아동·청소년 우울증의 근거기반치료
Evidence-Based Treatments for Depression in Children and Adolescents
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참고문헌
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초록
우울한 기분과 흥미나 즐거움의 감소가 주요 증상인 우울장애는 대중적으로 널리 알려진 정신장애 중 하나이다. 아동·청소년기의 우울증의 높은 만성화 가능성과 한 개인의 삶에 미치는 장기적인 영향에 대한 인식이 높아지면서 아동·청소년 우울증에 대한 심리치료에 대한관심 또한 더욱 높아지고 있다. 이에 본 논문에서는 아동·청소년 우울장애에 관한 최근 20년간 해외 및 국내 연구 결과에 근거하여 심리치료의 효과를 살펴보고, 관련 연구 결과들을 정리 및 요약하여, 이를 바탕으로 아동·청소년 우울장애에 대한 근거기반심리치료의 권고안을 제시하였다. 해외의 메타분석 연구와 체계적인 리뷰를 근거로 인지행동치료(CBT)와 대인관계치료(IPT)를 “치료효과가 강력하고 근거가 잘 정립된 치료법(strong/well-established)”으로, 가족치료(FT)를 “효과가 있음직한 치료법(modest/probably efficacious)”으로, 마지막으로 정신역동치료(PDT)는 “실험적인 수준의 치료법(controversial/experimental)”으로 제안하였다. 국내에서 실시된 연구를 개관한 결과, 사전-사후 설계연구가 주를 이루고 있었으며 이를 통해 국내에서는 CBT와 IPT를 “효과가 있음직한 치료법(modest/probably efficacious)” 으로 제안하였다. 마지막으로 국내 심리치료 연구의 현황과 문제점 및 연구 방향에 대해 논의하였다.
Abstract
Depression in child and adolescent tends to presage a chronic and recurrent course of illness and impairment in adulthood. Concerns about medication also prompt growing interest in the effects of psychotherapy in child and adolescent depression. The main purpose of this study is to identify evidence-based treatments of child and adolescent depression. For this purpose, we reviewed the clinical features and researches on evidence-based treatments of child and adolescent depression. Based on overseas meta-analysis and systematic reviews, both cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) have a “strong/well-established” evidence base, family therapy (FT) has a “modest/probably efficacious” evidence, and psychodynamic therapy (PDT) has a “controversial/experimental” base. Although domestic researches on psychotherapy are limited, several trials had examined the efficacy of CBT or IPT for youth depression. Based on domestic researches, CBT and IPT have a “modest/probably efficacious” evidence base in Korea.
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