정신분열증 경과중 Dexamethasone 억제 검사의 변화

Other Titles
Dexamethasone Suppression Test During Active Psychotic State of Schizophrenia
Authors
박영남강석헌
Department
Dept. of Psychiatry (정신건강의학)
Issue Date
1987
Citation
Keimyung Medical Journal, Vol.6(2) : 300-306, 1987
Abstract
요 약 정신분열증의 경과중 DST와 정신병리의 관계를 조사하기 위하여 입원치료를 요하는 25명의 정신분열증환자를 대상으로 입원 제1주와 제4주에 DST를 실시하였다. DST와 함께 BPRS, HRSD, BDI를 이용하여 정신병리를 평가하였다. 기준혈청 cortisol 값은 입원 제1주(8.90±4.08㎍/dl)와 제4주(8.06±3.95㎍/dl)사이에 변화가 없었으나 Dexamethasone 투여후 혈청 cortisol 값는 입원 제1주(4.23±3.45㎍/dl)에 제4주(1.80±2.25㎍/dl)에 비하여 유의하게 높았다. Dexamethasone 투여후 혈청 cortisol 값이 5㎍/dl 이상을 비억제로 규정하여 입원 제1주에는 25명중 9명(36%), 제4주에는 25명중 2명(8%)가 비억제였다. DST 비억제군과 억제군사이에 BPRS, HRSD, BDI의 총점에는 유의한 차이가 없었으나 개별항목들을 비교할때 BPRS의 긴장, 신체에 대한 관심, 불안, HRSD의 신체불안, 말기수면장애 등이 비억제군에서 높았으며 이러한 증상들은 정신분열증이나 우울증의 핵심증상들이 아니고 여러 정신질환에서 흔히 보는 비특이한 불안증상들이다. 본 연구의 성적은 정신분열증에 나타난 DST 비억제는 stress에 동반한 비특이한 생물학적 반응이라는 가설을 지지한다.
To understand the relationship between DST and psychiatric symptoms in schizophrenia, 25 hospitalized schizophrenic patients underwent DST during 1st week of their hospitalization along with BPRS, HRSD and B야 at the same time. There were no significant differences between mean vaseline cortisol levels at first week(8.90±4.08㎍/dl) and 4th week (8.06±3.95㎍/dl) but mean postdexamethasone cortisol levels were significantly higher at first week (4.23±3.45㎍/dl) than at forth week(1.80±2.25㎍/dl). When DST nonsuppression was defined as above 5㎍/dl of postdexamethasone cortisol level, 9 of 25(36%) at first week and 2 of 25(8%) at 4th week were nonsuppressors. There were no significant differnces of total scores of each of BPRS, HRSD and BDI between nonsuppressors and suppressors. Among indevidual symptoms, tension, somatic, concern and anxiety of BPRS, and somatic anxiety and psychic anxiety of HRSD were higher in nonsuppressors. Those symptoms that were higher in nonsuppressors were not the essential symptoms of either schizophrenia or depression. This result support the hypothesis that DST nonsuppression in schizophrenia was from nonspecific stress reaction.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/14489
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Psychiatry (정신건강의학)
2. Keimyung Medical Journal (계명의대 학술지) > 1987
Keimyung Author(s)
박영남
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