주요 우울장애 입원환자에서 비정형 항정신병약물 강화요법이 체중에 미치는 영향：예비연구 = Effect of Augmentation Therapy with Atypical Antipsychotics on Weight Gain of Major Depressive Inpatients：A Preliminary Study

다국어 초록 (Multilingual Abstract)

Objective：Few studies have investigated the effect of atypical antipsychotics augmentation with antidepressant
in patients with depression. We monitored the weight of major depressive patients treated with either standard or
atypical antipsychotic augmentation therapy in a closed ward. Methods：Patients with major depressive disorder
were treated with atypical antipsychotic augmentation (AAP group) or antidepressants only (non-AAP group).
The body weight of each patient was measured once per week, and the maximum weight gain was calculated
during the study period. An increase of more than 5 kg or 7% over the initial body weight was used to determine
the incidence of substantial weight gain (SWG), and the body mass index (BMI) was also calculated. Analysis of
covariance (ANCOVA) and the chi-square test were used to compare the statistical significance of the differences
in weight gain between the two groups. Results：The mean weight gain in the APP group (N=72) was 3.07±
1.84 kg and that in the non-AAP group (N=103) was 1.66±1.88 kg. When weight gain was controlled with respect
to some of the different variables between the two groups, the difference in mean weight gain was statistically significant
(F=13.943, p<0.001), but the differences in SWG (F=0.013, p=0.573) and BMI (F=0.014, p=0.557)
were not. However, when we compared the incidence of SWG, 20 patients (27.8%) from the AAP group, but only
13 patients (12.6%) from the larger non-AAP group, satisfied SWG criteria; this difference was statistically
significant between the two groups (F=6.362, p=0.018). Conclusion：Significant weight gain can occur in major
depressive patients who are treated with atypical antipsychotic augmentation therapy, despite the use of relatively
small doses and short treatment periods.

국문 초록 (Abstract)

본 연구에서는 주요 우울장애 환자에서 비정형 항정신
병약물이 다양한 항우울제와 병용으로 사용되었을 때 체
중 증가에 어떠한 영향을 미치는지 알아보고자 급성기 주
요 우울장애 입원환자 중 항우울제를 단독으로 사용하고
있는 군과 비정형 항정신병약물의 강화치료를 받고 있는
군의 체중 변화를 비교하였다. 선정 기준에 따라 비정형
항정신병약물 병용사용군 72명과 항우울제 단독사용군
103명이 선별되었다. 입원 기간 동안의 체중 변화를 살
펴보았을 때 기저 체중과 입원 기간, 연령과 질병기간 등
의 차이를 보정한 비교에서 두 군간의 유의한 차이가 관
찰되었다. BMI를 이용하여 입원기간 동안 과체중과 비
만의 발생율을 비교하였을 때 두 군 사이에 유의한 차이
가 발견되지 않았으나 SWG의 기준에 따라 대상군을 분
류하였을 때 비정형 항정신병약물 사용군에서 통계적으
로 유의하게 SWG에 해당되는 환자들이 많았다. 비정형
항정신병약물이 일반적으로 정신분열병이나 양극성 장애
에서 사용되는 치료용량에 비해 매우 적은 용량으로 사
용되었음에도 불구하고 주요 우울장애 환자에서 단기간
의 입원 치료 기간 동안 유의한 체중의 차이가 관찰되었
다는 이번 연구의 결과는 주요 우울장애에서도 정신분열
병이나 양극성 장애 등과 마찬가지로 비정형 항정신병약
물의 사용이 체중의 변화에 민감한 영향을 미칠 수 있다
는 사실을 의미한다.

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