소셜미디어를 통한 우울 경향 이용자 텍스트 양상 분석

서하림 연세대학교 대학원 2019 국내석사

Depression is a serious psychological disease that is expected to afflict an increasing number of people, raising concerns about its effects and those of related diseases. However, one of the main problems in treating depression is its identification because its symptoms are common and not always the product of depression. Those who suffer from depression are often reluctant to their condition and so do not seek treatment. Studies on depression have been conducted in the context of social media because social media is a platform through which users often frankly express their emotions and often reveal their mental states. However, the text are unstructured data such that any expressions associated with depression are likely to be unique (Hoyun Song et al. 2017). Various studies have been conducted on the analysis of social media data to detect user depression in various countries, but few such studies have been conducted in South Korea, so in this study large amounts of Korean text were collected and analyzed to determine whether such data could be used to detect depression in users. This study analyzed data collected from Twitter users who had and did not have depressive tendencies between January 2016 and February 2019. The data for each user was separately analyzed before and after the appearance of depressive tendencies to see how their expression changed. Regarding of data collection, data were automatically collected which searched Twitter for depression diagnostic expressions such as “depression diagnosis” and “depression prescription” instead of surveys which were frequently used in other studies. These data were subjected to preprocessing based on a stop word list. In this study the data were analyzed through co-occurrence word analysis, topic modeling, and sentiment analysis. Co-occurrence word analysis showed that users without depressive tendencies were more likely to use words such as “politics,” “citizens,” “participation,” and “life”. Users with depressive tendencies wrote words related to depression and to human relationships, such as “mom” and “friend”. This difference was also found in the same users over time before and after exhibiting depressive tendencies. Dirichlet Multinomial Regression (DMR) topic modeling showed that users differed in the types of words for each of 20 topics they used before and after exhibiting depressive tendencies. Especially, users who were not expressing depressive tendencies tended to highly care about topics such as the arts, including ‘writing(photography, painting)’, ‘religion’, ‘feelings - expression and behavior’ and ‘broadcasting’ and ‘acting’. Users with depressive tendencies responded more to topics such as ‘gender issues’, ‘sex offenses’, ‘appearance and fashion’, ‘country’, and ‘depression’. Users with depressive tendencies showed more interest in topics related to ‘gender issues’ and ‘sex crimes’ related to ‘women’ than those without depressive tendencies. The sentiment analysis showed that users with depressive tendencies confirmed that the positivity sentiment value of the core topic word differed according to whether the user had begun exhibiting depressive tendencies or not. This study analyzed a large amount of Korean Twitter data to detect depressive tendencies in users. This study’s automated data collection method overcame the limitations of related studies and enabled analyses of data collected over a relatively long period of time. This study also compared the textual characteristics of users with depressive tendencies to those without depressive tendencies. 우울증은 전 세계적으로 많은 사람들이 겪고 있으며, 앞으로도 우울증을 앓고 있는 사람들의 수의 증가와 우울증과 관련된 다른 질병들의 우려 등은 계속될 것으로 전망된다. 그러나 사람들이 쉽게 접하고 겪을 수 있는 정신질환 중 하나지만, 우울증에 대한 대처나 치료에 대해서는 아직도 많은 문제점이 지적되고 있는 실정이다. 이는 우울증의 증상이 사람들이 흔하게 겪을 수 있는 모습으로 나타나게 되면서 사람들이 이를 대수롭지 않게 여기고 넘어가서 우울증에 대해 제대로 치료를 받지 못한다는 점과, 또한 아직 정신질환에 대해 밝히기를 꺼려하고 치료받는 것에 막연히 두려움을 느끼는 거부감에 이러한 우울증 증상에 대해 적당한 시기에 적절한 대처가 이루어 지지 않고 있기 때문이다. 이러한 우울증에 대한 여러 우려와 관심을 바탕으로, 최근에는 다양한 분야에서 꾸준히 우울증에 대한 연구가 시도되고 있다. 특히, 소셜미디어를 통한 우울증 환자와 관련된 연구도 활발하게 이루어지고 있는 분야 중 하나이다. 이는 소셜미디어가 사람들이 본인의 의견이나 생각, 그리고 감정상태에 대해 솔직하게 작성한 글로 데이터가 이루어져 있다는 속성을 바탕으로, 소셜미디어를 통해 해당 이용자들의 감정이나 상태를 파악할 수 있다고 보기 때문이다. 즉, 사람들이 본인의 스트레스나 감정상태에 대해 소셜미디어에 공유한 글들을 살펴봄으로써 그들의 심리와 정신건강에 대해 파악해보고자 하는 접근방법 중 하나로 소셜미디어가 영향력 있는 도구로 받아들여지고 있는 것이다. 그러나, 소셜미디어의 텍스트 데이터를 대상으로 이용자들의 우울증 여부를 판단하고 예측해보려고 하는 많은 연구들의 경우 몇 가지 문제점을 가지고 있다. 먼저 비정형 데이터인 텍스트의 특성과, 우울증 및 감정과 관련된 어휘 표현에는 새로 등장한 단어이거나 사전에 등록되지 않은 형태로 나타날 가능성이 많이 있다는 것이 있다 (송호윤 외. 2017). 특히 선행 연구를 살펴보면, 외국에서는 영어 데이터를 대상으로 하여 소셜미디어에서의 우울증과 관련된 데이터 분석을 위한 다양한 시도들이 이루어 지고 있지만, 국내의 경우에는 소셜미디어에서 우울증 이용자의 한글 텍스트를 대상으로 분석한 연구는 많이 부족한 실정이다. 따라서 본 연구에서는 우울 경향을 보이는 이용자들을 대상으로 많은 양의 한글 텍스트 데이터를 수집하여 분석을 진행해보고자 하였다. 본 연구에서는 우울 경향의 이용자와 그렇지 않은 이용자들의 2016년부터 2019년 2월까지의 트위터 데이터를 수집하였으며, 특히 우울 경향 이용자 중에서도 특정 기간별로도 어떠한 텍스트 양상을 보이는지 보기위해 우울 경향 관측 날짜(Decision)를 기준으로 이전(Before)과 이후(After)와 같이 세분화 된 세 그룹으로 나누어 분석해보았다. 수집 방법에 대해서는, 기존 우울증을 다루는 선행연구의 방법인 설문조사(Survey) 방법이 아닌, 우울 진단 표현을 사용하여 – “우울증 진단”, “우울증 처방” – 해당 표현을 포함하고 있는 트위터 데이터를 자동으로 수집할 수 있는 방법을 사용하였다. 이런 방법을 통해 수집하고 세분화 한 데이터를 대상으로 불용어 사전을 기반으로 정제과정을 거쳐 전처리를 수행하였다. 이후 수집한 데이터로 수행한 동시출현 단어 분석, 토픽모델링, 감성분석 등의 실험을 통해 얻은 실험 결과는 다음과 같다. 먼저 우울 경향을 보이지 않는 이용자와 우울 경향을 보이는 이용자들을 대상으로 수행한 동시출현 단어 분석의 경우, 비(非)우울 경향 이용자의 네트워크에서 확인할 수 있는 군집들의 내용은 ‘정치’, ‘시민’, ‘참여’, ‘생활’ 등과 같이, 보다 일반적이고 다양한 주제들이 고르게 분포되어 있는 모습을 볼 수 있었다. 반면에 우울 경향을 보이는 이용자 네트워크에서는 ‘우울’과 관련된 내용뿐 아니라 ‘엄마’, ‘친구’와 같은 인간관계에 해당하는 내용이 보였으며 특히 ‘여성’, ‘여자’와 관련된 군집이 크게 형성되어있다. 그리고 우울 경향 이용자에서도 기간별로 구분한 그룹을 대상으로 각 기간에서만 등장한 단어들을 분석하였을 때, 주제적 차이를 보이는 것을 확인할 수 있었다. 두 번째로, DMR 토픽모델링의 결과로는 포착된 20개의 주제항목마다 비우울 경향/before 그룹/ decision 그룹/ after 그룹 마다 어느정도 차이를 보이는 것을 알 수 있었다. 비(非)우울 경향 이용자들은 ‘기록(글,사진,그림)’, ‘종교’, ‘느낌’, ‘표정/행동’, ‘방송/연기’, 등의 주제에 높은 반응을 보였고, 반면에 우울 경향 이용자들은 ‘젠더이슈’, ‘성범죄’, ‘외모/패션’, ‘국가’, ‘우울’ 이라는 주제에 더 큰 반응을 보였다. 특히 동시출현 단어 분석과 토픽모델링 실험 수행 후 주목할만 한 특성으로는 우울 경향 이용자들이 그렇지 않은 이용자들보다 ‘여성’과 관련된 젠더이슈 및 ‘성범죄’와 관련된 주제에 더 많은 관심과 언급을 보인다는 점이다. 세 번째로, 우울 경향 이용자들의 기간별 감성분석 실험에서도 긍정/부정의 감성값에서 핵심 중심 단어와 동시에 출현하는 단어들의 주제 범위들이 기간에 따라 어느정도 차이가 있는 것도 확인할 수 있었다. 이러한 실험을 통해, 본 연구는 우울증이라는 정신질환에 대해 한글로 된 많은 양의 트위터 데이터를 수집하여 분석을 시도했다는 점에서 유의미하다고 볼 수 있다. 또한 기존의 설문조사를 기반으로 한 데이터 수집방법이 아닌, 자동 수집 방법을 통해 기존 방법의 한계를 보완하여 비교적 긴 기간동안의 데이터 수집을 통해 다양한 분석시도가 가능했다. 이 외에도 단순히 우울 경향을 보이는 이용자와 그렇지 않은 이용자간 특성을 비교할 뿐 아니라, 더 나아가 우울 경향 이용자들의 기간별 텍스트 양상을 추적하여 우울 경향 이용자들의 특성을 파악하려고 했다는 점에서 효용성이 있다고 본다.

우울증을 통한 윌리엄 스타이론과 니콜라이 고골의 비교 연구

Azamat Ganiev 충북대학교 2016 국내석사

William Styron was one of the most influential American authors of the 20th century. He was a master of prose and one of a group of highly respected American writers who continued the traditions set by Hemingway and Faulkner. He is considered by the international press to be not only a great literary stylist, but also a born storyteller. Styron is widely known for his novel "Confessions of Nat Turner", which describes the uprising of black slaves led by Nat Turner, beginning in 1831 in Virginia. This was one of William Styron’s most controversial novels but also the most commercially successful. It was first published in 1967, and has since spawned many editions and been translated into 20 languages. In the wake of the civil rights struggle, Styron was awarded the Pulitzer Prize for the novel "Confessions" in 1968, and in 1970 received a Medal Howells (Howells medal) from the American Academy of Arts and Letters. Even if William Styron enjoyed success as one of the most well-known American writers, he abused alcohol at his 40 years. He saw drinking as the daily washing of his mood. When he was in his 60’s, Styron suddenly appeared to develop a complete alcohol intolerance, and just one sip of wine could cause nausea and a state of stupefaction. Without daily servings of alcohol Styron began to develop severe depression and his mood for the next six months deteriorated to the extent that he had thoughts of suicide. In 1990 he wrote "Darkness Visible," which most vividly described his struggle with depression. In this work I am going to write about the origin of the word “depression”; types of depression, the possible causes for the depression and how we can see depression reflected in literature. This thesis will look at Styron, who ultimately survived his depression, and the Russian 19th century author Nikolai Gogol who eventually killed himself after a long time suffering from depression. Firstly the focus is on Styron’s book specifically about his struggle with depression, Darkness Visible. I will try to explain the reason for his madness and understand his point of view according to his book. He struggled with depression and although this could have been misunderstood by his habits of drinking alcohol every day, it was this mental disorder which caused serious problems between him and his family, friends and loved ones. William Styron chooses the best way of talking about his problems with the readers, as he is giving information and helpful advice to somebody who is struggling with the same depressive mood as he suffered. He does not feel uncomfortable talking to his readers but he understands how it might be helpful for him to give practical advice from personal experience. After I have considered William Styron’s work on depression, I will compare it to the work of a prominent Russian author from the 19th century, Nikolai Vasilyevich Gogol. It is an interesting comparison as their environment is so different (different eras, different countries, different experiences) but their disease is the same. Ultimately their main difference is that Styron was able to overcome his demons, but Gogol eventually succumbs to them and ended his own life aged just 43. Gogol also didn’t write directly about his experience with depression, and he was never formally diagnosed with it, but symptoms of his depression became clear after his death. It is important to look at influential writers experiences with depression, as these are the people other sufferers of depression may relate to when they are having trouble. Styron in particular helped many people overcome their difficulties, whereas Gogol created as a cautionary tale for how dangerous it was not to get the right treatment. Depression is, simply, a mental disease, but it seems to matter a lot to both writers and sufferers of depression in terms of how much support they get from people who understand their feelings.

우울증 치료용 웨어러블 기술 제품의 수용 의도 : 우울증 정도의 조절 효과를 중심으로

형원원 제주대학교 대학원 2021 국내석사

Depression: Moderation Effects of Depression Degree, using a wearable device named “Flow” aimed at treating depression with a technique called tDCS (transcranial direct current stimulation) developed by a Swedish company. In recent years, attention has been called to the drastically increased number of depression patients. In the context of flawed conventional treatment, this study creates a TAM (technology acceptance model) based model for depression treatment wearables, combining the features of the product and users. The independent variables include innovation, social influence, mobility, perceived cost and result demonstrability; the dependent variables include perceived usefulness, perceived ease of use, attitude and behavioral intentions; the moderating variable is depression degree. This study analyzes the degree of influence by independent variables and the effects of the moderating variable using SmartPLS 3.0 based on 386 conducted surveys. It is found out that innovation, social influence, mobility, perceived cost, result demonstrability, and perceived ease of use directly affect perceived usefulness; innovation and mobility affect perceived ease of use; social influence and perceived cost do not affect perceived ease of use. For a clearer and more systematic view of how independent variables affect dependent variables, 2nd Order CFA(Second Order Confirmatory Factor Analysis) method is utilized to prove the influence of external factor on perceived usefulness and perceived ease of use. It is also proved that perceived usefulness and perceived ease of use directly affect attitude, and attitude directly affects perceived usability. In the moderation study of depression degree, it is concluded that depression degree moderates 1) how social influence affects perceived usefulness, 2) how perceived ease of use affects perceived usefulness, and 3) how attitude affects behavioral intentions. Other assumptions of moderation effects are not proved. In a nutshell, this study sheds some light on the application and acceptability of new wearable products, and the popularization of depression treatment knowledge.

Stress increases depression-like behaviors in Alzheimer’s disease mice

유승식 충북대학교 2022 국내석사

알츠하이머성 치매 (AD) 는 인지 장애, 기억 상실, 행동 변화 및 기능적 능력 상실을 특징으로 하는 치매의 가장 흔한 질환이다. 또한, 우울증은 AD 환자에게서 흔히 나타나는 동반 질환이다. 최근 AD는 우울증과 병태생리학적으로 공통된 기전을 공유한다는 것이 밝혀졌다. 만성 스트레스는 글루코코르티코이드 (GC)의 분비를 증가시키고 글루코코르티코이드 수용체 (GR)에 결합하여 뇌의 기능을 조절한다. 많은 양의 GC 분비는 아밀로이드 전구체 단백질 (APP)의 잘못된 processing과 아밀로이드 베타 (Aβ) 생성을 유발하여 AD를 유발한다. 또한, 우울증은 스트레스와 관련된 질병으로 잘 알려져 있으며 코르티솔 수치가 우울증의 바이오마커로 사용된다. 나는 우울증과 AD의 관계를 조사하기 위해 Tg2576 마우스와 WT 마우스를 10일 동안 물 회피 스트레스 (WAS)에 노출시켰다. WAS 에 노출시킨 이후 Tg2576 WAS 마우스 를 대상으로 기억 기능 및 우울증 관련 행동실험을 진행하였다. 우울증 관련행동실험에서는 Tg2576 WAS 마우스가 WT WAS 마우스 및 Tg2576 CON 마우스보다 더 우울한 행동을 나타내는 것으로 확인하였다. 또한, Tg2576 CON 마우스는 WT CON 마우스보다 더 우울한 행동을 나타내었다. 나아가,코르티코스테론 수치와 인산화된 글루코코르티코이드 수용체 (p-GR)도 Tg2576 WAS 마우스에서 Tg2576 CON 마우스보다 더 높게 나타났다. SPNS2의 주요 기능은 S1P 를 밖으로 방출하는 역할을 한다. GEO 데이터베이스는 AD 및 우울증 환자에서 SPNS2 유전자 발현을 분석하는 데 사용되었다. 결과는 SPNS2의 유전자 발현이 AD 및 우울증과 상관관계가 있음을 보여 주었다. 다음으로 Tg2576 WAS 마우스에서 SPNS2의 발현정도를 확인하였다. Tg2576 WAS 마우스에서 SPNS2의 발현량은 Tg2576 CON 마우스와 비교하였을 때 크게 증가하였다. 또한 SPNS2 발현이 세포 내 S1P 수준을 감소시키면서 세포외 S1P level이 증가되는지를 확인하기 위해 Tg2576 WAS 마우스 의 뇌와 혈청에서 S1P level을 측정하였다. Tg2576 CON 마우스와 비교하여 뇌의 S1P level은 증가하였고 혈청에서 S1P level은 감소하였다. 또한, stress 는 뇌의 S1P 수치를 더욱 감소시켰다. 그러나 혈청 내 수치는 더욱 증가하였다. 따라서 이러한 결과는 AD와 우울증이 연관성이 있으며, 스트레스 매개 우울증이 SPNS2를 상향 조절함으로써 S1P의 방출을 통해 Tg2576 형질전환 마우스에서 더 많은 영향을 미칠 수 있음을 나타낸다. Alzheimer’s disease (AD) is the most common form of dementia characterized by cognitive impairment, loss of memory, behavioral changes and loss of functional abilities. Depression is a common co-morbidity seen in people with AD. Recent evidence suggests that AD and depression share common mechanisms of pathogenesis. Chronic stress leads to increased secretion of glucocorticoid (GC) and modify brain functions by binding glucocorticoid receptor (GR). High levels of GC secretion, triggers AD by causing the misprocess of amyloid precursor protein (APP) and the production of amyloid-beta (Aβ). Moreover, depression is well-known stress related illness and elevated levels of cortisol are used as a biomarker of depression. To investigate relationship between depression and AD, water avoidance stress (WAS) was induced for 10 days in both Tg2576 mice and wild-type (WT) mice. After WAS, memory function and depression-related test were investigated in Tg2576 WAS mice. On depression-related behavioral tests showed that Tg2576 WAS mice exhibited more depressive behaviors than WT WAS mice and Tg2576 CON mice. Tg2576 CON mice showed more depressive behaviors than WT mice. Moreover, corticosterone levels and phospho-glucocorticoid receptor (p-GR) were also higher in Tg2576 WAS mice than in Tg2576 CON mice. Sphingolipid Transporter 2 (SPNS2) is a Sphingosine-1-Phosphate (S1P) transporter. GEO database was used to analyze SPNS2 gene expression in AD and depression patients. The reults shows that SPNS2 gene expression correlates with AD and depression. Next, expression level of SPNS2 in Tg2576 WAS mice brains was measured. In Tg2576 WAS mice, SPNS2 was significantly increased compared with Tg2576 CON mice. SPNS2 was also higher in Tg2576 CON mice compared with WT CON mice. To study whether increased SPNS2 expression release more level of S1P, the S1P levels in the Tg2576 WAS mice brains and serum were measured. Compared with Tg2576 CON mice, the S1P level in the brains was decreased, but was increased in the serum. Moreover, WAS treatment further decreased S1P level in the brains. However, the level in the serum further increased. Therefore, these results indicate that AD and depression could be associated, and stress mediated depression could affect more in Tg2576 transgenic mice through the release of S1P by up-regulating SPNS2.

Association between Depression and Anemia with Physical activity by Isotemporal Substitution Analysis

남희경 서울대학교 대학원 2021 국내석사

Introduction: Depression is one of the important cause of Years Lived with Disability(YLD) for female in 2017. In Korea, prevalence of depression in 2014 was 6.7% for total population. Also, it is one of the main causes of death regarding to suicide. Anemia is prevalent worldwide with the 32.9% of prevalence in 2010. In Korea, about 7.4% people are affected by the disease, anemia. Physical activity is beneficial not only physically but also socially and psychologically. Especially team-based activities work as a role of social integration compare to sedentary activities such as watching television while seated. Many studies presented that physical activity has a protective effect on the depression. In addition, association of the depression and anemia has been studied by several studies. In spite of the association of the three keywords, association of depression, anemia and physical activities has not been studied. The purpose of this study is first, to observe different effect of the physical activity(effect modification) on depression related to anemia. Second, to measure the time substitution effect on depression according to types of the physical activities. Methods: This study is a cross-sectional study with the Korean National Health and Nutrition Examination Survey(KNHANES) data. Depression examination had been conducted by Patient Health Questionnaire-9(PHQ-9), physical activity has been measured by Global Physical Assessment Questionnaire(GPAQ) and for the anemia, hemoglobin status was considered. For all the analysis, SAS 9.4 has been utilized. Result: Effects of the physical activity were different between anemic patients and non-anemic patients. In anemia group, more than ten minutes of moderate physical activity(OR: 0.526, CI:0.296 – 0.937), moderate to vigorous physical activity(OR: 0.543, CI: 0.326 – 0.905) and walking(OR: 0.670, CI: 0.457 – 0.982) had statistically significant protective effect on depression compare to those with less than ten minutes of exercise when adjusted. In non-anemic group, more than ten minutes of moderate physical activity(OR: 0.746, CI: 0.0644 – 0.864), moderate to vigorous physical activity(OR: 0.749, CI: 0.655 – 0.856), walking(OR: 0.733, CI: 0.641 – 0.838) and muscle training(OR: 0.825, CI: 0.723 – 0.940) were statistically significant compare to those who exercised less than ten minutes when adjusted. According to the time substitution analysis, isotemporal substitution model was not significant in anemic patients, however, substitution of sedentary behaviors to walking(OR: 0.985, CI: 0.976 – 0.995) and to moderate to vigorous physical activity(OR: 0.958, CI: 0.929 – 0.987) showed significant protective effect on depression in non-anemic participants. As shown in partition model, moderate to vigorous physical activity(OR:0.580, 0.346 – 0.971) presented the significant protective effect for the anemic group. For the non-anemic group, walking(OR: 0.767, CI: 0.671 – 0.876) and moderate to vigorous physical activity(OR: 0.783, CI:0.684 – 0.896) revealed to have the protective effect on depression. Conclusion: Physical activity had a certain protective effect on depression, however it was different by anemia status. For the anemia patients, moderate to vigorous physical had an association of lower risk of depression. In other hands, for the non-anemic patients, walking and moderate to vigorous physical activity had significant association related to lower risk of depression. Regarding to time-replacement approach by isotemporal substitution analysis, walking and moderate to vigorous physical activities showed significant protective effect on depression when it substituted by sedentary behaviors only in non-anemic group. 배경: 우울증은 2017년 여성 장애 보정 손실 수명(Years Lived with Disability, YLD)에 있어 주요한 원인 중 하나이다. 한국의 2014년 우울증 유병률은 전체 인구의 6.7%이다. 또한, 우울증은 자살의 주요 사망 원인 중 하나이다. 전 세계적으로, 빈혈은 2010년 유병률은 32.9%이다. 한국의 경우 약 7.4%가 빈혈로 인한 영향을 받고 있다. 신체활동은 신체적인 부분 뿐만 아니라, 사회적으로, 또는 심리적으로도 유익하다. 특히 단체로 하는 신체 활동은 앉아서 텔레비전을 보는 것과 같은 좌식 활동과 비교했을 때, 조직에의 참여 또는 사회활동참여의 역할을 한다. 많은 연구들은 신체활동이 우울증에 보호 효과가 있음을 제시하였다. 또한, 우울증과 빈혈의 연관성은 여러 연구에 의해 연구되어 왔다. 세 가지 주요어의 연관성에도 불구하고, 신체활동, 빈혈 그리고 우울증을 고려한 연구가 이뤄지지 않고 있다. 따라서 본 연구의 목적은 첫째, 빈혈과 우울증에 대한 신체 활동(효과 변경 인자)의 영향을 알고자 한다. 둘째, 등시간대체 분석법을 통해, 우울증에 대한 신체활동의 시간 대체 효과를 측정하고자 한다. 연구 방법: 본 연구는 한국 국민건강영양조사(KNHANES) 2014, 2016, 그리고 2018년 자료를 활용한 단면연구이다. 우울증 검사는 9가지 항목의 총합 점수를 이용하여 우울감의 여부 및 심각도를 판단하는 우울증 평가 도구(PHQ-9)에 의해 실시되었고, 신체활동은 국제신체평가도구(GPAQ)에 의해 측정되었으며, 빈혈은 헤모글로빈 수치를 고려하였다. 표본에 가중치를 적용하여 국민 전체의 대표성을 가진 결과로 분석하고자 하였다. 모든 분석에는 SAS 9.4가 활용되었다. 결과: 우울증에 대한 효과 변경 인자로서 신체활동의 역할은 빈혈의 유무에 따라 달랐다. 빈혈 환자 집단에서 10분 이상의 중강도 신체활동(OR: 0.526, CI:0.296 – 0.937), 중고강도 신체활동(OR: 0.543, CI: 0.326 – 0.905) 및 걷기(OR: 0.670, CI: 0.457 – 0.982)를 실천한 사람은 10분 미만의 중강도 신체활동, 중고강도 신체활동 그리고 걷기를 실천한 사람에 비해 우울증에 있어 통계적으로 유의한 보호효과를 보였다. 반면에, 빈혈이 없는 집단에서는 10분 이상의 중강도 신체 활동(OR: 0.746, CI: 0.0644 – 0.864)과 중고강도 신체 활동(OR: 0.749, CI: 0.655 – 0.856)과 걷기(OR: 0.733, CI: 0.641 – 0.838), 근력 운동(OR: 0.864)을 실천한 사람들이 10분 미만의 중강도 신체활동, 중고강도 신체활동, 걷기 그리고 근력 운동을 실천한 사람에 비해 우울증에 있어 통계적으로 유의한 보호효과를 나타냈다. 등시간 대체 분석의 경우, 빈혈 환자 그룹에서는 시간 대체 모델(Isotemporal substitution model, ISM) 결과가 유의하지 않았다. 반면에, 빈혈이 없는 그룹에서는 앉아서 보내는 시간(Sedentary behavior, SB)을 걷기(OR: 0.985, CI: 0.976 – 0.995) 또는 중강도 운동(OR: 0.958, CI: 0.929 – 0.987)으로 대체했을 때, 우울증에 유의미한 보호 효과를 보였다. 마지막으로, 파티션 모델(partition model) 결과에 따르면, 중강도 신체활동(OR:0.580, 0.346 – 0.971)은 빈혈 집단에 있어서 유의미한 보호 효과를 나타냈다. 빈혈이 없는 집단의 경우 걷기(OR: 0.767, CI: 0.671 – 0.876)와 중강도 신체활동(OR: 0.783, CI:0.684 – 0.896)에 있어 우울증에 대한 보호 효과가 관찰되었다.

Study on the Role of Habenular Calcium-dependent Secretion Activator 2 in Depression

Hyeijung Yoo 고려대학교 대학원 2023 국내박사

우울증은 전세계적으로 유병률이 높은 심각한 정신질환으로, 사회경제적 부담 또한 매우 크다. 세계보건기구(world health organization)에 따르면, 전 세계적으로 약 2억 6천만 명이 우울증으로 고통받고 있으며, 남녀 모두에서 건강상실년수 (years lived with disability)의 증가에 가장 큰 원인 중 하나이다. 주요 우울 장애 환자의 60 ~ 70%만이 1차 약물요법에 반응하며, 치료 저항성 우울증 환자는 전체의 3 분의 1 이상이다. 따라서 우울증의 병태생리 연구는 인류의 정신건강 향상을 위해 매우 중요하다. 고삐핵(habenula)은 전뇌 영역과 중뇌 및 후뇌 영역을 연결하는 시상상부의 작은 핵으로, 다양한 유전자 발현 패턴에 의해 내측(medial habenula, MHb)과 외측(lateral habenula, LHb) 고삐핵으로 나눠진다. 고삐핵은 우울증, 조울증, 정신분열증, 약물 사용 장애를 포함한 다양한 정신 질환과 관련이 있다고 알려졌으나, 고삐핵의 신경정신질환 병태생리에서의 작용기전에 관해서는 추가적인 연구가 필요하다. 만성 스트레스 우울증 동물 모델과 자살 환자의 고삐핵에서 대조군에 비해 차등 발현하는 유전자(differentially expressed genes, DEGs)를 확인하기 위해서 유전체 분석을 진행하였다. 그 결과, 만성 스트레스 동물 모델에서 신경 활성 리간드-수용체 상호 작용 및 시냅스 신호와 관련된 생물학적 경로에 작용하는 유전자들이 발현의 변화를 보이는 것을 확인하였다. 차등 발현 유전자 목록을 고삐핵 단일 세포 RNA 염기서열분석 데이터(GSE137478)를 비교한 결과 많은 수의 유전자가 내측 고삐핵 신경세포에 풍부하게 존재하였다. 우울증 자살환자의 사후 고삐핵 조직을 이용한 유전체 분석에서, 주요 차등발현 유전자가 내피세포에서 주로 발현되어 혈액-뇌장벽의 유지와 혈관구조 발달과 관련이 있음을 확인하였다. 따라서, 고삐핵 유전체 분석을 통해 우울 증상에 영향을 미치는 유전자와 생물학적 경로에 대해 확인할 수 있었다. 칼슘 의존성 분비 활성화 단백질 2(calcium-dependent secretion activator 2, CAPS2 또는 CADPS2)는 신경펩타이드 분비를 매개하며, 내측 고삐핵 특이적인 발현을 보인다. 또한 CAPS2는 만성 스트레스 우울증 동물 모델 유전자 발현 분석에서 시냅스 신호전달경로에 관여하는 차등발현 유전자 중 하나이다. 내측 고삐핵 CAPS2 유전자의 발현을 감소시킨 생쥐의 우울 증상을 확인한 결과, 꼬리 현수 검사(tail-suspension test) 및 강제 수영검사(forced swim test)에서 절망감 증상이 유발되는 것을 확인하였다. 전자현미경으로 내측 고삐핵의 하위 부위인 각간핵(interpeduncular nucleus)을 관찰한 결과, 시냅스 전 축삭 말단에 치밀 소포체(dense-core vesicle)가 대조군에 비해 많이 축적되어, 내측 고삐핵 축삭 말단에서 신경펩타이드 분비가 감소되었음을 확인할 수 있었다. 또한, 각간핵, 복측피개핵(ventral tegmental nucleus)과 등쪽솔기핵(dorsal raphe nucleus)을 포함하는 모노아민 중추에서 신경세포 활성이 감소하여 내측 고삐핵의 CAPS2가 내측고삐핵−각간핵 간 신경회로에서 신경펩타이드 분비 조절을 통해 우울증상에 관여함을 확인할 수 있었다. 이 연구에서는, 만성 스트레스 우울증 동물모델 및 우울증 자살환자의 고삐핵 유전체 분석을 통해 유전자 발현 변화 및 관련 생물학적 경로를 확인하였으며, 우울증에 관여할 가능성이 높은 유전자인 CAPS2를 선별하여 우울증상 발현에서의 작용기전을 규명하였다. 이상의 연구 결과는 우울증 및 스트레스 관련 정신 질환에서 고삐핵의 중요성을 밝혔으며, 향후 우울증 병태생리 연구에 기여할 것으로 생각한다. Depression is a serious psychiatric disorder widely distributed in the population and imposing a substantial socioeconomic burden. According to the WHO, 260 million people worldwide suffer from depression, and it is one of the biggest causes of years lived with disability for both men and women. Only 60 to 70% of major depressive disorder patients respond to first-line therapy, and of all depressive disorder patients, over one-third are treatment-resistant. Thus, researching the underlying mechanisms of depression and investigating new therapeutic targets should be a priority. The habenula is a small nucleus in the epithalamus, connecting the forebrain areas to the midbrain and hindbrain regions. It is subdivided into medial (MHb) and lateral habenula with associated differences in gene expression. The habenula is involved with various psychiatric disorders, including depression, bipolar disorder, schizophrenia, and substance use disorders. However, further investigations into the underlying mechanism of the relationship between the habenula and the pathophysiology of neuropsychiatric diseases are needed. To investigate the molecular mechanisms of the habenula in depression, I analyzed genome-wide gene expression in the habenula of chronically stressed rats and human suicide cases to identify differentially expressed genes (DEGs) compared to unaffected control groups. Using the animal model of depression, genetic profile and bioinformatics analysis identified important biological pathways related to DEGs, such as neuroactive ligand-receptor interaction and synaptic signaling. Comparing the DEG list with habenular single-cell RNA-sequencing data (GSE137478) showed that these critical genes are enriched in the MHb neurons. Using the human postmortem habenular gene analysis, the DEGs, which were cell-type markers in single-cell RNA sequencing data, were found to be enriched in endothelial cells and related to the maintenance of the blood-brain barrier and vasculature development. The gene expression analysis suggested a list of genes and biological pathways that affect the depressive phenotype in the habenula. In the gene expression analysis of chronically stressed rats, calcium-dependent secretion activator 2 (CAPS2 or CADPS2), which mediates neuropeptide secretion, was one of the DEGs enriched in the MHb and included in the trans-synaptic signaling pathway. Therefore, CAPS2 was selected as the target gene, and the depressive phenotypes of the MHb CAPS2 knockdown mice were investigated. The reduction of CAPS2 expression in medial habenula induced despair-like symptoms in behavioral tests. In the interpeduncular nucleus (IPN), a direct downstream of the medial habenula, decreased neuronal activation and accumulated dense-core vesicles (DCVs) in the presynaptic terminal were observed, indicating reduced exocytosis of DCVs and decreased release of neuropeptides from medial habenular axon terminals. This led to diminished neuronal activation in the IPN and monoaminergic centers, including the ventral tegmental area and the dorsal raphe nucleus. This suggests that medial habenular CAPS2 plays a role in depressive behavior by regulating the neuropeptide secretion of the medial habenula-interpeduncular pathway. In this study, I identified genes with considerably altered expression in chronic stress animal models and suicide patients. CAPS2 downregulation in the habenula confirmed that controlling the gene expression level of DEG within the habenula led to a depressive phenotype. This study shed light on the importance of the habenula in stress and depression, and it should help to identify a mechanism of depression.

유방암 환자에서 혈장 사이토카인과 우울증의 위험성

김선영 전남대학교 대학원 2012 국내박사

Objective Few studies on the prevalence of depression and its association with cytokines have been conducted with patients with breast cancer, and those studies that have been conducted have produced conflicting results. Using a large panel of pro-inflammatory and anti-inflammatory cytokines, this study investigated the prevalence of depression and associated risk factors and examined the association of these variables with plasma cytokines in patients with breast cancer. Method This study was conducted in two stages. Study I investigated 335 patients with breast cancer who had been hospitalized for surgery. All patients were interviewed 2–5 days after surgery, and depression (major and minor depressive disorders) was diagnosed with the Mini-International Neuropsychiatric Interview according to DSM-IV criteria. To analyze risk factors, socio-demographic and clinical characteristics were used as covariates in a logistic regression model. In Study II, data from 273 patients who consented to blood sampling were analyzed. Preoperative plasma samples, including pro-inflammatory cytokines (interleukin [IL]-2, IL-12, interferon [IFN]-γ, and tumor necrosis factor [TNF-α]), anti-inflammatory cytokines (IL-4, IL-5, IL-10, and IL-13), and granulocyte/macrophage colony-stimulating factor (GM-CSF), were obtained for cytokine analysis. Depressed mood was measured with the Montgomery–Åsberg Depression Rating Scale (MADRS) 2–5 days after surgery, when patients could cooperate. Covariates included demographic and clinical characteristics. Associations between MADRS scores and cytokine levels were estimated using linear regression models. Results Of the 335 breast cancer patients analyzed, 80 (23.9%) met criteria for depression. According to the adjusted logistic regression analyses, personal and family histories of depression were significantly associated with current depression (odds ratio [OR]: 2.56, 95% CI 1.09–6.02 and OR: 10.75, 95% CI 1.10–104.99, respectively). In Study II, depressive mood was associated with lower levels of pro-inflammatory cytokines (IL-2, IL-12, and TNF-α), anti-inflammatory cytokines (IL-5, IL-10, and IL-13), and GM-CSF, independent of potential covariates such as living area, history of depression, and functional level. Conclusion Depression is common among Korean women with breast cancer and is related to personal and familial histories of depression. Depressed mood in patients with breast cancer was correlated with decreased levels of several cytokines, which suggests alteration of the immune system. Clinicians should be encouraged to screen for depression and to consider psychiatric consultation to help patients with breast cancer with both the psychological and biological aspects of their conditions.

The Optimal Amount and Appropriate State of Physical Activity for the Prevention of Depression: A Cohort Study

김선영 성균관대학교 일반대학원 2019 국내박사

The aim of this study was to identify the optimal amount and appropriate state of physical activity for preventing the onset of depression. The data of 107,901 participants aged between 18 and 64 years who had undergone comprehensive health examinations at Kangbuk Samsung Hospital Health Screening Center, South Korea, in January 2012 and who were followed up yearly until December 2015 were analyzed. Using the Korean version of the International Physical Activity Questionnaire-Short Form, total physical activity was computed in metabolic equivalents. The Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms, with scores of 21 and above defined as the effective point to indicate “caseness.” A Cox proportional hazards model was used to identify the optimal amount of physical activity for reducing incident depression. Based on whether baseline physical activity and 1-year follow-up of physical activity were lower or higher than the minimal amount of physical activity for preventing the onset of depression, the state of physical activity was classified into four groups: persistent sedentary, maintenance, adoption, and relapse. The relationship between the state of physical activity and risk of depression was identified by Cox proportional hazards models which were used to estimate hazard ratios and 95% confidence intervals (CI). The U- or J-shaped curve showed that 2 to 5 times the minimum recommended amount of physical activity (1,200–3,000 METs-min/wk) was associated with a significantly lower risk of incident depression (1,200–1,800 METs-min/wk: HR, 0.90 [95% CI, 0.82-0.99], 1,800–3,000 METs-min/wk: HR, 0.86 [95% CI, 0.78-0.95]). After stratifying data by sex, the results showed the amount of physical activity for reducing incident depression was higher for men (1,800–3,000 METs-min/wk: HR, 0.84 [95% CI, 0.74–0.95]) than women (1,200–1,800 METs-min/wk: HR, 0.84 [95% CI, 0.71–0.99]). In comparison with the persistent sedentary group, the maintenance group was associated with a significantly lower risk of incident depression in both sexes (men: HR, 0.81 [95% CI, 0.71–0.93]; women: HR, 0.84 [95% CI, 0.75-0.94]). In women, adoption group also had a positive effect on reducing incident depression (HR, 0.87 [95% CI, 0.76–0.99]). This study identified the optimal amount of physical activity for preventing the onset of depression. Regardless of sex, when an appropriate level of physical activity is maintained, it could result in a positive effect on decreasing incident depression. The adoption status, changing from being sedentary to physically active, was efficacious in reducing incident depression for women.

대학생의 자기불일치가 우울 및 불안에 미치는 영향 : 수치심과 죄책감의 매개효과

오현주 연세대학교 대학원 2021 국내석사

본 연구는 대학생을 대상으로 자기불일치가 우울 및 불안으로 이행되는 과정에서 수치심과 죄책감의 매개효과를 검증하였다. 이를 통해 대학생의 주요 심리부적응 지표로서 우울 및 불안의 발생 기제를 밝힘으로써 각기 다른 자기불일치 성향(실제-이상간 자기불일치, 실제-의무간 자기불일치)을 가진 대학생들의 우울 및 불안에 대한 효과적인 치료적 개입을 위한 중간 단계로서 수치심과 죄책감의 차별적인 역할을 밝히는 데 연구의 목적이 있다. 다음은 본 연구의 연구문제이다. 첫째, 실제-이상간 자기불일치, 실제-의무간 자기불일치, 수치심, 죄책감, 우울, 불안 간에는 어떤 관련성이 있는가? 둘째, 수치심과 죄책감은 각각 실제-이상간 자기불일치와 우울 그리고 실제-의무간 자기불일치와 불안의 관계에서 매개효과가 있는가? 이를 위해 전국의 4년제 대학의 학부생을 대상으로 온라인 설문을 실시하였고, 총 403명의 자료를 분석에 사용하였다. 변인들 간의 관련성을 확인하기 위해 상관분석을 하였고, 연구모형의 적합성 및 연구 주요변인 간 영향 관계를 확인하기 위해 구조방정식 분석을 하였다. 다음은 본 연구의 주요 결과이다. 첫째, 실제-이상간 자기불일치, 실제-의무간 자기불일치, 수치심, 죄책감, 우울, 불안은 모두 정적 상관을 보였다. 둘째, 실제-이상간 자기불일치와 우울 간의 관계에서 수치심이 부분 매개하였다. 셋째, 실제-의무간 자기불일치와 불안의 관계에서 죄책감이 완전 매개하였다. 이러한 결과는 본 연구의 가설을 지지하는 것으로, 실제-이상간 자기불일치와 실제-의무간 자기불일치가 서로 다른 경로를 통해 우울과 불안을 유발하며, 그 경로에서 수치심과 죄책감의 차별적인 역할을 경험적으로 확인했다는 의의가 있다. 이는 Higgins(1987)의 자기불일치 이론과 Lewis(1971)의 선행연구를 확대 검증함으로써 각각의 자기불일치 유형이 심리부적응(우울/불안)으로 이어지는 차별적인 심리내적 과정을 밝혔다는 데 의의가 있다. 따라서 우울하고 불안한 심리적 불편감을 호소하는 대학생들을 상담할 때 자기불일치 유형과 그 수준을 확인하고, 그에 동반되는 수치심과 죄책감을 완화하는 것이 바람직함을 알 수 있다. 다만 자기불일치 점수에서 음수값인 집단을 제외하고 양수 값인 집단만을 대상으로 분석했을 때 실제-의무간 자기불일치가 죄책감을 통해 불안을 유발하는 간접효과가 유의하지 않은 반면, 실제-의무간 자기불일치가 불안으로 이행되는 직접효과만 유의했기 때문에 이 변인들 간의 관계에 대해서는 다양한 표본을 통한 반복검증이 요구된다. 핵심어: 자기불일치, 수치심, 죄책감, 우울, 불안 This study examined the mediating effects of shame and guilt on the relationship between self-discrepancy and two indices of psychological problems, depression and anxiety. Through the investigation of what affects young adults’ depression and anxiety, this study aimed to reveal distinct roles of shame and guilt and thus provide an effective intervention to alleviate the level of depression and anxiety for those who have each different type of self-conflicts (actual-ideal discrepancy, actual-ought self-discrepancy). The research questions of the study are as follows. First, are there significant relationships among actual-ideal self-discrepancy, actual-ought self-discrepancy, shame, guilt, depression, and anxiety? Second, do shame and guilt have a mediation effect on the relationship between 1) actual-ideal self-discrepancy and depression and 2) actual-ought self-discrepancy and anxiety, respectively? A total of 403 college students completed an online survey as the basis for data analysis. A correlation analysis method was performed to examine the relationships among the variables for this study and further the goodness of fit of the proposed model and structural relationships among the variables were investigated in application of structural equation modeling (SEM) analysis. The main results of the study were as follows. First of all, actual-ideal self-discrepancy, actual-ought self-discrepancy, shame, guilt, depression, and anxiety were all positively correlated. Second, shame partially mediated the relationship between actual-ideal self-discrepancy and depression. Third, guilt fully mediated the relationship between actual-ought self-discrepancy and anxiety. These results supported the research hypothesis, confirming each actual-ideal self-discrepancy and actual-ought self-discrepancy affects each of the kinds of psychological maladjustment (depression & anxiety) by different paths, and further empirically identified the distinction between shame and guilt in the process. Also, the current study successfully expands the self-discrepancy theory by Higgins (1987) and the previous research on shame and guilt (Lewis, 1971) in that the findings revealed a distinct intra-psychological process whereby each type of self-discrepancy leads to different psychological problems (depression & anxiety). Based on these results, counseling professionals whose clients experience symptoms of depression and anxiety are advised to take account of shame and guilt depending on different types and levels of self-discrepancy for therapeutic intervention. However, additional data analysis of 331 samples in a population of 403, whose average self-discrepancy score had only positive values indicated that the direct effect of self-ought self-discrepancy on anxiety was statistically significant. On the other hand, the indirect effect of guilt in the relationship between self-ought self-discrepancy and anxiety was not significant. Therefore, these results highlight the need for a replication study on the relationship among these variables(self-ought self-discrepancy, guilt, and anxiety) with samples drawn from more diverse populations in future self-discrepancy research. Key Words: self-discrepancy, shame, guilt, depression, anxiety

(The) Relationship between Academic Stress and Depression among Korean Adolescents : The Moderating Effects of Perceived Self-Efficacy and Parental Support

박숙영 서울대학교 대학원 2019 국내석사

이미 많은 연구로 청소년 학업스트레스와 우울의 관계가 밝혀졌지 만, 우리나라의 학벌주의로 인한, 청소년기 학업스트레스 때문에 발생하는 우울에 대한 해결책을 사회적 차원에서 찾기에는 부족한 실상이다. 따라서 개인적 차원의 해결책을 마련하도록 이론•실천적 함의를 이끌어내기 위해, 인식된 자기효능감과 부모 지지 두 가지 변수 모두 학업스트레스-우울 관계 에 있어 조절효과를 가지는지를 살펴보고자 하였다. 연구대상을 중학교 3학 년으로 정했는데, 그 이유는 종단적 연구에 의하면 중학교 3학년이 청소년 기 중에 우울 수준이 가장 높고, 부모 관련 스트레스 수준도 가장 높으며, 아울러 자기효능감 수준이 가장 높은 시기이기 때문이다. 이론적 틀로 Lazarus와 Folkman (1984) 의 스트레스와 평가, 그리고 대처에 관한 인지 이 론을 사용했다. 스트레스, 평가, 대처, 정서, 사기 중에 대처 및 정서 단계를 제외하고 모두 본 연구에 적용했다. 단, 선행 연구 중에 인식된 부모 지지 가 조절효과를 가지지 못한다는 부분적인 결과가 있는 연구도 존재했다. 본 연구는 한국청소년정책연구원에서 실시한 한국아동청소년패널조사 초4코호 트 제6차(2015년) 자료를 사용했다. 총 2,061명의 중학교3학년 학생들이 설 문에 응답했다. 연구결과는 다음과 같다. 첫째, 학업스트레스와 우울은 유의 미한 관계가 있다. 둘째, 자기효능감은 학업스트레스와 우울의 관계에서 유 의미한 조절효과를 갖는다. 셋째, 부모 지지는 학업스트레스와 우울의 관계 에서 유의미하지 않은 조절효과를 갖는다. 셋째 연구결과가 보여주는 사실 은, 선행연구에서는 인문계 고등학생 집단과 높은 스트레스 수준을 가진 집 단에서는 부모 지지가 조절효과를 가지지 못한다는 점을 비추어볼 때, 전반 적으로 높은 스트레스 수준을 가진 집단이 부모 지지의 조절효과를 보지 못할 것이라는 점이다. 또한 중학교3학년이 자기효능감과 부모스트레스가 가장 높은 학년이라는 점을 본 연구의 결과와 연결시킬 수 있다. Many studies have already pointed out problems relating to the relationship between academic stress and depression. However, despite such interest from researchers, depression arising from academic stress continues to plague Korean adolescents. The emphasis on alma mater is widespread in Korean society. Consequently, adolescents’ competition to obtain a place at a top university is real. This struggle results in academic stress which leads to lower life satisfaction and happiness levels. This study deemed the 3rd year of middle school as a crucial stage in adolescents’ mental health issues. Adolescents must, at least tentatively, decide on their career path; studies have reported adolescents to be the most depressive overall then; adolescents are under the most stress from their parents; and, they are at the peak of self-efficacy. It is difficult to conjure a social solution to the influence academic stress has on adolescent depression. Nevertheless, it is possible to study and analyze factors that may protect adolescents on an individual level. Among the protective factors that alleviate adolescent depression, this study will focus on perceived self-efficacy and parental support. Although research has been conducted on perceived self-efficacy and parental support respectively, few studies have valued a simultaneous emphasis (note: this is not a simultaneous analysis) on perceived self-efficacy and parental support. One can consider two facets to moderating factors in the relationship between academic stress and depression for Korean adolescents: the person and situational factors. Social support alone does not suffice in explaining what leads to low, or high, morale. Concerning the person factor, “Everyone needs resilience,” and self-efficacy is a subordinate concept of self-resilience. For the situational factor, a child’s perceived relationship with their parents can lead to higher levels of resilience. A study also showed that among protective factors leading to adolescent resilience, parental support showed the highest frequency. The theoretical framework of this study is Lazarus and Folkman’s (1984) cognitive theory of stress, appraisal, and coping. There are five components in this theory: (1) stress, (2) appraisal, (3) coping, (4) emotions, and (5) morale. Among the components of this theory, this study will deal with mainly (1) stress, (2) appraisal, and (5) morale. This study will not deal with coping due to the fact that the nature of its focused moderator variables, which are perceived self-efficacy and perceived parental support, are “appraisal” and not “coping”. Neither is depression “emotion”; it is a type of negative morale. First, (1) stress in this study is “academic stress”, which is the independent variable. Second, (2) cognitive appraisal (of stress), includes the moderator variables “perceived self-efficacy” and “perceived parental support”. In other words, if one thinks they can control a stressful situation well (i.e. self-efficacy, Lazarus & Folkman, 1984), the outcome the person with high self-efficacy experiences will differ substantially in quality with the person with low self-efficacy. On the other hand, perceived parental support (cognitive appraisal) that an adolescent retains on an everyday basis becomes the basis for an adolescent’s belief that they will receive parental support in time of need. Thus, this study sees “perceived parental support” as the second moderator variable in the relationship between academic stress and depression for adolescents. Finally, the (5) morale part of the process includes depression. Concerning empirical research, many consistently show that adolescents’ academic stress spawns negative mental health problems such as depression. Various studies also attest to the moderating effects of self efficacy, in a variety of mental health-related situations. Although most literature reported a moderating effect of parental support in the relationship between stress and depression for adolescents, a few studies showed mixed results, such as different types of groups having different results. Therefore, this study will examine firstly the effect of academic stress on adolescent depression, and secondly whether self-efficacy and parental support have a moderating effect on the relationship between academic stress and depression. The three hypotheses to be examined are as follows. [Hypothesis 1]: Increase in academic stress is associated with increase in symptoms of depression, for Korean 3rd-year middle school students. [Hypothesis 2]: Perceived self-efficacy will moderate the relationship between academic stress and depression such that the impact of academic stress on depression will be affected among Korean 3rd-year middle school students with higher perceived self-efficacy levels. [Hypothesis 3]: Perceived parental support will moderate the relationship between academic stress and depression such the impact of academic stress on depression will be affected among Korean 3rd-year middle school students with higher perceived parental support levels. This study uses Korean Children and Youth Panel Survey (KCYPS) data following 4th year elementary school students into the 6th year of the survey, 2015, when the subjects were in their 3rd year of middle school. A total of 2,061 students were surveyed. From the KCYPS research table, ten questions relating to depression were used to measure depression, and five concerning studying habits were used to measure academic stress. Four from the category of self-identity, that by face validity reflects Sherer et al.’s (1982) original scale on self-efficacy, were used to measure self-efficacy. Four from the category of parental affection/attachment were used to measure parental support, given that Tsai et al. (2018) cites Armsden and Greenberg’s (1987) scale on parent-child “attachment” and uses it interchangeably with the words “parental support”, and Bong-eun Seo (2009) reports parental attachment is a subordinate factor of parental support. Concerning the results, the researcher examined sample characteristics, descriptive statistics, and correlation coefficients. Following this, the relationship between academic stress and depression was examined. Then, through hierarchical regression analysis, the moderating variables — self-efficacy and parental support — were inserted into the equation, along with their interaction terms. Study results are as follows. Firstly, this study supports the first hypothesis that as academic stress increases, depression increases. Secondly, the second hypothesis was supported in that self-efficacy proved to be a significant moderator variable in the relationship between academic stress and depression. Thirdly, the third hypothesis was rejected in that parental support proved to not be statistically significant in moderating the relationship between academic stress and depression. The regression coefficient of the interaction term of academic stress and parental support was not statistically significant. Past research also presents mixed results similar to that of the third result of this study, which was a rejection of the original hypothesis—a lack of statistical significance in the moderating effects of parental support. In other words, the relationship between academic stress and depression for Korean adolescents with high stress levels cannot be significantly moderated by parental support. Additionally, the fact that the 3rd year of middle school is highest in parental stress may hinder the affect parental support has on the relationship. The second result may be supported or elucidated by the fact that the 3rd year of middle school is highest in self-efficacy. Conclusively, the result that self-efficacy is statistically significant as a moderator in the relationship between academic stress and depression for Korean adolescents, holds many theoretical and practical implications for studies on social welfare.