군 복무 중 발병한 공황장애 환자에 대한 한의 복합치료 및 한방정신요법 기반 노출치료 병행 1례 보고

Abstract

Objectives: The objective of this study was to observe changes in clinical symptoms and autonomic nervous system indices following a combination of Korean medical treatments and exposure therapy based on traditional Korean psychotherapy for a patient with panic disorder and agoraphobia that developed during military service who had a history of childhood trauma due to school bullying. Methods: A 23-year-old male diagnosed with panic disorder according to DSM-5 criteria received a combination of herbal medicine, acupuncture, and relaxation therapy. Starting on the 7th day of hospitalization, exposure therapy sessions based on Korean psychotherapy were conducted two to three times per week. Psychological assessments including BDI-II, BAI, STAI, PAS, and SCL-90-R were performed before and after treatment, along with Heart Rate Variability (HRV) measurements such as RMSSD. Results: Significant reductions were observed in major psychological assessment scores (BDI, BAI, STAI, PAS), with improvements in anxiety, frequency of panic attacks, and physical symptoms. During exposure therapy, HRV assessments including RMSSD showed a tendency of increase in variability after relaxation training, which was interpreted as reflecting a relaxation response of the autonomic nervous system. Conclusions: Korean medical treatment combined with traditional psychotherapy-based exposure therapy appears to be effective in alleviating symptoms of panic disorder and promoting psychological stability. HRV assessment might serve as a useful physiological marker for tracking treatment response. Further studies are warranted to develop systematic clinical protocols based on these findings.