공황장애 환자에서 인지행동치료 전후의 불안민감성의 남녀차이

Abstract

이 연구에서는 공황장애 환자에서 인지행동치료 전후의 불안민감성의 남녀 차이를 조사하였다. DSM-VI에 따라 광장공포증을 동반하거나 동반하지 않은 공황장애로 진단된 남자 28명과 여자 31명에 대해 인지행동치료 시작전후의 불안민감성지표(ASI)를 측정하였다. 여자에서 치료전 ASI 총점 및 인지적 염려요인의 점수만이 유의하게 높았다. ASI 총점 및 각 소척도 점수가 남녀 모두에서 각각 유의하게 감소하였지만 남녀간의 차이는 유의하지 않았다. 인지행동치료 후에는 여자에서 인지적 염려요인 및 사회적 염려요인만이 높게 나타났다. 이는 인지적 염려요인이 공황장애의 병인 및 예후의 남녀 차이와 연관있을 가능성을 보여준다. 사회적 염려요인에 대해서는 추후 논의가 필요하다.

This study examined gender differences in anxiety sensitivity in patient with panic disorder with or without agoraphobia that were treated with cognitive behavioral therapy (CBT). Fifty nine outpatients (men 28, women 31) with DSM-IV confirmed panic disorder completed the Anxiety Sensitivity Index (ASI) at baseline and after 12 week CBT. Women scored significantly higher than men in total ASI score and Mental Incapacitation Concern subscale score at baseline. And no significant gender differences were found in Physical Concern subscale score and Social Concern subscale score at baseline. This study also compared total ASI score and each subscale scores between baseline and post-treatment. Although total ASI score and each subscale scores decreased significantly in both sexes, no significant gender differences were founded. After CBT, women scored significantly higher than men on Mental Incapacitation Concern subscale and Social Concern subscale. But no significant gender differences were found in total ASI score and Physical Concern subscale score. This finding that women scored high Mental Incapacitation Concern subscale score both at baseline and after CBT and supports previous finding that Mental Incapacitation subscale can be associated with gender differences in pathogenesis and prognosis of panic disorder. Total ASI score, Physical Concern subscale score and decrease of anxiety sensitivity after treatment do not seem to be associated with gender differences in pathogenesis and prognosis of panic disorder directly. Further discussion is needed about Social Concern subscale. (Korean J Str Res 2008;16:199∼205)