주요우울장애 환자의 퇴원 이후 외래 유지 치료에 미치는 요인

Abstract

ABSTRACT

The factors affecting follow-up treatment of major depressive disorder after discharge

Lim dae-chang Advisor : Prof. Kim sang-hoon M.D. Ph.D Department of Medicine, Graduate School of Chosun University

Objectives This study aims to identify sociodemographic, disease-related and pharmacological variables associated with continuity of outpatient treatement after discharge of patient with major depressive disorder.

Methods The medical records of patients who discharged with the diagnosis of major depressive disorder from department of psychiatry, Chosun university hospital in 2008-2011 were reviewed. Data on sociodemographic, disease-related and pharmacological variables were analyzed.

Results Comparing sociodemographic variables, 12-month follow-up group showed higher rate of old age(p=0.043) and female(p=0.006) than non follow-up group. Comparing disease-related variables, 3-month non follow-up group showed higher rate of none of previous psychiatric treatment history(p=0.008), less than a week index hospitalization(p=0.0 17), against discharge(p=0.002). 12-month follow-up group showed higher rate of voluntary admission(p=0.043), duration of illness of 1-5years(p=0.049), presence of previous psychiatric treatment history(p= 0.0001), recurrence(p=0.012), 2-3weeks index hospitalization(p=0.014) and showed low rate of against discharge(p=0.004), suicidal attempt history(p=0.003). Comparing pharmacological variables, 12-month follow-up group showed higher rate of prescription of antianxiety drug at discharge(p=0.020).

Conclusion The none of previous psychiatric treatment history, less than a week index hospitalization, against discharge were related to an increased likelihood of 3-month non follow-up of patients with major depressive disorder after discharge. And female, voluntary admission, duration of illness of 1-5years, presence of previous psychiatric treatment history, prescription of antianxiety drug at discharge, 2-3weeks index hospitalization were related to an increased likelihood of 12-month follow-up. But against discharge, suicidal attempt history were related to a decreased likelihood of 12-month follow-up.

KEY WORDS : Psychiatric outpatient treatment, Major depressive disorder, Predictor, Follow-up treatment.