role in the pathophysiology of depression. However which psychiatric symptoms are related to HPA system dysregulation has not been studied well. The primary aim of this study was to investigate which symptom components of the Hamilton Depression Rating Scale (HAM-D) are related to HPA system dysregulation in Korean psychiatric outpatients. The secondary aim was to find other variables that have association with HAM-D components. MethodsZZThis study was a retrospective review of the charts of outpatients who first visited Samsung Medical Center Depression Clinic between July 2012 and October 2013. Among them those who checked the plasma cortisol level and HAM-D within one week of their first visit were selected. Fifty nine patients were selected. The HAM-D was divided into four components, including depression, anxiety, insomnia, and somatic components. Multiple regression of cortisol level was used for four subscales. ResultsZZSignificant positive correlations were observed between the plasma cortisol level and depression component of HAM-D (beta=0.251, p=0.049). Age also showed negative correlation with the depression component of HAM-D (beta=-0.427, p=0.002). However anxiety, insomnia and somatic components of HAM-D did not show correlation with plasma cortisol level. ConclusionZZOur study suggests that in Korean depression clinic outpatients, the depression component of HAM-D is related to plasma cortisol level