• 생물정신의학
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• 제25권3호
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• pp.45-52
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• 2018

Objectives The objective of this study was to investigate the differences in sociodemographic and clinical characteristics, temperaments, and quality of life between panic disorder (PD) patients with and without major depressive disorder (PD+MDD and PD-MDD patients, respectively). Methods We compared 411 PD-MDD and 219 PD+MDD patients. All patients who were drug-free for at least 1 month were assessed at initial outpatient visits before the administration of medication. The following instruments were used for assessment: the NEO Personality Inventory-Neuroticism (NEO-N) ; the Temperament and Character Inventory-Harm Avoidance (TCI-HA) ; the State-Trait Anxiety Inventory (STAI) ; the Intolerance of Uncertainty Scale-Short (IUS); the Anxiety Sensitivity Index-Revised (ASI-R); the Beck Depression Inventory (BDI) ; the Beck Anxiety Inventory (BAI); the Penn State Worry Questionnaire (PSWQ) ; the Generalized Anxiety Disorder for 7 item (GAD-7) ; the Albany Panic and Phobia Questionnaire (APPQ) ; the Panic Disorder Severity Scale (PDSS) ; the Early Trauma Inventory Self Report-Short Form (ETISR-SF) ; the Scale for Suicidal Ideation (SSI) ; the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) ; the Sheehan Disability Scale (SDS) ; and the Short Form health survey (SF-36). Results Compared to the PD-MDD patients, the PD+MDD patients were younger and more likely to be unmarried. They showed higher rates of unemployment, lower levels of education and income, younger age of onset, more previous suicide attempts, a greater incidence of agoraphobia, and more previous treatments. The PD+MDD patients showed significantly higher scores on the NEO-N, the TCI-HA, the STAI, the IUS, the ASI-R, the BDI, the BAI, the PSWQ, the GAD-7, the APPQ, the PDSS, the ETISR-SF, and the SSI. In addition, the PD+MDD patients showed significantly lower quality of life than did the PD-MDD patients. In contrast with previous studies, we observed no significant differences between the two groups in terms of gender, duration until treatment, and psychiatric comorbidities. Conclusions This study showed that the PD+MDD patients have more early trauma experiences, higher levels of anxiety-related temperaments, more severe panic and depressive symptoms, and lower quality of life than the PD-MDD patients.

• 대한불안의학회지
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• 제14권2호
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• pp.53-62
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• 2018

Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea. Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval. Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.

• 대한상한금궤의학회지
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• 제8권1호
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• pp.109-119
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• 2016

Objective : The purpose of this paper is to report the effect of Daehamhyung-tang(DHHT) on tinnitus with panic disorder from the disease pattern identification diagnostic system based on Shanghanlun provisions. Methods : According to a disease pattern identification diagnostic system based on Shanghanlun provisions, the patient was diagnosed with 'Taeyang-byung Gyeolhyung'. He took DHHT for 82 days. This paper evaluated the results of treatment on tinnitus by Tinnitus Handicap Inventory(THI) and Verbal Numercial Rating Scale(VNRS). To assess the mental state of anxiety, this paper used Hamilton Anxiety Rating Scale(HAM-A) Results : The THI score was declined from 58 to 6 And the VNRS score was declined from 6 to 1. HAM-A score was declined from 28 to 3. Conclusions : This case study suggests that DHHT has effectiveness on a patient suffers from tinnitus with panic disorder and diagnosed with 'Taeyang-byung Gyeolhyung'.

• 대한불안의학회지
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• 제3권1호
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• pp.32-40
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• 2007

Objectives : To investigate the validity of an abbreviated self-rated Korean version of MINI (Mini International Neuropsychiatric Interview) patient health survey which screening social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder. Methods : 115 subjects completed MINI and MINI patient health survey. The validity of MINI patient health survey was assessed by whether the results from MINI patient health survey were compatible with the results from MINI or not. The Cohen's kappa value, specificity, sensitivity, positive predictive value, and negative predictive value was calculated for this purpose. Results : The Kappa values of social anxiety disorder (0.60), panic disorder (0.49), generalized anxiety disorder (0.60) and major depressive disorder without other co-morbid disorder (0.59) were at least moderate in strength of agreement. Conclusion : The abbreviated self-rated Korean version of MINI patient health survey has the moderate to good validity in social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder without other co-morbid disorders. Our result suggests that this instrument might be useful for screening above 4 disorders if it is used under careful supervision of experienced clinicians.

• 사상체질의학회지
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• 제32권2호
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• pp.61-70
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• 2020

Objectives The purpose of this case study was to report that a patient with Panic Disorder concurrently treated with psychotherapy based on Sasang Constitutional Medicine was able to discontinue the drugs. Methods The patient was diagnosed as Soeumin and consulted according to her Sasang constitution while being administered with herbal medicines. The psychotherapy applied in the consultation was to reduce excessive expectations towards her family members or situations. Results and Conclusions Anxiety of the patient was alleviated and the patient was able to discontinue the drugs during the treatment period. And no panic attack or adverse effect of the discontinuation of the drugs was observed during the rest of the time of 7 months and 4 months later after the termination of the treatment.

• 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.

• 동의신경정신과학회지
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• 제16권2호
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• pp.301-308
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• 2005

Pain disorder is the chronic syndrome that onset and change of pain is associated with mood change. But the patient of pain disorder can't perceive their inner conflict. We experienced a 58 year-old woman who had general pain, and whose condition was improved through oriental medical treatment. In this case, we assessed the pain disorder patient at MMPI. So we learned out the patient's inner conflict and dynamic. The applicability of understanding with MMPI has positive effects on the patient with Panic disorder.

• 대한불안의학회지
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• 제7권2호
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• pp.85-91
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• 2011

본 연구에서는 공황장애 환자의 심리도식 특성을 조사하였다. 대조군에 비해 환자군은 상태 및 특성불안, 우울 점수가 유의하게 높았으며 YSQ 중에서는 유기/불안정, 위험/질병에 대한 취약성 도식 점수가 유의하게 높았다. 환자군에서 ST-AI로 평가한 불안 수준은 모든 심리도식과, BDI로 평가한 우울 수준은 특권의식/과대성을 제외한 14개 도식과 상관관계가 있었으나 대조군에서는 훨씬 적은 수의 도식만이 상관관계를 보였다. 환자군에서 위험/질병에 대한 취약성, 유기/불안정 도식이 특성불안 수준을 가장 잘 예측하였으며 의존/무능, 유기/불안정 도식은 상태불안 수준을, 결함/수치심, 복종 도식은 우울 수준을 가장 잘 예측하였다. 이를 종합할 때, 초기부적응 심리도식은 공황장애의 발병과 경과 그리고 치료 반응에 영향을 미칠 가능성이 있다. 향후 대규모 집단을 대상으로 공황장애 환자의 심리도식 특성을 파악하고 치료에 접목시키는 작업이 필요할 것으로 생각된다.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 2006년도 제15차 추계학술대회
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• pp.145-146
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• 2006

• 대한불안의학회지
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• 제2권2호
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• pp.136-141
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• 2006

Objectives : This study aimed to investigate the therapeutic effect of combined biofeedback training with pharmacotherapy for patients with anxiety disorder. Methods : 12 patients with panic disorder and generalized anxiety disorder were enrolled this study. They were tested for State Trait Anxiety Inventory-State (STAI-S), State Trait Anxiety Inventory-Trait (STAI-T), Beck's Depression Inventory (BDI) and Symptom CheckList-90-Revision Somatization (SCL-90-R-SOM) before and after the biofeedback training program. Results : The score of STAI-T (p=0.023) and BDI (p=0.0018) were the significantly decreased after the biofeedback training program. In Female group, the score of STAI-T (p=0.028), STAI-S (p=0.028) and BDI (p=0.009) were significantly decreased after the biofeedback training program. In the group which age is lower than 40 years old, the score of BDI (p=0.046) were significantly decreased after the biofeedback training program. In Panic disorder group, the score of STAI-S (p=0.046) were significantly decreased after the biofeedback training program. Conclusion : The result of this study is useful for the treating the anxiety disorder patients using the biofeedback training program.