공황장애에서 Paroxetine 단기약물치료가 심리적 상태에 미치는 영향

Effect of the Short-Term Treatment of Paroxetine on Psychological States in Panic Disorder

Objectives：This study was designed to evaluate clinical effect of paroxetine treatment and to explore psychological predictors of treatment response. Methods：Patients (n=26) who met DSM-IV criteria for panic disorder with or without agoraphobia were treated by paroxetine for 12 weeks. We assessed symptom improvement using Clinical Global Impression (CGI), and clinical characteristics using Anxiety Sensitivity Index (ASI), Anxious Thoughts and Tendencies (AT & T), Agoraphobic Cognition Questionnaire (ACQ), Body Sensation Questionnaire (BSQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). T-test, correlation analysis, and stepwise multiple regression analysis were performed. Results：Panic patients showed significant improvement in severity of illness and each clinical characteristic after 12 weeks of paroxetine treatment. There were significant correlations among severity of illness, anxiety, and depression, and subjective severity was related with catastrophic thoughts. The more catastrophic thoughts and the higher sensitivity of body sensation, Patients had the worse symptom improvement they shorved. Multiple regression analysis showed that catastrophic thought related to agoraphobia was the best predictor of symptom improvement (22%). Conclusion：This study suggests that short-term treatment of paroxetine is effective in panic disorder with or without agoraphobia, and that catastrophic thought could be a predictor of poor treatment response. Thus cognitive intervention on catastrophic thoughts may play an important role in symptom improvement in panic disorder