• 제목/요약/키워드: Generalized anxiety disorder (GAD)

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공황장애 환자에서 범불안장애 공존 유무에 따른 임상적 특징 비교 (A Comparison of the Clinical Characteristics of Panic Disorder with and without Generalized Anxiety Disorder)

  • 오종수;정슬아;최태규
    • 대한불안의학회지
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    • 제13권1호
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    • pp.10-16
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    • 2017
  • Objective : This study aimed to investigate differences in demographic, clinical characteristics, and quality of life between panic-disorder patients with generalized anxiety disorder (PD+GAD) and without generalized anxiety disorder (PD-GAD). Methods : We examined data from 218 patients diagnosed with PD+GAD (150 patients) and PD-GAD (68patients). The following instruments were applied: Stress coping strategies, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Panic Disorder Severity Scale (PDSS), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), NEO-neuroticism(NEO-N), Short Form health survey-36 (SF-36). Results : Compared to the PD-GAD group, the PD+GAD group had higher scores in emotion-focused coping strategies and clinical severity, such as BDI, BAI, PDSS, ASI, APPQ, and neuroticism. The PD+ GAD group showed lower scores in most scales in SF-36 status than PD-GAD group. Conclusions : This study shows that PD+GAD patients are different from PD-GAD patients in coping strategies, clinical severity and quality of life. It emphasizes the need of personalized therapy in clinical approach among patients with PD+GAD.

범불안장애 환자와 일반인의 걱정 내용 및 심각도의 비교 (Contents and Severity of Worries in Outpatients with Generalized Anxiety Disorder Compared to Normal Control)

  • 김휘곤;김대호;오대영;서호준;허휴정;채정호
    • 대한불안의학회지
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    • 제11권1호
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    • pp.47-53
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    • 2015
  • Objective : Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by excessive worries and anxiety symptoms. To distinguish between pathological and normal worries, this study compared the contents and severity of worries among patients with GAD with those of matched non-psychiatric control Methods : Thirty outpatients with GAD receiving treatment at the psychiatric department of Hanyang University Guri Hospital were recruited. As a matched control group, we selected 30 adults without psychiatric history who participated in the Anxiety Disorder Survey, during the Mental Health Exposition held in Seoul in April, 2014. Matched demographic data were age, sex, education, and household income. Self-questionnaires included demographic data, contents of worry (10 categories of worries and each severity), and the Pennsylvania State Worry Questionnaire (PSWQ). Results : There was no statistical difference in the contents of worry between patient and control groups. However, the total PSWQ scores significantly higher in the GAD group. Conclusion : Our findings suggest that patients and non-patients worry about the similar contents and worries in GAD cannot be differentiated by what people worry about. Only the severity of worry was a distinguishable feature. Our finding supported inclusion of the diagnostic criterion of "excesslve wornes" in GAD.

범불안장애 환자의 스트레스 대처방식과 신체증상 지각에 대한 인지적 특성 (Stress Coping Strategies and Cognitive Characteristics of Somatic Symptom Perception in Patients with Generalized Anxiety Disorder)

  • 김용;박종일;박태원;정상근;양종철
    • 대한불안의학회지
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    • 제13권2호
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    • pp.100-107
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    • 2017
  • Objective : The purpose of this study was to investigate strategies used to cope with stress and the cognitive characteristics of somatic symptom perception in patients with generalized anxiety disorder(GAD). Methods : A total of 55 patients meeting DSM-5 criteria for GAD and 55 normal controls were recruited for participation in this study. We evaluated subjects using The Way of Stress Coping Questionnaire (SCQ), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and the Generalized Anxiety Disorder for 7 Item (GAD-7). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In terms of SCQ, GAD patients presented significantly lower scores on seeking social support and higher scores on wishful thinking than normal controls. GAD patients had significantly greater amplification of physical sensation in SSAS and higher scores in physical, psychological interpretation subsets of SIQ than normal controls. GAD-7 scores were positively correlated with physical interpretation scores on SIQ. Conclusion : Results reveal that patients with GAD have insufficient coping strategies for stress, greater amplification of body sensations, and tendency towards a physical, psychological interpretation of somatic symptoms.

한국 범불안장애 환자의 자율신경심장기능 (Heart Rate Variability of Korean Generalized Anxiety Disorder Patients)

  • 추정숙;이승환;김현;이강준;남민;정영조
    • 생물정신의학
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    • 제12권1호
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    • pp.13-19
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    • 2005
  • Objective:The purposes of this study were to investigate heart rate variability(HRV) in patients with generalized anxiety disorder(GAD) compared with major depressive disorder in Korea. Methods:Fifty-six GAD patients(20 male and 36 female) was classified into their comorbid psychiatric illness. Among them, Twenty-five patients(10 male and 15 female) who do not have any psychiatric comorbidity were compared with 30 major depressive disorder patients(12 male and 18 female). Clinical symptoms, HRV and MMPI were analysed between two group. Results:Comorbid psychiatric illnesses of GAD were ranked into no diagnosis(44.6%), MDD(32.1%), panic disorder(10.7%), social phobia(5.3%), PTSD(1.7%), OCD(1.7%), MDD+panic disorder(1.7%) and MDD+specific phobia(1.7%). GAD patients showed low functioning in HRV, but degree of decreasing HRV is not so severe compared with MDD patient. Balance of sympathetic and parasympathetic nerve tone is more severely impaired in GAD patients compared with MDD patient. The score of MMPI did not reveal any differences between two groups. Conclusions:The result showed that HRV can differenciate GAD and MDD patients. GAD patients could show decreased HRV functioning, less than MDD patients. But autonomic imbalance could be more severe in GAD than MDD patients.

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불안 및 우울 장애에 있어서 불확실성에 대한 불내성의 역할 (The Role of Intolerance of Uncertainty in Anxiety and Depressive Disorders)

  • 이준엽;이상혁;서호석
    • 대한불안의학회지
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    • 제9권1호
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    • pp.3-9
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    • 2013
  • Intolerance of uncertainty (IU) is defined as the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events. However, this definition is somewhat categorical and does not explain the phenomenology of IU. Intolerance of uncertainty scale (IUS), the standard measure of IU, was considered to have two factors : 'unacceptability and avoidance of uncertainty' and 'uncertainty leading to the inability to act'. IU may be a cognitive vulnerability factor for clinical worry and generalized anxiety disorder (GAD). A number of moderators and mediators including cognitive avoidance, experiential avoidance and rumination influence the relationship between IU, worry, obsessive-compulsive symptoms, anxious and depressive symptoms. IU may be more strongly related to the symptoms of GAD than to symptoms of other anxiety disorders including obsessive-compulsive disorder (OCD), and major depressive disorder. IU may serve as an important transdiagnostic feature across anxiety and depressive disorders. Incorporating IU-specific treatment components into therapeutic protocols may result in pervasive benefits, and not only for those with GAD or OCD, but for people with any anxiety disorder or with depression.

범불안장애의 한약 치료에 관한 체계적 문헌고찰 및 메타분석: 최근 5년 임상연구를 중심으로 (Systematic Review and Meta-Analysis on Herbal Medicine for Generalized Anxiety Disorder: Focusing on Clinical Studies over the Past 5 Years)

  • 김민재;박현섭;권찬영
    • 동의신경정신과학회지
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    • 제34권4호
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    • pp.403-420
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    • 2023
  • Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was 'Phlegm fire disturbing upward' (痰熱上擾), and the most used herb for therapeutic purposes was 'Rhizome of Poria cocos' (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.

주의 피드백 인식 및 조절 훈련이 대학생의 주의편향 및 범불안에 미치는 효과 (Effect of Attention Feedback Awareness and Control Training on Attention Bias and Generalized Anxiety Symptoms in college students)

  • 김수정;심은정
    • 한국심리학회지:학교
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    • 제16권2호
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    • pp.207-230
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    • 2019
  • 본 연구는 범불안 성향의 대학생을 대상으로 주의편향 및 범불안 증상에 대한 주의 피드백 인식 및 조절 훈련의 효과를 확인하였다. 범불안장애 척도(GAD-7) 10점 이상 또는 펜실베니아 걱정 질문지 척도(K-PSWQ) 56점 이상이며, 주의편향을 나타내는 범불안 성향의 대학생 31명을 선발하여 주의 피드백 인식 및 조절 훈련(Attention Feedback Awareness and Control Training, A-FACT) 집단(n = 11), 주의편향수정(Attention Bias Modification, ABM) 집단(n = 10) 및 활성 위약 통제(Active Placebo Control, APC) 집단(n = 10)에 무선할당하였다. A-FACT 집단은 탐침탐사과제를 이용한 주의편향수정 훈련 시, 개인의 기저반응시간(Baseline Neutral Response time, BNR)을 기준으로 편향 여부에 대한 피드백을 실시간으로 제공받았다. ABM 집단은 기존 ABM 절차와 동일하며, APC 집단은 주의편향을 감소시키기 위한 프로그램이라는 안내는 주어지지만 피드백이 주어지지 않는 탐침탐사과제를 실시하였다. 총 8회기로 구성되어, 주 2회로 4주간 진행되었다. 주의편향수정 훈련의 효과는 주의편향점수(Attention Bias Score, ABS)와 GAD-7, K-PSWQ 및 상태 및 특성 불안 검사(K-STAI) 점수 변화로 평가하였다. 반복측정 변량분석 결과, A-FACT 집단은 ABM 집단과 APC 집단에 비해 ABS가 유의하게 감소하였으며, GAD-7, K-PSWQ 및 K-STAI 점수도 유의하게 감소하였다. 이는 주의편향수정 훈련 시 편향에 대한 피드백을 통해 편향의 여부를 인식시키고 이를 통한 주의의 자기 조절적 통제가 주의편향 및 범불안장애 증상 경감에 효과적일 가능성을 시사한다.

1차 확산기 이후 코로나바이러스감염증-2019의 전파가 부모와 아동의 심리에 미치는 영향 (The Effect of the Transmission of Coronavirus Disease-2019 on the Mentality of Parents and Children After the First Wave of Infections)

  • 김정연;이고은;남옥형;이효설;최성철;김광철;김미선
    • 대한소아치과학회지
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    • 제48권3호
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    • pp.269-279
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    • 2021
  • 이 연구의 목적은 코로나바이러스감염증-2019의 전파가 학령기 아동과 부모의 심리에 미친 영향을 수면장애와 우울증의 측면에서 평가하는 것이었다. 2020년 4월 2일부터 2020년 4월 25일까지 강동 경희대학교 치과병원 소아치과를 방문한 123명의 부모와 108명의 학령기 아동을 대상으로 직접 기입 방식의 설문조사를 실시하였다. 참가자들은 Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder (GAD) - 7, Center for Epidemiology Scale for Depression 로 평가되었다. 로지스틱 회기 분석은 유의 수준 5%로 시행되었다. 부모의 GAD, 우울증, 낮은 수면의 질은 각각 34.1%, 17.1%, 44.7%에서 나타났다. 아동의 GAD 유병률은 20.4%였다. 로지스틱 회기분석 결과 코로나바이러스 관련 안전재난문자로 인한 스트레스가 부모의 불안장애, 우울증과 관련이 있었다. 아동의 경우, 코로나바이러스감염증 발생 이후의 감정 변화 정도가 GAD와 연관성이 있었다. 이 연구를 통해 코로나바이러스감염증-2019의 유행으로 인한 어린이와 보호자들의 심리적 상태 변화가 있음을 확인하였고, 치과진료 시 이들의 심리상태를 고려해야 하겠다.

한국 군 장병에서의 불안장애의 발생률 (The Incidence Rate of Anxiety Disorders in the Korean Military)

  • 이승엽;윤창교;민정아;이창욱;박동언;안종성;이상돈;백명재;장준영;양주연;채정호
    • 대한불안의학회지
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    • 제10권1호
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    • pp.59-67
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    • 2014
  • Objective : To obtain the incidence rate of anxiety disorders among the active duty Korean military personnel, who visited the military hospitals from 2011 to 2013, this descriptive epidemiological study was performed. Methods : After acquiring the data for the anxiety disorders from Defense Medical Statistics Information System, the annual incidence rates were analyzed by forces, position status, and specific disease entities. Results : One thousand, nine hundred and thirteen (1,913) active duty male military personnel were diagnosed with any kinds of anxiety disorders in their first visit to the psychiatric outpatient department (OPD). The total OPD visit counts were 7,870 during the same period. Anxiety disorder, NOS was the most frequent disorder, followed by panic disorder. While the incidence rate for anxiety disorder, NOS decreased, panic disorder displayed increasing tendency. Stress-related disorders and obsessive-compulsive disorder were positioned third and fourth, respectively, for the number of first visit and they both showed decreasing tendency in annual incidence rates. Social anxiety disorder, specific phobias, generalized anxiety disorder (GAD) and mixed anxiety-depressive disorder followed next. The annual incidence rates for anxiety disorders showed decreasing tendency, particularly evident in army soldiers. However, naval officers showed higher anxiety disorder incidence rate compared to those of the army and the air forces. Conclusion : Comparing to general population, panic disorder was higher while specific phobias and GAD were lower in the Korean military. It is interesting to observe higher incidence rate for anxiety disorder in naval officers and warrants further evaluation.

Screening Tool for Anxiety Disorders: Development and Validation of the Korean Anxiety Screening Assessment

  • Kim, Yeseul;Park, Yeonsoo;Cho, Gyeongcheol;Park, Kiho;Kim, Shin-Hyang;Baik, Seung Yeon;Kim, Cho Long;Jung, Sooyun;Lee, Won-Hye;Choi, Younyoung;Lee, Seung-Hwan;Choi, Kee-Hong
    • Psychiatry investigation
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    • 제15권11호
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    • pp.1053-1063
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    • 2018
  • Objective This study evaluated the psychometric properties of the Korean Anxiety Screening Assessment (K-ANX) developed for screening anxiety disorders. Methods Data from 613 participants were analyzed. The K-ANX was evaluated for reliability using Cronbach's alpha, item-total correlation, and test information curve, and for validity using focus group interviews, factor analysis, correlational analysis, and item characteristics based on item response theory (IRT). The diagnostic sensitivity and specificity of the K-ANX were compared with those of the Beck Anxiety Inventory (BAI) and Generalized Anxiety Disorder 7-item scale (GAD-7). Results The K-ANX showed excellent internal consistency (${\alpha}=0.97$) and item-total coefficients (0.92-0.97), and a one-factor structure was suggested. All items were highly correlated with the total scores of the BAI, GAD-7, and Penn State Worry Questionnaire. IRT analysis indicated the K-ANX was most informative as a screening tool for anxiety disorders at the range between 0.8 and 1.6 (i.e., top 21.2 to 5.5 percentiles). Higher sensitivity (0.795) and specificity (0.937) for identifying anxiety disorders were observed in the K-ANX compared to the BAI and GAD-7. Conclusion The K-ANX is a reliable and valid measure to screen anxiety disorders in a Korean sample, with greater sensitivity and specificity than current measures of anxiety symptoms.