우울 장애 환자 중 자살 고위험군의 심리적 특성: MMPI-2-RF를 이용하여

Abstract

본 연구는 정신건강의학과에 내원한 환자들을 대상으로 MMPI-2-RF를 통해 우울장애를 진단받은 환자들 중 자살 기도 과거력이 있는 집단과 자살사고만 있는 집단, 그리고 정상 대조군 사이의 심리적 특성을 알아보았다. 우울장애를 진단받은 두 집단은 정상 집단보다 정서적/내재화 문제 (EID), 의기소침(RCd), 역기능적 부정정서(RC7), 부정적 정 서성/신경증(NEGE-r), 인지적 증상 호소(COG), 자살/죽음 사고(SUI), 무력감/무망감(HLP), 자기 회의(SFD), 스트레 스/걱정(STW) 척도 등에서 유의하게 상승하였고, 특히 자 살기도 과거력이 있는 우울집단은 자살사고만 있는 우울집 단에 비해 행동적/외현화 문제(BXD)에서 유의미한 차이를 보였다. 이를 통해 MMPI-2-RF가 자살 고위험군에서 자살 을 예측하는 도구로서 유용할 것이며, 특히 충동성의 문제는 실제 자살 행동과 강한 관련성을 갖는 것으로 보인다. Objectives The purpose of this study was to examine whether or not MMPI-2-RF can be used as a useful tool to differentiate between the subtypes of high suicide risk among patients with depression. Methods Patients were recruited from the department of psychiatry at a university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed, and participants were put into three groups (Depression with suicide attempt, Depression with suicide ideation, and Normal as a control group). For statistical comparison, MANCOVA with gender as a covariate was used. Results Similar to pervious research, the two Depression groups with high suicide risk showed significantly higher Emotional/Internalizing Dysfunction, Negative Emotionally/Neuroticism-Revised, Demoralization, Dysfunctional Negative Emotions, Suicidal/Death Ideation, Helplessness/ Hopelessness, Self-Doubt, Stress/Worry, and Cognitive complaints than the normal group. In the Depression with suicide attempt group, Behavioral/Externalizing Dysfunction scales were significantly higher than the Depression with suicide ideation group. Conclusion The results show the significant prediction of MMPI-2-RF scales for suicide risk. Severity of mental pain (EID) and impulsive acting-out tendency of mental pain (BXD) were identified as important psychological characteristics of depression patients with suicide risk. The limitations of this study and suggested directions for future research are also discussed.