2024 한국형 범불안장애 치료지침 II: 정신치료전략
Korean Guidelines for the Treatment of Generalized Anxiety Disorder 2024 Part II: Psychological Treatment Strategies
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective : This study aimed to establish a consensus on treatment strategies for psychological therapy in generalized anxiety disorder (GAD) as outlined in the 2024 Korean guidelines for treating GAD. Methods : The executive committee developed questionnaires on treatment strategies for patients with GAD based on previous treatment guidelines and academic articles published internationally and in Korea. Sixty-two experts responded to questionnaires developed. The consensus of expert opinions was classified into three categories (first-line, second-line, and third-line choices) using chi-square test and 95% confidence intervals. Results : Findings of this study suggest that individual cognitive behavioral therapy (CBT), group CBT, mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and applied relaxation are appropriate psychotherapies for GAD. Additionally, it is recommended to initiate CBT early when treating GAD, with eight treatment sessions being the most preferred for both individual and group CBT. Conclusion : This expert consensus survey reflected clinical experiences of Korean practitioners. Results of this study provide valuable insights for Korean clinicians when implementing psychotherapy for GAD. (Anxiety and Mood 2024;20(2):65-71)
Abstract
Objective : This study aimed to establish a consensus on treatment strategies for psychological therapy in generalized anxiety disorder (GAD) as outlined in the 2024 Korean guidelines for treating GAD. Methods : The executive committee developed questionnaires on treatment strategies for patients with GAD based on previous treatment guidelines and academic articles published internationally and in Korea. Sixty-two experts responded to questionnaires developed. The consensus of expert opinions was classified into three categories (first-line, second-line, and third-line choices) using chi-square test and 95% confidence intervals. Results : Findings of this study suggest that individual cognitive behavioral therapy (CBT), group CBT, mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and applied relaxation are appropriate psychotherapies for GAD. Additionally, it is recommended to initiate CBT early when treating GAD, with eight treatment sessions being the most preferred for both individual and group CBT. Conclusion : This expert consensus survey reflected clinical experiences of Korean practitioners. Results of this study provide valuable insights for Korean clinicians when implementing psychotherapy for GAD. (Anxiety and Mood 2024;20(2):65-71)
참고문헌 (25)
- Stein MB, "Generalized anxiety disorder", New England Journal of Medicine, 373, pp.2059~2068 (2015)
- Ruscio AM, "Cross-sectional comparison of the epidemiology of DSM-5 generalized anxiety disorder across the globe", JAMA Psychiatry, 74, pp.465~475 (2017)
- Tyrer P, "Thirty-year outcome of anxiety and depressive disorders and personality status : comprehensive evaluation of mixed symptoms and the general neurotic syndrome in the follow-up of a randomised controlled trial", Psychological Medicine, 52, pp.3999~4008 (2022)
- Hoffman DL, "Human and economic burden of generalized anxiety disorder", Depression and Anxiety, 25, pp.72~90 (2008)
- Andrews G, "Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder", Australian & New Zealand Journal of Psychiatry, 52, pp.1109~1172 (2018)
- Bandelow B, "World Federation of Societies of Biological Psychiatry(WFSBP)guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders–Version 3. Part I : Anxiety disorders", The World Journal of Biological Psychiatry, 24, pp.79~117 (2023)
- Katzman MA, "Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders", BMC Psychiatry, 14, pp.1~83 (2014)
- Papola D, "Psychotherapies for generalized anxiety disorder in adults : a systematic review and network meta-analysis of randomized clinical trials", JAMA Psychiatry, 81, pp.250~259 (2024)
- Kim MS, "Korean Medication Algorithm Project for Generalized Anxiety Disorder 2009(I) : initial treatment strategy", Journal of Korean Neuropsychiatric Association, 49, pp.546~552 (2010)
- Lee JY, "Korean medication algorithm project for generalized anxiety disorder 2009(II) : medication algorithm & long-term medication treatment strategy", Journal of Korean Neuropsychiatric Association, pp.553~563 (2010)
- Borkovec TD, "Psychotherapy for generalized anxiety disorder", Journal of Clinical Psychiatry, 62, pp.37~45 (2001)
- Cuijpers P, "Psychological treatment of generalized anxiety disorder : a meta-analysis", Clinical Psychology Review, 34, pp.130~140 (2014)
- Jiang Ss, "Effects of group mindfulness-based cognitive therapy and group cognitive behavioural therapy on symptomatic generalized anxiety disorder : a randomized controlled noninferiority trial", BMC Psychiatry, 22, pp.481~ (2022)
- Williams M, "Psychological outcomes and mechanisms of mindfulness-based training for generalised anxiety disorder : a systematic review and metaanalysis", Current Psychology, 43, pp.5318~5340 (2024)
- Avdagic E, "A randomised controlled trial of acceptance and commitment therapy and cognitive-behaviour therapy for generalised anxiety disorder", Behaviour Change, 31, pp.110~130 (2014)
- Hemmings NR, "Development and feasibility of a digital acceptance and commitment therapy–based intervention for generalized anxiety disorder : pilot acceptability study", JMIR Formative Research, 5, pp.e21737~ (2021)
- Kelson J, "Internet-delivered acceptance and commitment therapy for anxiety treatment : systematic review", Journal of Medical Internet Research, 21, pp.e12530~ (2019)
- Hunot V, "Psychological therapies for generalised anxiety disorder", Cochrane Database of Systematic Reviews (2007)
- Covin R, "A meta-analysis of CBT for pathological worry among clients with GAD", Journal of Anxiety Disorders, 22, pp.108~116 (2008)
- Gearing RE, "The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders", Depression and Anxiety, 30, pp.800~808 (2013)
- Beidel DC, "The impact of social skills training for social anxiety disorder : A randomized controlled trial", Journal of Anxiety Disorders, 28, pp.908~918 (2014)
- Fava G, "Long-term outcome of panic disorder with agoraphobia treated by exposure", Psychological Medicine, 31, pp.891~898 (2001)
- Berg H, "A randomized clinical trial of behavioral activation and exposure-based therapy for adults with generalized anxiety disorder", Journal of Mood and Anxiety Disorders, 1, pp.100004~ (2023)
- Firth J, "Digital technologies in the treatment of anxiety : recent innovations and future directions", Current Psychiatry Reports, 20, pp.1~8 (2018)
- Newman MG, "Psychotherapeutic treatments for generalized anxiety disorder : cognitive and behavioral therapies, enhancement strategies, and emerging efforts", Expert Review of Neurotherapeutics, 22, pp.751~770 (2022)