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공황장애에 대한 근거기반치료

Evidence-based Treatment of Panic Disorder

박수현
한국임상심리학회 (Korean Clinical Psychology Association)|2017.11|Korean Journal of Clinical Psychology|제36권 제4호|pp. 458-469|DOI https://doi.org/10.15842/kjcp.2017.36.4.002

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참고문헌

키워드

근거기반치료evidence-based treatment공황장애panic disorder심리장애psychological disorders
주제분류심리과학

초록

공황장애는 극심한 불안감과 함께 자율신경계 각성을 반영하는 다양한 증상이 예기치 못한 상황에서 동반되어 나타나는 불안장애로 이와 같은 공황발작이 다시 경험될 것이라는 예기불안이 특징적으로 보고된다. 전 세계적으로 1–4% 사이의 유병률이 보고되고 있으며 모든질환 중 장애 지속기간이 11번째로 높은 장애로 알려져 있다. 지난 30여 년간 많은 연구가 진행되었고 이를 기반으로 인지행동치료 중심의경험적으로 검증된 다양한 치료 프로그램들이 개발되었다. 본 논문에서는 공황장애에 대한 임상적 기술 및 원인론에 대해 살펴보고 이에기반을 두고 개발된 치료적 접근들을 소개할 것이다. 국내외에서 진행된 치료효과 및 메타분석 연구결과를 토대로 공황장애에 대한 근거기반치료로 우선적으로 권장되고 있는 인지행동치료의 핵심 구성 요소가 무엇인지 그리고 치료효과에 대한 조절 또는 매개변인에는 어떠한 것이 있는지 논의될 것이다. 또한 최근 검증 작업이 시작된 공황장애에 대한 컴퓨터 또는 인터넷 기반 치료프로그램의 효과 및 임상적유용성과 관련된 연구 결과들을 토대로 향후 공황장애 치료에 있어 어떠한 함의를 갖는지 질문을 던지고자 한다. 마지막으로 국내외 저명기관 및 주요 연구결과가 제안하고 있는 공황장애에 대한 치료 권고안을 토대로 현재 어떠한 방향으로 공황장애에 대한 근거기반 치료가권장되고 있는지 요약할 것이다.

Abstract

Panic disorder is an anxiety disorder characterized by the presence of autonomic arousal symptoms in unexpected situations (panic attacks), which are accompanied by anticipatory anxiety regarding possible future attacks. Its prevalence rate is reported to be 1–4% worldwide and it ranks 11th among all diseases in terms of years lived with disability. Numerous studies have been conducted in the past 30 years and empirically validated cognitive behavior therapy for panic disorder has been developed based on the results of such studies. To this end, this review will focus on providing a brief clinical description and etiology of panic disorder, followed by an overview of the specific nature of evidence-based treatment for panic disorder. What are the core components of evidence-based treatment for panic disorder according to Korean and foreign treatment effectiveness studies and/or meta-analyses? What are the moderating or mediating factors that affect treatment effectiveness and outcomes? Furthermore, this review will summarize the current status of the effectiveness of computer- and internetbased treatment programs for panic disorder. Finally, a summary of treatment guidelines for panic disorder will be provided based on the treatment guidelines recommended by different related disciplines and organizations.

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