Factors Associated with Treatment Outcomes in Mindfulness-Based Cognitive Therapy for Panic Disorder
2
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
Purpose: Although the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for panic disorder (PD) has been studied previously, data on the predictors of treatment outcomes in MBCT for PD are scarce. Materials and Methods: Eighty patients with PD were screened to analyze treatment outcomes such as MBCT completion, treatment response, and remission after undergoing MBCT for PD. Sociodemographic characteristics, comorbid personality disorders, and baseline medication doses were examined. The study administered the Panic Disorder Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale and Anxiety Sensitivity Inventory-Revised to patients at baseline and at eight weeks. Results: Sixty-five participants were enrolled in the present study. Comorbid personality disorder was significantly associated with MBCT non-completion. We found that anxiety sensitivity (AS) improvement after an eight week MBCT program was a statistically significant factor associated with treatment response. Using logistic regression analysis, AS improvement after MBCT showed significant association with PD remission after MBCT. Conclusion: Comorbid personality disorders of participants could be a potential predictor of MBCT non-completion. Furthermore, AS improvement after MBCT may predict treatment response and remission after MBCT for PD. However, better designed studies with a larger number of patients are needed to confirm our findings.
Abstract
Purpose: Although the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for panic disorder (PD) has been studied previously, data on the predictors of treatment outcomes in MBCT for PD are scarce. Materials and Methods: Eighty patients with PD were screened to analyze treatment outcomes such as MBCT completion, treatment response, and remission after undergoing MBCT for PD. Sociodemographic characteristics, comorbid personality disorders, and baseline medication doses were examined. The study administered the Panic Disorder Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale and Anxiety Sensitivity Inventory-Revised to patients at baseline and at eight weeks. Results: Sixty-five participants were enrolled in the present study. Comorbid personality disorder was significantly associated with MBCT non-completion. We found that anxiety sensitivity (AS) improvement after an eight week MBCT program was a statistically significant factor associated with treatment response. Using logistic regression analysis, AS improvement after MBCT showed significant association with PD remission after MBCT. Conclusion: Comorbid personality disorders of participants could be a potential predictor of MBCT non-completion. Furthermore, AS improvement after MBCT may predict treatment response and remission after MBCT for PD. However, better designed studies with a larger number of patients are needed to confirm our findings.
참고문헌 (52)
- Kabat-Zinn J, "An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results", Gen Hosp Psychiatry, 4, pp.33~47 (1982)
- Kabat-Zinn J, "Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness" (1990), Dell Publishing
- Miller JJ, "Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders", Gen Hosp Psychiatry, 17, pp.192~200 (1995)
- Teasdale JD, "Prevention of relapse", recurrence in major depression by mindfulness-based cognitive therapy, 2000, pp.68, 615~623
- Evans S, "Mindfulness-based cognitive therapy for generalized anxiety disorder", J Anxiety Disord, 22, pp.716~721 (2008)
- Williams JM, "Mindfulness-based Cognitive Therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on between-episode functioning", J Affect Disord, 107, pp.275~279 (2008)
- Kim B, "Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder", J Anxiety Disord, 24, pp.590~595 (2010)
- Kim YW, "Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder", Depress Anxiety, 26, pp.601~606 (2009)
- Yook K, "Usefulness of mindfulness-based cognitive therapy for treating insomnia in patients with anxiety disorders: a pilot study", J Nerv Ment Dis, 196, pp.501~503 (2008)
- Coelho HF, "Mindfulness-based cognitive therapy: evaluating current evidence and informing future research", J Consult Clin Psychol, 75, pp.1000~1005 (2007)
- Lovas DA, "Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: a pilot study", J Anxiety Disord, 24, pp.931~935 (2010)
- Chiesa A, "Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis", Psychiatry Res, 187, pp.441~453 (2011)
- Finucane A, "An exploratory mixed methods study of the acceptability and effectiveness of Mindfulness-Based Cognitive Therapy for patients with active depression and anxiety in primary care", BMC Psychiatry, 6, pp.14~ (2006)
- Sharplin GR, "Mindfulness-based cognitive therapy: an efficacious community-based group intervention for depression and anxiety in a sample of cancer patients", Med J Aust, 193(5), pp.S79~S82 (2010)
- Williams MJ, "Mindfulness-based cognitive therapy for severe health anxiety (hypochondriasis): an interpretative phenomenological analysis of patients’ experiences", Br J Clin Psychol, 50, pp.379~397 (2011)
- Brown KW, "The benefits of being present: mindfulness and its role in psychological well-being", J Pers Soc Psychol, 84, pp.822~848 (2003)
- Segal ZV, "Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse" (2002), Guilford Press
- Schmidt NB, "Anxiety sensitivity: prospective prediction of panic attacks and Axis I pathology", J Psychiatr Res, 40, pp.691~699 (2006)
- Bishop SR, "Mindfulness: a proposed operational definition", Clin Psychol Sci Pract, 11, pp.230~241 (2004)
- Carter JD, "Patient predictors of response to cognitive behaviour therapy and interpersonal psychotherapy in a randomised clinical trial for depression", J Affect Disord, 128, pp.252~261 (2011)
- Jarrett RB, "Clinical, cognitive, and demographic predictors of response to cognitive therapy for depression: a preliminary report", Psychiatry Res, 37, pp.245~260 (1991)
- Thase ME, "Do depressed men and women respond similarly to cognitive behavior therapy?", Am J Psychiatry, 151, pp.500~505 (1994)
- Michalak J, "Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression", Psychol Psychother, 84, pp.230~236 (2011)
- First MB, "Structured Clinical Interview for DSM-IV Axis I Disorders (SCID)" (1996), American Psychiatric Press, Inc
- Han OS, "Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) Korean version" (2000), Hana Medical
- Ballenger JC, "Treatment of anxiety disorders to remission", J Clin Psychiatry, 62(12), pp.5~9 (2001)
- Guy W, "Clinical Global Impressions (CGI). ECDEU Assessment Manual for Psychopharmacology revised" (1976), National Institute of Mental Health
- Lee SH, "Effectiveness of a meditation-based stress management program as an adjunct to pharmacotherapy in patients with anxiety disorder", J Psychosom Res, 62, pp.189~195 (2007)
- Kabat-Zinn J, "Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders", Am J Psychiatry, 149, pp.936~943 (1992)
- First MB, "Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II)" (1997), American Psychiatric Press, Inc
- Kim CG, "Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) Korean version" (2005), Hana Medical
- Lim YJ, "Korean panic disorder severity scale: construct validity by confirmatory factor analysis", Depress Anxiety, 24, pp.95~102 (2007)
- Shear MK, "Reliability and validity of the Panic Disorder Severity Scale: replication and extension", J Psychiatr Res, 35, pp.293~296 (2001)
- Taylor S, "An expanded anxiety sensitivity index: evidence for a hierarchic structure in a clinical sample", J Anxiety Disord, 12, pp.463~483 (1998)
- Lim YJ, "Korean Anxiety Sensitivity Index-Revised: its factor structure, reliability, and validity in clinical and nonclinical samples", Depress Anxiety, 24, pp.331~341 (2007)
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- Hamilton M, "The assessment of anxiety states by rating", Br J Med Psychol, 32, pp.50~55 (1959)
- Aaronson CJ, "Predictors and time course of response among panic disorder patients treated with cognitive-behavioral therapy", J Clin Psychiatry, 69, pp.418~424 (2008)
- Furukawa TA, "Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale", Depress Anxiety, 26, pp.922~929 (2009)
- Bados A, "The efficacy of cognitive-behavioral therapy and the problem of drop-out", J Clin Psychol, 63, pp.585~592 (2007)
- Robinson LA, "Psychotherapy for the treatment of depression: a comprehensive review of controlled outcome research", Psychol Bull, 108, pp.30~49 (1990)
- Dow MG, "Prognostic indices with brief and standard CBT for panic disorder: II. Moderators of outcome", Psychol Med, 37, pp.1503~1509 (2007)
- Dow MG, "Prognostic indices with brief and standard CBT for panic disorder: I. Predictors of outcome", Psychol Med, 37, pp.1493~1502 (2007)
- Martinsen EW, "Cognitive-behavioral group therapy for panic disorder in the general clinical setting: a naturalistic study with 1-year follow-up", J Clin Psychiatry, 59, pp.437~442 (1998)
- Shea MT, "Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program", Am J Psychiatry, 147, pp.711~718 (1990)
- Hardy GE, "Impact of Cluster C personality disorders on outcomes of contrasting brief psychotherapies for depression", J Consult Clin Psychol, 63, pp.997~1004 (1995)
- Dreessen L, "The impact of personality disorders on treatment outcome of anxiety disorders: best-evidence synthesis", Behav Res Ther, 36, pp.483~504 (1998)
- Kliem S, "Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-effects modeling", J Consult Clin Psychol, 78, pp.936~951 (2010)
- Linehan MM, "Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder", Arch Gen Psychiatry, 63, pp.757~766 (2006)
- Rosenthal MZ, "Dialectical Behavior Therapy, In Kaplan & Sadock’s Comprehensive Textbook of Psychiatry", pp.2884~2893 (2009), Lippincott Williams & Wilkins
- Stewart SH, "Causal modeling of relations among learning history, anxiety sensitivity, and panic attacks", Behav Res Ther, 39, pp.443~456 (2001)
- Safran JD, "Interpersonal process in cognitive therapy" (1990), Basic Books