Clinical Manifestations of Depressive Symptoms in Korean Elderly

ABSTRACT

OBJECTIVE: To analyze characteristics of depressive symptom manifestation in Korean elderly by use of the Psychogeriatric Assessment Scale-Korean Version (PAS-K). METHOD: In the two epidemiological studies conducted in Yoncheon and Ulsan separately, PAS-K (Psychogeriatric Assessment Scale-Korean Version) was used as a common screening tool for depression in aged persons (65+). We analyzed the symptom characteristics in total subjects (n=1.641) by factor analysis and compared depressive symptomatology between male and female, urban and rural, educated and uneducated persons. Chi-square method was used to evaluated the differences in positive response rates of each depressive symptoms, and also item response theory was used to compare depressive symptomatology between male and female subject groups. RESULTS: Two factor structure that comprises 'combined emotional, cognitive and somatic factor' and 'sleep factor' was found in female, rural and uneducated groups. While, three factor structure composed of 'emotional factor', 'combined cognitive and somatic factor' and 'sleep factor' was found in male, urban and educated groups. Women endorsed significantly more depressive symptoms than men. Depressive mood, fatigue, restlessness, thoughts mixed up and suicide idea were more prevalent in female group. However, women reported their symptoms, especially emotional symptoms like depressive mood, restlessness, suicide idea, in less severe state of depression than men. In the evaluation of each item characteristics, most items were relevant in their item characteristics for the assessment of depressive symptoms in Korean elderly. However, 'hypnoticsalcohol use' item had very low correlation coefficient with total symptom score and it was less discriminative than other symptom items. CONCLUSION: Symptom characteristics of depression in Korean aged persons were different between groups according to sex, urbanicity and education level. An influence of Confucian culture on different symptom expression between male and female groups should be considered.