Anxiety and mood (대한불안의학회지)

Korean Academy of Anxiety Disorders (대한불안의학회)
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Comparison of Effectiveness of Psychotherapies for Relieving Depressive Symptoms in Anxiety Disorders : A Systematic Review

불안장애에 동반된 우울증상에 대한 Psychotherapies의 효과비교 : 체계적 문헌고찰

  • Kim, Sun-Young (Department of Psychiatry, Ewha Woman's University Seoul Hospital, Ewha Women's University College of Medicine) ;
  • Kim, Eun-Jin (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jeon, Sang-Won (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shin, Dong-Won (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shin, Young-Chul (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Oh, Kang-Seob (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 김선영 (이화여자대학교 의과대학 이대서울병원 정신건강의학과) ;
  • 김은진 (성균관대학교 의과대학 강북삼성병원 정신건강의학과) ;
  • 전상원 (성균관대학교 의과대학 강북삼성병원 정신건강의학과) ;
  • 신동원 (성균관대학교 의과대학 강북삼성병원 정신건강의학과) ;
  • 신영철 (성균관대학교 의과대학 강북삼성병원 정신건강의학과) ;
  • 오강섭 (성균관대학교 의과대학 강북삼성병원 정신건강의학과)
  • Received : 2018.08.29
  • Accepted : 2019.01.22
  • Published : 2019.04.30
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Abstract

Objective : The purpose of this study was to compare and analyze effectiveness of various psychotherapies of depressive symptoms in patients with anxiety disorders by means of a systemic review. Methods : A systematic search using key words was conducted using EMBASE, MEDLINE and CENTRAL. Results : Five studies were included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for quality assessment. Diagnostic-specific cognitive behavioral therapies for various anxiety disorders (ds CBT) were also effective in reducing comorbid depression. Transdiagnostic cognitive behavioral therapies targeting anxiety and depression (tCBT-AD) were not superior than ds CBT for anxiety disorders. Mindfulness-based stress reduction (MBSR) was more effective than traditional cognitive behavioral therapy. Conclusion : ds CBT relieves anxiety symptoms as well as depressive symptoms comorbid with anxiety disorders effectively. In addition, MBSR is more successful for anxiety disorders with co-occurring depression by focusing broadly on the shifting relationship to internal experience rather than focusing narrowly on specific symptoms.

Keywords

References

  1. Kessler RC, Ruxcio AM, Shear K, Wittchen HU. Epidemiology of anxiety disorders. In: Stein MB, Steckler T, editors. Behavioral neurobiology of anxiety and its treatments. New York: Springer;2010. p.21-35.
  2. Merikangas KR, Swanson SA. Comorbidity in anxiety disorders. In: Stein MB, Steckler T, editors. Behavioral neurobiology of anxiety and its treatments. New York: Springer;2010. p.36-59.
  3. Brown TA, Campbell LA, Lehman CL, Grisham JR, Mancill RB. Current and lifetime comorbidity of the dsm-iv anxiety and mood disorders in a large clinical sample. J Abnorm Psychol 2001;110:585-599. https://doi.org/10.1037/0021-843X.110.4.585
  4. Lamers F, van Oppen P, Comijs HC, Smit JH, Spinhoven P, van Balkom AJ, et al. Comorbidity patterns of anxiety and depressive disorders in a large cohort study: The netherlands study of depression and anxiety (nesda). J Clin Psychiatry 2011;72:341-348. https://doi.org/10.4088/JCP.10m06176blu
  5. Wittchen HU, Essau CA, Krieg JC. Anxiety disorders: Similarities and differences of comorbidity in treated and untreated groups. Br J Psychiatry Suppl 1991:23-33.
  6. Dolnak DR. Treating patients for comorbid depression, anxiety disorders, and somatic illnesses. J Am Osteopath Assoc 2006;106:S1-8.
  7. Heuzenroeder L, Donnelly M, Haby MM, Mihalopoulos C, Rossell R, Carter R, et al. Cost-effectiveness of psychological and pharmacological interventions for generalized anxiety disorder and panic disorder. Aust N Z J Psychiatry 2004;38:602-612. https://doi.org/10.1080/j.1440-1614.2004.01423.x
  8. Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognit Ther Res 2012;36:427-440. https://doi.org/10.1007/s10608-012-9476-1
  9. Clark LA, Watson D. Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. J Abnorm Psychol 1991;100:316-336. https://doi.org/10.1037/0021-843X.100.3.316
  10. Mineka S, Watson D, Clark LA. Comorbidity of anxiety and unipolar mood disorders. Annu Rev Psychol 1998;49:377-412. https://doi.org/10.1146/annurev.psych.49.1.377
  11. Ellard KK, Fairholme CP, Boisseau CL, Farchione TJ, Barlow DH. Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cogn Behav Pract 2010;17:88-101. https://doi.org/10.1016/j.cbpra.2009.06.002
  12. Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta trade paperbacks; 1990.
  13. Wolitzky-Taylor KB, Arch JJ, Rosenfield D, Craske MG. Moderators and non-specific predictors of treatment outcome for anxiety disorders: A comparison of cognitive behavioral therapy to acceptance and commitment therapy. J Consult Clin Psychol 2012;80:786-799. https://doi.org/10.1037/a0029418
  14. Cuijpers P, Cristea IA, Weitz E, Gentili C, Berking M. The effects of cognitive and behavioural therapies for anxiety disorders on depression: A meta-analysis. Psychol Med 2016;46:3451-3462. https://doi.org/10.1017/S0033291716002348
  15. Newby JM, McKinnon A, Kuyken W, Gilbody S, Dalgleish T. Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clin Psychol Rev 2015;40:91-110. https://doi.org/10.1016/j.cpr.2015.06.002
  16. Pearl SB, Norton PJ. Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: A meta-analysis. J Anxiety Disord 2017;46:11-24. https://doi.org/10.1016/j.janxdis.2016.07.004
  17. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. Neca's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-Based Healthcare Collaborating Agency;2011.
  18. Scottish Intercollegiate Guidelines Network. Methodology checklist 2: Randomized controlled trials. 2018; Available from: http://www.sign.ac.uk/checklists-and-notes.html.
  19. Arch JJ, Ayers CR. Which treatment worked better for whom? Moderators of group cognitive behavioral therapy versus adapted mindfulness based stress reduction for anxiety disorders. Behav Res Ther 2013;51:434-442. https://doi.org/10.1016/j.brat.2013.04.004
  20. Bomyea J, Lang A, Craske MG, Chavira DA, Sherbourne CD, Rose RD, et al. Course of symptom change during anxiety treatment: Reductions in anxiety and depression in patients completing the coordinated anxiety learning and management program. Psychiatry Res 2015;229:133-142. https://doi.org/10.1016/j.psychres.2015.07.056
  21. Dear BF, Staples LG, Terides MD, Karin E, Zou J, Johnston L, et al. Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial. J Anxiety Disord 2015;36:63-77. https://doi.org/10.1016/j.janxdis.2015.09.003
  22. Fogliati VJ, Dear BF, Staples LG, Terides MD, Sheehan J, Johnston L, et al. Disorder-specific versus transdiagnostic and clinician-guided versus self-guided internet-delivered treatment for panic disorder and comorbid disorders: A randomized controlled trial. J Anxiety Disord 2016;39:88-102. https://doi.org/10.1016/j.janxdis.2016.03.005
  23. Talkovsky AM, Green KL, Osegueda A, Norton PJ. Secondary depression in transdiagnostic group cognitive behavioral therapy among individuals diagnosed with anxiety disorders. J Anxiety Disord 2017;46:56-64. https://doi.org/10.1016/j.janxdis.2016.09.008
  24. Moscovitch DA, Hofmann SG, Suvak MK, In-Albon T. Mediation of changes in anxiety and depression during treatment of social phobia. J Consult Clin Psychol 2005;73:945-952. https://doi.org/10.1037/0022-006X.73.5.945
  25. Aderka IM, Foa EB, Applebaum E, Shafran N, Gilboa-Schechtman E. Direction of influence between posttraumatic and depressive symptoms during prolonged exposure therapy among children and adolescents. J Consult Clin Psychol 2011;79:421-425. https://doi.org/10.1037/a0023318
  26. McHugh RK, Murray HW, Barlow DH. Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: The promise of transdiagnostic interventions. Behav Res Ther 2009;47:946-953. https://doi.org/10.1016/j.brat.2009.07.005
  27. Teasdale JD, Moore RG, Hayhurst H, Pope M, Williams S, Segal ZV. Metacognitive awareness and prevention of relapse in depression: Empirical evidence. J Consult Clin Psychol 2002;70:275-287. https://doi.org/10.1037/0022-006X.70.2.275
  28. Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000;68:615-623. https://doi.org/10.1037/0022-006X.68.4.615