• Title/Summary/Keyword: 공황

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A Case of Cognitive-Behavioral Therapy for a Patient with Panic Disorder (공황 장애 환자의 인지-행동 치료 1례)

  • Kang, Dong-Woo;Choi, Young-Hee;Lee, Jung-Hum;Chung, Young-Cho
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.245-253
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    • 1996
  • In spite of its prominent effects on reduction of panic attacks and preveniton of relapse, cognitive-behavioral therapy(CBT) for panic disorder is seldomly utilized and studied in this country. for the past year, authors have modified CBT program for panic disorder that was based on PCT(panic control program) designed by Dr. Barlow and Dr. Craske. Our program is composed of informational component, somatic management skills, cognitive restructuring, interoceptive exposure and in vivo exposure. One patient has significantly improved by this program and satisfied with the treatment result. The aim of this article is to present our experience of treating a panic patient with CBT.

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Efficacy and Safety of Venlafaxine Extended-release in Panic Disorder (공황 장애 환자에서 Venlafaxine Extended-release의 치료 효과와 안전성)

  • Ryu, Vin;Kim, Chan-Hyung
    • Anxiety and mood
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    • v.2 no.1
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    • pp.17-21
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    • 2006
  • SSRIs have been considered as the first line of treatment for patients with panic disorder since 1990s along with cognitive behavioral treatments. High potency benzodiazepines (e.g. alprazolam, clonazepam) have had advantages in anti-panic effects. However, these drugs have limitations of treating panic disorder because of their dependency, tolerance and withdrawal. Serotonin and noradrenaline reuptake inhibitors (SNRIs) such as venlafaxine were introduced as antidepressants since 1990s. Recently, it is confirmed that SNRIs have the remarkable anti-panic effects although some concerns about its cost, tolerance, withdrawal, side effects such as dry mouth, constipation, and hypertension have emerged. In this regard, further study is required to confirm the efficacy of long term treatment of panic disorder. Despite these concerns, venla-faxine extended-release is an effective treatment in patients with panic disorder.

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The Effect of Venlafaxine in One Patient with Panic Disorder and Generalized Anxiety Disorder : A Case Report (Venlafaxine 투여로 회복을 보인 공황장애와 범불안장애가 병발한 환자의 치료 1예)

  • Choi, Hong;Yoon, Se-Chang
    • Anxiety and mood
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    • v.2 no.1
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    • pp.56-60
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    • 2006
  • Panic disorder is a relatively common psychiatric illness (life time prevalence 3.5%), and it is known that 91% of patients with panic disorder have at least one other psychiatric disorder. And patients with panic disorder, who have coexisting generalized anxiety disorder, tend to have more severe symptoms and less favorable outcome and respond less well to psychological and pharmacologic treatment. The authors report a 51-year old male who was previously diagnosed as panic disorder in the out-patient clinic, showed poor response to antipanic treatment. However, he showed great improvement after he was treated for panic disorder and comorbid generalized anxiety disorder. This case report showed that more effort to identify comorbid conditions is needed in panic disorder patients and the effectiveness of venlafaxine in the treatment of panic disorder with generalized anxiety disorder.

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Thyroid Indices in Patients with Panic Attack (공황장애 환자에서의 갑상선 지표)

  • Kim, Young-Chul
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.65-72
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    • 1995
  • The author compared indices of thyroid function in 76 patients with panic attack and 80 control subjects. And SCL-90-R was performed to evaluate the relationship between the psychiatric symptoms and thyroid indices in the patients with panic attack The results were as follows: 1). No siginificant differences in T3, T4 or TSH were found between the two groups. But T3 level was significantly lower in male panic patients than male controls(p<0.005). 2) The T3 level was significantly lower in male panic patients who had higher depression socre than average in SCL-90-R(p<0.025). 3) The TSH level was significantly lower in patients with higher anxiety(p<0.001) and phobia(p<0.05) score and in female panic patients(p<0.001) with higher anxiety and phobia score than average in SCL-90-R. 4) The phobic symptom(p<0.001) was siginificantly higher and the T3 level(p<0.005) was lower in the male than the female patients with panic attack.

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

  • Kim, Yoo-Ra;Lee, Kyoung-Uk
    • Anxiety and mood
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    • v.7 no.1
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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.

Incremental Early Risk Detection using Dialogue State Tracking for Panic Disorder (대화 상태 추적 모델을 활용한 공황 장애 점진적 조기 위험 검출 시스템)

  • Chaebin Lee;Geunbae Lee
    • Annual Conference on Human and Language Technology
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    • 2022.10a
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    • pp.497-501
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    • 2022
  • 대화 상태 추적(Dialogue State Tracking)은 특정 목적을 달성하기 위한 대화 시스템인 목적 지향 대화 시스템의 핵심 부분으로, 대화에서 표현된 사용자의 목적을 추출한다. 조기 위험 검출 시스템은 연속적으로 들어오는 정보를 바탕으로 분류 대상인지 아닌지를 판별하며, 정확도 저하를 피하면서 최대한 빠르게 분류하는 것을 목표로 한다. 본 연구에서는 대화 상태 추적 시스템에서 나온 은닉층을 입력으로 하여 실시간으로 공황 장애 여부를 점진적으로 조기 분류하는 시스템과 조기 분류를 위한 새로운 손실 함수를 제안한다. 조기 위험 검출 시스템에 대화 상태인 belief state의 정보를 함께 사용했을 때, 큰 성능 향상을 보였으며 대화 상태가 조기 위험 검출에 필요한 정보를 담고 있음을 확인할 수 있다.

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Recent Advances in Cognitive Behavioral Therapy for Panic Disorder (공황장애 인지행동치료의 최신 지견)

  • Seo, Ho-Jun;Lee, Kang-Soo;Lee, Sang-Hyuk;Suh, Ho-Suk
    • Anxiety and mood
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    • v.12 no.1
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    • pp.47-55
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    • 2016
  • 30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.

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Assessment of Health-Related Quality of Life among Patients with Panic Disorder Using EuroQol in Korea (EuroQol 도구로 측정한 성인 공황장애 환자의 건강관련 삶의 질 수준)

  • Son, Myoung-Ha;Byun, Keum-Ryung;Choi, Byung-Hwi;Woo, Jong-Min
    • Anxiety and mood
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    • v.8 no.1
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    • pp.9-15
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    • 2012
  • Objectives : The purpose of this study was to assess the health-related quality of life (HRQoL) for patients with panic disorder using EQ-5D and EQ-VAS, and to examine the relationship between health-related quality of life and clinical outcomes following treatment. Methods : 29 patients with panic disorder were recruited from the Seoul Metropolitan area and 20 patients were followed up after two months of outpatient treatment. The Panic Disorder Severity Scale (PDSS) was used to assess the severity of the panic disorder and the changes in symptoms. HRQoL was assessed with EQ-5D and EQ-VAS at baseline and at two months of treatment. Results : All enrolled panic disorder patients showed significantly impairment of HRQoL in view of the subscales of EQ-5D, EQ-VAS index scores. The severity of PDSS was correlated the HRQoL in the panic patients. After treatment, the EQ-5D, EQ-VAS index scores showed significant improvement. Conclusion : Panic disorder patients suffer from lower HRQoL as well as from symptoms of the disorder. They showed clinical improvement and a restored HRQoL with treatment. These outcomes suggest using the EQ-5D, EQ-VAS such as the HRQoL in the assessment of patients with panic disorder is essential.

Evaluation of Therapeutic Effects of Cognitive-Behavioral Therapy in Patients with Panic Disorder using Serial $^{99m}Tc-ECD$ Brain Perfusion (공황장애 환자에서 $^{99m}Tc-ECD$ 뇌관류 SPECT를 이용한 인지행동치료 효과 평가)

  • Kim, Jung-Hee;Song, Ho-Chun;Yang, Jong-Chul;Lee, Byeong-Il;Heo, Young-Jun;Bom, Hee-Seung;Park, Tae-Jin;Min, Jung-Joon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.302-308
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    • 2006
  • Purpose: Although several neuroanatomical models of panic disorder have been proposed, little is known regarding the neurological mechanisms underlying cognitive-behavioral therapy (CBT) in patients with panic disorder. This study was performed to identify the brain structures that show changes of regnioal cerebral blood flow (rCBF) after CBT in patients with panic disorder. Materials and Methods: Seven patients who were diagnosed as panic disorder by DSM-IV were treated with CBT for 8 weeks and twelve healthy volunteers joined in this study. Serial $^{99m}Tc-ECD$ brain perfusion SPECT images were acquisited and PDSS-SR (Self-Report version of Panic Disorder Severity Scale) and ACQ (Agoraphobic Cognitive Question) scores were measured just before and after CBT in all patients. Data were analyzed using SPM2. Results: Subjective symptoms were improved, and PDSS-SR and ACQ scores were significantly reduced ($14.9{\pm}3.9\;vs.\;7.0{\pm}1.8$, p<0.05; $30.3{\pm}8.5\;vs.\;21.6{\pm}3.4$, p<0.05, respectively) after CBT in panic patients. Before CBT, a significant increase of rCBF was found in the cingulate gylus, thalamus, midbrain, both medial frontal and temporal lobes of the panic patients compared to the normal volunteers. After CBT, we observed a significant rCBF decrease in the left parahippocamus, right insula and cingulate gyrus, both frontal and temporal lobes, and a significant rCBF increase in both the occipital lobes, left insula, both frontal and left parietal lobes. Conclusion: These data suggested that CBT is effective for panic disorder and diminish the activity of the brain areas associated with fear in panic disorder.