• 제목/요약/키워드: Cognitive Disorder

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틱 장애 아동의 인지행동치료 증례: 5회기 습관뒤집기 훈련과 호흡훈련을 중심으로 (Cognitive Behavioral Therapy in Childhood Tic Disorder : A Case of Report)

  • 송정림;홍종우;도진아;김현우;임명호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권1호
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    • pp.38-43
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    • 2011
  • Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.

한국형 마음챙김 명상에 기초한 인지 치료가 불안 장애 환자의 불안과 우울에 미치는 효과 비교 (The Effectiveness of Mindfulness-Based Cognitive Therapy-Korean (MBCT-K) for Anxiety and Depression in Patients with Anxiety Disorder)

  • 신나연
    • 디지털정책학회지
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    • 1권1호
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    • pp.1-5
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    • 2022
  • 본 연구의 목적은 마음 챙김에 기반한 인지치료가 불안장애 환자의 불안, 우울에 미치는 영향을 알아보기 위해 수행되었다. 본 연구는 24명의 불안장애 환자를 대상으로 하였으며, 인구사회학적 특성은 빈도, 평균과 표준편차으로 분석하였고 마음챙김 명상에 기반한 인지 치료 전후 불안과 우울은 Wilcoxon signed rank test를 이용하였다. 본 연구 결과 한국형 마음 챙김 명상에 기반한 인지치료는 불안과 우울을 유의하게 감소시킬 수 있었다(Z=-1.9, p=.06, Z=-2.9, p<.001). 본 연구 결과를 통하여 마음 챙김 명상을 불안장애 환자에게 적용하고 이들의 삶의 질을 향상시키는 방법을 모색하는 것이 필요하다고 할 수 있다.

공황장애에서 1회기 집단인지행동치료의 효능 ; 예비 연구 (A Pilot Study of the Effectiveness of a Session of Group Cognitive Behavioral Therapy for Patients with Panic Disorder)

  • 장은진;정영은;서호준;채정호
    • 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.

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한방치료와 인지행동치료를 병행한 공황장애 환자 1례에 대한 임상적 고찰 (A Case of Combination Therapy of Cognitive - Behavioral Therapy and Oriental Medical Treatment On Panic Disorder)

  • 정효창;성우용;김진원;정병주;장하정
    • 동의신경정신과학회지
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    • 제15권2호
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    • pp.211-219
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    • 2004
  • 상기 환자는 $4{\sim}5$년 발한 공황장애로 로컬 정신과에서 1년간 po. med 하시다 별무 호전하시고, 입원 3일전 증세 심하여 본원의 한방치료를 받은 환자로, DSM-4에 의거하면 광장공포증을 동반한 공황장애 환자로 한방적으로는 신음양구허(腎陰陽俱虛)에 간울화화(肝鬱化火)를 겸하였다고 하겠다. 지원탕(志遠湯)을 투여하고, 변증에 따라 자침하며, 주관법(走罐法)을 시행하고, 더불어 인지행동치료를 병행하여 PDSS상 21점이 13점으로 감소하는 좋은 결과를 내어 이를 보고하는 바이다. 하지만 관찰 기간이 그리 길지 않았고, 한방치료와 인지행동치료를 함께 시행함으로써 이상의 치료들 중 어떤 치료가 어느 정도의 효과를 내었는지 그 정도를 측정할 수 없으며, 측정절차도 환자의 주관적인 증상의 호소에 의존하여 객관성이 다소 결여되었다. 이를 보완하기 위해 공황장애에 대한 한방치료, 인지행동치료, 그리고 두 가지를 병행한 치료를 각각 시행한 후 효과를 후위분석연구를 통해 검증한다면 한방치료와 인지행동치료가 각각 어느 부분에 어느 정도의 치료효과를 발생시켰는지 검증할 수 있을 것이다. 이를 위한 향후 객관적이고 지속적인 연구가 필요하리라 사료된다.

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도박문제 심각도와 도박인지오류 간 우울의 매개효과: 도박문제치료 지역센터 자료 이차분석 (Mediating Effect of Depression on the Relationship between Gambling Severity and Cognitive Distortion: Secondary Data Analysis of Korea Center on Gambling Problems)

  • 이기령;홍정아
    • 정신간호학회지
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    • 제27권4호
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    • pp.370-379
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    • 2018
  • Purpose: The purpose of this study was to test the mediating effect of depression on the relationship between gambling severity and cognitive distortion in Koreans with a gambling disorder. Methods: Secondary data from a comprehensive assessment of problematic gambling between 2015 and 2017 on Korea Center on Gambling Problems were used. The subjects in this study were 254 Koreans with that gambling disorder. Data were collected with self-report structured questionnaires which included individual characteristics, the Korean version of Problem Gambling Severity Index, the Center for the Epidemiologic Studies Depression, and the Gambling Related Cognitions Scale. Data were analyzed by using descriptive statistics, independent t-test, one-way ANOVA with the $Scheff{\acute{e}}$ test, Pearson's correlation coefficients, and a mediation analysis of the Baron and Kenny method with the SPSS 22.0 program. Results: Significant correlations emerged among the three variables, gambling severity, depression, and cognitive distortion. Depression exerted a partial mediating effect (${\beta}=.20$, p<.001) on the relationship between gambling severity and cognitive distortion (Sobel test: z=2.33, p=.012). Conclusion: Based on this study's findings, nursing intervention programs focused on managing gambling severity and decreasing depression are highly recommended to alleviate cognitive distortion in people with a gambling disorder.

약물에 노출되지 않은 공황장애 환자들에서 인지행동치료 후 뇌혈류 변화에 대한 예비연구 (Preliminary Study for Changes in Brain Perfusion in the Drug-Naive Patients with Panic Disorder with SPECT Following Cognitive-Behavioral Therapy)

  • 김정범;신영아;채정호;장은진;류설영;원경숙;전석길;정용안
    • 대한불안의학회지
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    • 제4권2호
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    • pp.148-156
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    • 2008
  • Objective : Although cognitive-behavior therapy (CBT) is effective in patients with panic disorder, its the-rapeutic mechanism of action in the brain remains unclear. This study was performed to investigate regional blood flow changes associated with successful completion of CBT in drug-naive patients with panic disorder. Method : The regional blood flow in 4 patients with panic disorder was compared to that in 11 healthy controls before and after a 12-week group CBT using $^{99m}Tc$-ECD SPECT imaging. Psychopathology was assessed using Panic Disorder Severity Scale. Data were analyzed using software for statistical parametric mapping (SPM2). Results : Before CBT, significantly decreased blood flow was found in the parietal and occipital area in panic patients than normal volunteers. In all the patients who showed remission after CBT, increased blood flow was detected in the right cingulate gyrus, left lingual gyrus, and left superior parietal lobule, whereas decreased blood flow was seen in the left inferior temporal gyrus. Conclusion : These results suggested that CBT is effective for panic disorder and change the activity of cingulate gyrus and left temporal gyrus, a part of the brain areas associated with fear in panic disorder.

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Predictors of Cognitive Improvement during 12 Weeks of Antidepressant Treatment in Patients with Major Depressive Disorder

  • Lee, Jeong-Ok;Kim, Ju-Wan;Kang, Hee-Ju;Hong, Jin-Pyo;Kim, Jae-Min
    • Clinical Psychopharmacology and Neuroscience
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    • 제16권4호
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    • pp.461-468
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    • 2018
  • Objective: Cognitive disturbance is one of the major symptoms of depression and may be improved by treatment with antidepressants. This study aimed to investigate the predictors of cognitive improvement in patients with major depressive disorder (MDD) who were taking antidepressants. Methods: This study included 86 patients with MDD who completed 12 weeks of antidepressant monotherapy. Cognitive symptoms were assessed using the Perceived Deficits Questionnaire-Korean version (PDQ-K), which addresses four domains of cognitive functioning (attention/concentration, retrospective memory, prospective memory, and organization/planning) and was administered at study entry and at the 12-week end point. A variety of demographic, clinical, and treatment-related variables were evaluated as predictors of changes in total and domain scores. Results: All PDQ-K domains showed significant improvement after 12 weeks of antidepressant treatment. More severe initial depressive symptoms, fewer sick-leave days at study entry, and reduced use of concomitant anxiolytics/hypnotics during treatment were significantly associated with greater cognitive improvement. Conclusion: Cognitive symptoms are more responsive to antidepressant treatment in patients with severe MDD. Reduced use of anxiolytics and hypnotics could improve the cognitive functioning of patients with MDD taking antidepressants.

치매예방 통합프로그램이 경증인지 장애노인의 인지기능, 우울, 자아 존중감 및 삶의 질에 미치는 효과 (The Effects of Dementia Prevention Program on Cognition, Depression, Self-esteem and Quality of life in the Elderly with Mild Cognitive Disorder)

  • 이윤미;박남희
    • 성인간호학회지
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    • 제19권5호
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    • pp.104-114
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    • 2007
  • Purpose: This study was conducted to develop and evaluate a dementia prevention intervention program for the elderly with mild cognitive disorder. Methods: The study was nonequivalent control group pretest-posttest design. The subjects of the study were a total of 68 elderly who ranged from 21 to 24 of total scores of K-MMSE, aged over 65, in home. The program consisted of music therapy, humor therapy, art therapy, dancing therapy, recreation, and health education to enhance brain function. The program was applied to the experimental group twice a week, ninety minutes per session for eight weeks. The data were analysed by using chi-square test and t-test. Results: The variables measured in the experimental group and the control group before the intervention were not significantly different in the homogeneity test. The dementia prevention program improved the cognition(t=9.243, p<.001), self-esteem(t=.4.336, p<.001), quality of life(t=8.375, p<.001) and reduced depression(t=-3.913, p<.001). Conclusion: These findings confirmed that the dementia prevention program made a contribution to improving cognitive function, self-esteem, and quality of life and also to reduce depression in the elderly with mild cognition disorder. Therefore, it is recommended that this program could be used in clinical practice as an effective nursing intervention for the elderly with mild cognitive disorder.

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임상환자를 대상으로 한 인터넷 게임장애의 치료방법 고찰 (Internet Gaming Disorder Treatment Options in the Hospital Setting)

  • 박정하;현기정;손지현;이영식
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제26권2호
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    • pp.75-85
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    • 2015
  • Internet gaming disorder (IGD), one of the common subtypes of internet addiction, is now classified in Section 3 of DSM-5 and is increasingly regarded as a growing health concern in many parts of the world. Consequently, many psychotherapeutic and psychopharmacological approaches have been considered and some research regarding therapeutic strategies has been conducted. However, treatment of IGD is in its early stages and therefore is not yet well established. This article reviews multiple therapeutic modalities including our own treatment model for IGD according to clinical and biological effects, thus providing suggestions for standard treatment strategies. The two main streams are psychopharmacological treatment and cognitive-behavior treatment, and the cognitive-behavior approach includes cognitive reconstruction, psychoeducation, and parenting coach. Many other non-pharmacological treatments are also recommended for personalized treatment of IGD.

공황장애의 감정 인식 및 조절 메커니즘 (Emotion Recognition and Regulation Mechanism in Panic Disorder)

  • 김유라;이경욱
    • 대한불안의학회지
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    • 제7권1호
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    • pp.3-8
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    • 2011
  • Cognitive models of panic disorder have emphasized cognitive distortions' roles in the maintenance and treatment of panic disorder (PD). However, the patient's difficulty with identifying and managing emotional experiences might contribute to an enduring vulnerability to panic attacks. Numerous researchers, employing emotion processing paradigms and neuroimaging techniques, have investigated the empirical evidence for poor emotion processing in PD. For years, researchers considered that abnormal emotion processing in PD might reflect a dysfunction of the frontal-temporal-limbic circuits. Although neuropsychological studies have not provided consistent results regarding this model, a few studies have tried to find the biological basis of dysfunctional emotion processing in PD. In this article, we examine the possibility of dysregulation of emotion processing in PD. Specifically we discuss the neural basis of emotion processing and the manner in which such neurocognitive impairments may help clarify PD's core symptoms.