본 연구는 국내 여러 대학병원 정신과에 의뢰된 암환자들을 대상으로 내과 및 정신과적 임상 특징과 정신과적 약물 치료 경향에 대해 조사하였다. 대상자들은 우울과 불안을 비롯하여 자살사고, 불면, 의욕감소, 통증 등 여러 증상을 경험하고 있으며 상당수는 우울장애와 불안장애로 진단받았다. 이러한 증상들이 암환자의 삶의 질과 치료 경과에 직접적인 영향을 주는 것으로 알려져 있는 반면 이에 대한 치료 지침은미비한 실정이다. 본 연구는 실제 임상에서 환자들이 호소하는 주된 문제와 함께 약물 치료 경향 및 치료 기간에 대해 제시 하였다. 여러 제한점에도 불구하고 본 조사 결과는 임상의들에게 암환자들의 정신과적 문제와 치료 현황에 대해 정보를 제공하며, 추후 치료 지침 수립에 있어 기초 자료로 활용될 수 있을 것이다.Objectives Antidepressants are frequently used for treatment of psychological distress among cancer patients. The aim of this study is to investigate the characteristics of psychiatric consultations and antidepressant use for cancer patients.
Methods Participants in the study included cancer patients who had been referred for psychiatric consultation. A total of 488 patients were recruited from nine general hospitals in Korea.
Questionnaires based on medical records, including antidepressants prescribed, were investigated by psychiatrists.
Results The most common psychiatric diagnosis of subjects was depressive disorders (72.4%),followed by anxiety disorders (13.0%), and adjustment disorders (7.3%). Antidepressants were prescribed for 96.3% of subjects and escitalopram, mirtazapine, and paroxetine were prescribed frequently, in order. Anxiolytics and hypnotics were used for 58.2% of the subjects, for which lorazepam and alprozolam were preferred. During the study period, 226 (46.8%) subjects discontinued treatment and the most common cause was improvement of symptoms (123, 54.4%).
Conclusion Our results showed a tendency of prescription of antidepressants and anxiolytics and common psychiatric problems in Korean cancer patients. We suppose that these data would be helpful to clinicians who manage psychiatric symptoms of cancer patients.