Predicting Factors of Discontinuation of Medication after Cognitive Behavioral Therapy for Panic Disorder

인지행동치료 후 약물 중단 예측 요인에 관한 연구

Objective : The authors experienced that cognitive behavioral therapy(CBT) could replace medication for controlling panic attacks and anticipatory anxiety symptoms. The objective of this study was finding out predicting factors of discontinuation of medication after CBT for patients with panic disorder. Method : A hundred forty-eight patients who met DSM-IV criteria for panic disorder with or without agoraphobia for at least 3 months had completed 12 weekly sessions of Panic Control Therapy(PCT ; Barlow et al). Eighty-one patients who could discontinue medication and sixty-seven patients who could not discontinue medication were measured with several scales as the pre- and post-treatment aassessment. The scales were Beck Depression Inventory(BDI), Clinical Global Impression(CGI), Spielberger State Anxiety Inventory(STAI-state), Anxiety Sensitivity Index(ASI), Body Sensation Questionnaire (BSQ), Panic Belief Questionnaire(PBQ), Agoraphobic Cognition Questionnaire(ACQ), Fear Questionnaire(FQ), Toronto Alexithymia Scale(TAS). Results : At the pre-treatment assessment, the scores of BDI, CGI, STAI-state, ACQ, BSQ were higher in the patients who could discontinue medication than in the patients who could not discontinue medication(t=-2.68, t=-4.88, t=-3.07, t=-3.68, t=-3.35, p<0.01). Conclusion : Patients with panic disorder who were less depressed, less anxious, less agoraphobic and who had less negative cognitions for the bodily sensation and who had higher scores in the therapist's assessment could discontinue their medications.