Korean Clinical Psychology Association
[ Review Article ]
Korean Journal of Clinical Psychology - Vol. 38, No. 4, pp.427-444
ISSN: 1229-0335 (Print) 2466-197X (Online)
Print publication date 30 Nov 2019
Received 04 Sep 2019 Revised 03 Nov 2019 Accepted 07 Nov 2019
DOI: https://doi.org/10.15842/kjcp.2019.38.4.008

양극성 장애의 근거기반치료

김빛나
서울대학교 심리학과
Evidence-Based Treatments of Bipolar Disorder
Bin-Na Kim
Department of Psychology, Seoul National University, Seoul

Correspondence to: Bin-Na Kim, Department of Psychology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, Korea; E-mail: shine-binna@hanmail.net


© 2019 Korean Clinical Psychology Association

초록

양극성 장애는 양방향의 기분삽화가 주기적으로 반복되며, 다양한 범위의 기능장해 및 자살 위험성과 관련성이 높은 만성적인 정신장애이다. 본고에서는 양극성 장애의 치료에서 심리사회적 개입의 필요성과 유용성을 논의하고, 해외 및 국내 치료효과 연구를 검토함으로써 양극성 장애의 근거기반치료로서 어떠한 심리치료가 우선 활용 가능한지에 대한 최신지견을 제공하고자 하였다. 무선할당 통제연구를 중심으로 관련 연구들을 고찰한 결과, 해외에서는 대표적으로 4가지 근거기반치료(심리교육, 가족중심치료, 인지행동치료, 대인관계 및 사회적 리듬 치료)가 양극성 장애의 유지치료 및 우울 급성기 치료에 효과가 입증되어 있는 것으로 나타났다. 부가적으로 마음챙김 인지치료, 변증법적 행동치료의 잠정적인 치료 효과가 보고되기 시작하였다. 반면, 국내에서는 일부 예비연구들이 존재하기는 하지만, 확실한 경험적 근거를 갖춘 근거기반치료는 아직 없었다. 마지막으로 향후 국내에서 양극성 장애의 근거기반치료를 활성화시키기 위한 방안에 대하여 논의하였다.

Abstract

Bipolar disorder (BD) is a chronic mental disorder characterized by bidirectional mood episodes and associated with diverse functional impairments and suicidal risk. Firstly, this narrative review emphasized the necessity and utility of adjunct psychosocial interventions for BD. Next, the author attempted to provide up-to-date guidelines on which particular psychosocial interventions could be recommended as evidence-based treatment (EBT) of BD by reviewing treatment studies conducted in Korea as well as other countries. As a result, four psychosocial interventions (psychoeducation, family-focused therapy, cognitive behavioral therapy, and interpersonal and social rhythm therapy) were identified as EBTs with strong levels of evidence, based on randomized controlled trials conducted overseas. In general, adjunct psychosocial treatments showed effectiveness in relapse prevention and acute treatment during depressive episodes. Additionally, mindfulness-based cognitive therapy and dialectical behavioral therapy began to demonstrate promising outcomes. However, although several preliminary studies have been published, there was a shortage of empirical evidence for effective EBT of BD within Korea. Lastly, the author discussed how to promote and disseminate EBT of BD within Korea.

Keywords:

bipolar disorder, evidence-based practice, evidence-based treatment, randomized controlled trial

키워드:

양극성 장애, 근거기반실무, 근거기반치료, 무선할당통제연구

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