우울증의 행동활성화 치료: 체계적 개관
Behavioral Activation Treatment for Depression: A Systematic Review
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참고문헌
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초록
본 연구에서는 국내 임상 현장에 우울증의 행동활성화를 소개하고자 지난 25년간 축적된 행동활성화의 근간이 되는 이론과 연구 결과들을 체계적으로 개관하였다. 행동활성화는 항우울제 및 인지치료와 대등한 치료효과를 나타낸다는 것이 보고되었고, 우울장애를 포함한다양한 임상군에서의 효과성 또한 밝혀지고 있다. 본 개관 논문에서는 행동활성화에 대한 최신 정의를 소개하고, 치료 및 이론이 발전해온 역사, 기저이론, 기저이론을 뒷받침하는 기초 연구결과, 8가지 핵심치료요소를 분석하여 기술하였다. 또한 우울증 환자를 대상으로 실시한 행동활성화의 효능 및 효과 연구, 비용-효율성 검증 연구결과를 포괄적으로 정리하였다. 나아가 행동활성화의 광범위한 보급을 위해 다양한 형태(예, 인터넷 기반 등)로 치료를 전달하는 최근의 시도와 그 효과 연구들, 그리고 공병을 지닌 다양한 환자 군을 대상으로 실시한 논문들을 개관하였다. 마지막으로 앞으로 국내에서의 행동활성화 효과성 연구뿐 아니라 지역사회에서 다양한 임상군에게 보급할 수 있는 방안을 포함하여, 향후 연구 방향에 대해 논의하였다.
Abstract
This study systematically reviewed previous theories that are fundamental to behavioral activation and support evidences accumulated over the past 25 years, in order to introduce behavioral activation for depression into the domestic clinical field. Recently, behavioral activation has been recognized as a stand-alone psychotherapy for depression with results supporting comparable effects as antidepressant medications or traditional cognitive therapy. In this comprehensive literature review on behavioral activation, we aimed to introduce the latest definition with a brief history, underlying theories, and core therapeutic components, and to provide information on studies evaluating efficacy, effectiveness, and cost-effectiveness. Moreover, we have also summarized the most recent efforts and studies evaluating its effects that have been made to extensively deliver the behavioral activation in various form (e.g., internet based) and to patient groups with diverse comorbidity disorders. Future directions and implications for clinicians and researchers were also discussed to encourage behavioral activation research, including dissemination to the local community.
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