• 생물정신의학
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• 제26권1호
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• pp.1-7
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• 2019

Since non-cardiac chest discomfort (NCCD) can result in substantial healthcare burden and lower quality of life, interventions such as cognitive behavioral therapy (CBT) have been investigated for the relief of NCCD. In this review, we aimed to summarize the evidence on the efficacy of the CBT for the treatment of NCCD while introducing a newly-developed computerized CBT program for NCCD. Studies applying CBT to individuals with NCCD were searched for from both English and Korean electronic databases. Among 37 studies, 11 randomized controlled trials, 4 case-control studies, 1 case series, and 2 review articles were eligible for this review. Efficacy of conventional CBT for NCCD was shown in a series of studies as most of them reported improved symptom severity of NCCD or NCCD-related anxiety. However, a substantial variability existed among these studies in participants, treatment procedures and durations. High attrition rates were also reported in these studies on conventional CBT. Computerized CBT could be an alternative to the conventional CBT as it can be standardized and more easily accessible, but it was only reported in one previous study. In addition to the literature review, we presented a newly-developed computerized CBT program for NCCD which may overcome some of the limitations of conventional CBT. A computerized CBT could be an alternative treatment of NCCD, however, need further studies on its usefulness.

• 성인간호학회지
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• 제27권2호
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• pp.223-232
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• 2015

Purpose: Parkinson's disease (PD) has a high incidence of psychiatric comorbidity, specifically depression and anxiety. This study examined the effectiveness of group cognitive behavioral therapy (CBT) in treating depression and anxiety. Methods: The study included 42 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression and anxiety. Patients were attending a department of outpatient neurology at D University Schools of Medicine in B Metropolitan city. A structured telephone-administered cognitive behavioral therapy was conducted for eight weeks. A repeated measure ANOVA was used to analyze results at pretest, post-test, and four weeks follow up. Results: According to service method, there were significant differences between the two groups in depression, anxiety and stigma was significant difference between time (p<.05). Analysis of the interaction between time and service method revealed significant differences in depression and anxiety (p<.05). Conclusion: The results suggest that telephone-administered cognitive behavioral therapy may be effective and may provide opportunity to adapt to individual needs for treating depression and anxiety in patients with Parkinson's disease.

• 수면정신생리
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• 제17권1호
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• pp.34-40
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• 2010

목 적: 본 연구는 일차성 및 이차성 불면증 환자에서 인지행동치료(Cognitive Behavioral Therapy, 이하 CBT)의 임상적 효능을 평가하고자 하였다. 방 법: 2008년 1월부터 2009년 6월까지 일차의료기관 수면클리닉에 방문한 환자들을 대상으로 하였다. 전체 64명의 외래 환자가 모집되었으며, DSM-IV에 의거하여 진단 된 일차성 불면증 환자는 30명, 이차성 불면증 환자는 34명이었다. 환자들은 CBT 전후로 수면 일지, 수면에 대한 역기능적 신념 및 태도 척도(Dysfunctional Beliefs and Attitudes about Sleep Scale-16, 이하 DBAS) 및 상태-특성 불안척도(State-Trait Anxiety Inventory, 이하 STAI)를 각각 시행하였다. CBT는 1주 간격으로 7회, 1회당 40~50분 동안 개별적으로 진행하였다. 결 과: 일차성, 이차성 불면증 환자군 모두 입면 잠복기, 총 수면 시간, 수면 효율과 같은 수면 지표와 DBAS 점수의 유의한 호전을 보였다. 반복측정 분산분석에서는 두 군간에 시간에 따른 DBAS와 수면 지표의 유의한 차이는 없었다. 이차성 불면증에서의 CBT의 효과는 일차성 불면증에서의 효과와 동등하였다. 결 론: 이번 연구는 CBT가 일차의료 환경에서 일차성 및 이차성 불면증의 치료에 있어 효과적이라는 것을 시사한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권1호
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• pp.15-25
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• 2020

Prevalence of pediatric obesity has increased worldwide in the last 20 years. Obese children suffer not only physical complications but also mental health problems such as depression, attention deficit hyperactivity disorder (ADHD), and eating disorders, as well as psychosocial impairments, such as school adjustment problems, bullying, and low self-esteem. Recently, there have been some studies on the association of mental health problems and pediatric obesity. In the treatment of pediatric obesity, many previous studies suggest multidisciplinary treatment. However, cognitive behavioral therapy (CBT) has attracted attention because obese children are accompanied by body image distortion, emotion dysregulation, and difficulties in stimulus control. This review is a narrative summary of the recent studies on mental health problems and CBT in pediatric obesity. The relationship between depression/anxiety and pediatric obesity is still inconsistent but recent studies have revealed a bidirectional relation between depression and obesity. Additionally, some studies suggest that obese children may have eating disorder symptoms, like loss of control eating, and require therapeutic intervention for pediatric obesity treatment. Furthermore, impulsivity and inattention of ADHD symptom is thought to increase the risk of obesity. It has also been suggested that CBT can be very effective for mental health problems such as depression, impulsivity, and body image distortion, that may coexist with pediatric obesity, and use of multimedia and application can be useful in CBT.

• 여성건강간호학회지
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• 제28권4호
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• pp.275-285
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• 2022

Purpose: This study explored the experiences of pregnant women with depressed mood participating in a group cognitive behavioral therapy (CBT) program using video communication, based on Beck's cognitive theory. Methods: The participants were six pregnant women out of 13 women who had participated in an 8-session group CBT program using video communication for women with depressed mood (Edinburgh Postnatal Depression score of ≥9). Data were collected from February 20 through March 25, 2021. In-depth individual interviews were conducted through a video conferencing platform at 1 month post-baseline. Thematic analysis was done. Results: Three themes, 10 subthemes, and 38 concepts were derived from experiences of participating in the 4-week group CBT program (twice a week). The first theme, entitled "continuing realization" had subthemes of "a negative and instable self," "a selfish judgment that excludes others," and "a strong belief in self-control." The second theme, entitled "attempt to change for restoration" had subthemes of "shift to rational thinking," "freedom from suppressed beliefs," "tolerance of other people," and "courage for self-expression." The third theme, entitled "departure for a positive life," had subthemes of "emotional healing," "faith in oneself," and "reestablishing the criteria for happiness." Conclusion: Pregnant women with depressed mood expressed that continuing realizations and attempts to change supported their transition toward a positive direction of healing. Thus, they were able to change their distorted thinking into rational thinking through CBT using video communication. These findings support the use of group CBT using video communication with pregnant women who have depressed mood.

• 대한불안의학회지
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• 제5권1호
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• pp.36-41
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• 2009

Objectives : The purpose of this pilot study was to investigate the potential clinical benefits a single group session of cognitive behavioral therapy in the treatment of patients with panic disorder. Methods : The study participants were 18 patients (14 males, 4 females; mean age=38.9 years), all of whom were assessed as meeting the DSM-IV-TR criteria for panic disorder. All participants attended one two-hour session of structured group cognitive behavioral therapy (CBT). Clinical symptoms was assessed before and eight weeks after the single therapy session using the Panic Disorder Severity Scale (PDSS). Results : Eight weeks after a single session of group CBT significant improvements were found in panic attack frequency, distress during panic attacks, severity of anticipatory anxiety, agoraphobic fear/avoidance, panic-related sensation fear/avoidance, impairment in work functioning, impairment in social functioning. Conclusions : One session of group CBT appears to be an effective treatment of panic disorder by reducing the severity of all symptoms assessed on the PDSS. An attempt should be made to replicate the findings of this pilot study in a larger and controlled, comparative clinical trial.

• Perspectives in Nursing Science
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• 제15권1호
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• pp.29-40
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• 2018

Purpose: The present study aimed to review the characteristics of cognitive behavioral therapy (CBT) programs for alcohol use disorders and to examine the outcomes of such programs. Methods: We searched for domestic and foreign studies that implemented a CBT program for alcohol use disorders, published from 2006 to 2017. Studies that met inclusion/exclusion criteria were selected and a quality assessment was performed using the Risk of Bias (RoB) and Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) instruments. We utilized a five-stage analysis process, through which nine experimental studies were selected. Results: Of these nine studies, four were randomized controlled trials, four used a quasi-experimental design, and one used a qualitative design. The CBT involved the three domains of cognitive reconstruction, problem solving, and coping. Coping with drinking situations and communication constituted most of the sessions. The outcomes of such interventions showed that CBT had a positive effect on alcohol use and self-evaluation. Conclusion: CBT is an effective way to change alcohol use behaviors, motivation, interpersonal relationships, emotional control, and self-efficacy among patients with alcohol use disorders. This study provides evidence for the effectiveness of CBT-based programs for the treatment of alcohol use disorders.

• 대한한의학회지
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• 제43권2호
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• pp.75-91
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• 2022

Objectives: The purpose of this overview was to summarize the evidence regarding the effectiveness of Cognitive Behavioral Therapy (CBT) for sleep disorders through systematic reviews (SRs) and meta-analyses (MAs). Methods: An overview of systematic review was conducted according to the study protocol (reviewregistry1320). A comprehensive literature search was performed using three databases (Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science) and three Korean databases (KoreaMed, KMbase, and ScienceON). Final studies were selected by three authors according to inclusion and exclusion criteria, and data needed for analysis were extracted by a pre-planned extraction framework. Methodological quality of systematic review was assessed using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Results: Fourteen SRs and MAs were included, of which eleven SRs were performed MAs. Twelve studies studied insomnia among sleep disorders, and the rest are nightmares and sleep disturbances with PTSD. Ten studies reported the effect of CBT on sleep disorders measured by insomnia severity index (ISI) and sleep onset latency (SOL), and all reported a significant improvement effect. Eight studies reported the effect of CBT on sleep disorders measured by wake time after sleep onset (WASO), and seven studies reported a significant improvement effect. The methodological quality of the studies evaluated with AMSTAR 2 was mainly low or very low because of omission of protocol registration and excluded study list. Conclusions: Practical guidelines and studies show that CBT is effective for sleep disorders, but access to CBT needs to be improved.

• 한국산학기술학회논문지
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• 제17권9호
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• pp.407-421
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• 2016

본 연구는 만성 일차성 불면증 환자에게 적용한 인지행동중재의 효과를 평가하는 16개의 논문을 메타분석한 것이다. PubMed, Cochrane Library, EMBASE, CINAHL와 여러 개의 국내 데이타 베이스를 통해 2015년 1월부터 2015년 6월까지 자료검색이 이루어졌다. 주요 검색전략은 인지행동중재와 불면증을 병합하여 이루어졌다. 논문의 방법론적 질 평가는 코크란의 RoB(The Cochrane's Risk of Bias)를 사용하였다. 자료는 Cochrane Library의 RevMan 5.3 프로그램으로 분석하였다. 최종 16편의 논문, 1503명의 대상자가 선정기준에 부합되었다. 자극조절요법, 수면제한법, 수면위생교육과 인지적 재구성이 인지행동중재의 주요 치료적 구성요소였다. 인지행동 중재의 적용 주수는 평균 5.4주, 적용횟수 평균 5.5회, 1회 평균 중재시간 90분으로 조사되었다. 인지행동중재의 효과는 총 수면시간(d=-0.31), 수면 잠복기(d=-0.29), 입면 후 각성시간(d=-0.55), 수면효율성(d=-0.70), 불면증 심각성(d=-0.77)과 수면에 대한 신념 및 태도(d=-0.64)에 유의하였다. 전반적으로 작은 효과크기에서 중간 정도의 효과크기를 나타냈다. 인지행동중재는 불안(d=-0.30)과 우울(d=-0.35)에도 효과적이었다. 이러한 결과는 인지행동중재가 불면증이 있는 환자들의 수면의 질과 수면시간을 증진시키는 것으로 나타났다.

• 여성건강간호학회지
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• 제27권4호
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• pp.337-347
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• 2021

Purpose: This study presents the development of a group video communication-based cognitive behavioral therapy (CBT) program for depressed pregnant women. It also provides the results of a preliminary test of its effects on their depression, automatic thoughts, and dysfunctional attitudes. Methods: In this quasi-experimental single-group pre- and posttest design study, 13 pregnant women participated in a 4-week, eight-session group CBT program, based on Beck's cognitive theory and using video communications from November 2020 to January 2021. Pregnant women between 14 and 32 weeks who were members of an online maternity and parenting community and residing in the cities of Changwon and Gimhae, Korea, were invited to voluntarily participate. Trained nurses led CBT sessions of 3-4 participants per group via video communication. Participants were assessed pre- and postintervention with self-report questionnaires for measurement of depression, automatic thought, and dysfunctional attitude after normality test according to the Shapiro-Wilk test of the variables. The data were analyzed using paired t-test and Pearson correlation coefficients. Results: Depression (t=7.90, p<.001), automatic thoughts (t=4.89, p<.001), and dysfunctional attitudes (t=2.42, p=.032) significantly decreased after the 4-week online program. There were statistically significant correlations among the three variables. Conclusion: This program was found to be effective in reducing depression, automatic thoughts, and dysfunctional attitudes. Above findings suggest that a group CBT program using video communication can be an effective therapeutic modality that helps pregnant women at risk for depression alleviate their negative emotions related to depression.