Recent Advances in Cognitive Behavioral Therapy for Panic Disorder

공황장애 인지행동치료의 최신 지견

  • Seo, Ho-Jun (Department of Psychiatry, The Catholic University of Korea College of Medicine) ;
  • Lee, Kang-Soo (Department of Psychiatry, School of Medicine, CHA University) ;
  • Lee, Sang-Hyuk (Department of Psychiatry, School of Medicine, CHA University) ;
  • Suh, Ho-Suk (Department of Psychiatry, School of Medicine, CHA University)
  • 서호준 (가톨릭대학교 의과대학 정신과학교실) ;
  • 이강수 (차의과학대학교 정신과학교실) ;
  • 이상혁 (차의과학대학교 정신과학교실) ;
  • 서호석 (차의과학대학교 정신과학교실)
  • Received : 2016.04.19
  • Accepted : 2016.04.21
  • Published : 2016.04.30

Abstract

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.

Keywords

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