일 정신과 외래여자환자의 학대경험과 정신과적 증상

Reported Histories of Abuse and Psychiatric Symptomatology in Women Psychiatric Outpatients

연구목적 및 방법： 신체적 및 성적 학대가 정신과적 증상에 미치는 영향을 보고자, 정신과 외래를 초진 방문한 여자 환자 74 명을 대상으로 직접 면담 및 자기기술질문지, 간이정신진단검사지를 이용하여, 신체적 및 성적 학대경험유무 및 양상, 정신증상을 조사하였다. 결 과： 1) 전체 대상환자중 47.3%가 학대를 당한 적이 있다고 하였으며 신체적 학대를 20.3%, 성적 학대를 13.5%가 경험했다고 하였으며, 13.5%가 신체적학대와 성적 학대를 모두 경험했다고 하였다. 2) SCL-90-R로 본 증상척도상 성적 학대를 당했던 경우 학대 비경험군에 비하여 강박증, 우울증, 불안, 적대감, 정신증척도가 매우 유의하게 높았으며(p<.01), 공포불안척도가 유의하게 높았다(p<.05). 신체적 학 대를 당했던 경우는 강박증, 우울증척도가 학대 비경험군에 비하여 매우 유의하게 높았다(p<.01). 3) 16세이전 학대를 당했던 경우 학대 비경험군에 비하여 SCL-90-R 증상척도중 우울증, 불안, 적대감, 정신증척도가 매우 유의하게 높았으며(p<.01), 강박증척도가 유의하게 높았다(p<.05). 또한 16세이후 학대 를 당했던 경우는 우울증, 적대감척도가 학대 비경험군에 비하여 매우 유의하게 높았으며(p<.01), 16세이전 및 16세이후 학대 경험군의 정신증척도가 학대 비경험군에 비해 매우 유의하게 높았다(p<.01) 결 론： 신체적및 성적 학대는 정신증상정도와 관계있으며 특히 신체적 학대보다 성적 학대를 당한 경우, 16세이 후보다 16세이전에 학대당한 경우 정신증상이 더 나타난다 할 수 있으므로 앞으로 이에 대한 연구가 더욱 필요하리라 생각된다.

Objects：This study was designed to investigate the prevalence and characteristics of abuse and the effect of physical and sexual abuse on the psychiatric symptomatology. Methods：The subjects were 74 female patients who visited the psychiatric outpatient clinic. The author interviewed them, using self-report questionaires composed of the life experiences questionaire, the symptom checklist 90-R. Results： 1) Forty-seven point three percent of the total reported a history of physical abuse(20.3%), sexual abuse(13.5%), or both(13.5%). 2) Symptom checklist scores for obsessive-compulsive, depression, anxiety, hostility and psychoticism were very significantly higher(p<.01), and score for phobic anxiety was significantly higher(p <.05) among those reporting a history of sexual abuse than among those reporting no abuse. As for those reporting a history of physical abuse the scores for obsessive-compulsive and depression were very significantly higher than among those reporting no abuse(p<.01). 3) Symptom checklist scores for depression, anxiety, hostility and psychoticism were very significantly higher(p<.01), and score for obsessive-compulsive was significantly higher(p<.05) among those reporting a history of abuse before 16 years old than among those reporting no abuse. As for those reporting a history of abuse after 16 years old the scores for depression and hostility were very significantly higher than among those reporting no abuse(p<.01), and as for those reporting a history of abuse before and after 16years old the score for psychoticism was very significantly higher than among those reporting no abuse(p<.01). Conclusion：Severity of overall symptomatology is related to a reported history of abuse, since those who reported a history of sexual abuse especially before 16years old has more psychiatric symptomatology. Further research is necessary to understand in depth the impact of abuse on psychiatric symptoms.