Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Cognitive Processing Therapy as a First-line Treatment for Post-Traumatic Stress Disorder

인지처리치료: 외상후 스트레스 장애의 일차 치료

  • Jin-Hee, Choi (Department of Psychiatry, Veterans Health Service Medical Center) ;
  • Hyung-Seok, So (Department of Psychiatry, Veterans Health Service Medical Center) ;
  • Soonjo, Hwang (Department of Psychiatry, University of Nebraska Medical Center) ;
  • Ji-Woo, Suk (Department of Psychiatry, University of Nebraska Medical Center) ;
  • Hayun, Choi (Department of Psychiatry, Veterans Health Service Medical Center) ;
  • Seung-Hoon, Lee (Department of Psychiatry, Veterans Health Service Medical Center) ;
  • EunYoung, Lee (Department of Psychiatry, Veterans Health Service Medical Center)
  • Received : 2022.11.17
  • Accepted : 2022.12.05
  • Published : 2022.12.31
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Abstract

Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

외상후 스트레스 장애는 다양한 치료들에 대한 치료반응이 좋지 않아, 많은 임상가들에게 큰 도전이 되고 있다. 최근 발간된 여러 임상 진료지침들은 인지처리치료 및 지연노출치료를 포함한 트라우마 초점 정신치료들을 일차 치료로 공통적으로 권고하고 있다. 환자에게 근거에 기반한 치료적 선택지들에 대하여 정보를 제공함으로써 환자와 임상가가 함께 최선의 치료방법을 선택할 수 있도록 하는 것이 중요하며, 이를 위해 인지처리치료의 내용과 근거를 소개하는 것이 본 종설의 목적이다. 인지처리치료의 회기 구성과 내용을 요약하여 소개하고, 외상후 스트레스 장애에 대한 인지처리치료의 효과를 알아본 다양한 연구들을 민간인 집단과 재향군인/현역군인 집단으로 구분하여 제시하였다. 인지처리치료의 탈락율을 낮추고 치료성적을 올리며 치료접근도를 높일 수 있는 방법들 및 외상후 스트레스 장애에 대한 근거중심치료의 활성화를 위한 방안을 토의한다.

Keywords

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