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Yıl:2016; Cilt: 27; Sayı: 2>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2016;27(2):110-118
Çocukluk Çağı Kaygı Bozukluklarında Bilişsel Davranışçı Terapi, İlaç Tedavisi ve Kombine Tedavinin Etkililiğinin Karşılaştırılması
ESS Tok, H Arkar, T Bildik
İzmir Katip Çelebi Üniversitesi, İzmir
Amaç: Çalışmanın amacı, çocukluk çağı kaygı bozukluklarının tedavisinde kullanılmak üzere geliştirilen Korku Avcısı bilişsel davranışçı terapi programının etkililiğinin test edilmesi ve standart ilaç tedavisi ile karşılaştırılmasıdır. Yöntem: Ege Üniversitesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları polikliniğine başvuran ve kaygı bozukluğu tanısı alan 8-12 yaş arası toplam 46 katılımcı çalışmaya alınmıştır. Katılımcılar, bilişsel davranışçı terapi (BDT), standart ilaç tedavisi (ST) ya da kombine tedavi (BDT+ST) koşullarına başvuru sıralarına göre seçkisiz atanmışlardır. Katılımcılar, öntest, sontest ve 3 aylık izlemde değerlendirilmiştir. Çalışmada, Çocuklarda Anksiyete Bozukluklarını Tarama Ölçeği (ÇABTÖ), Çocuklar İçin Olumsuz Bilişsel Hatalar Ölçeği (ÇOBHÖ), Çocuklar İçin Genel Amaçlı Sağlıkla İlgili Yaşam Kalitesi Ölçeği (SİYKÖ) ve Çocuklar İçin Depresyon Ölçeği (ÇDÖ) kullanılmıştır. Bulgular: Yapılan tekrarlayıcı ölçümler için varyans analizi sonuçlarına göre, tüm tedavi koşullarındaki katılımcıların son test ve izlemdeki genel kaygı düzeyleri anlamlı seviyede azalmakla birlikte, BDT+ST kombine tedavi koşulu diğer iki tedavi koşuluna göre istatistiksel olarak anlamlı bir üstünlük sağlamıştır. Ayrıca, olumsuz otomatik düşünceler, depresyon düzeyi ve yaşam kalitesi düzeyi açısından, BDT içeren tüm koşullar (BDT ve BDT+ST), ST koşuluna anlamlı üstünlük sağlamıştır. Sonuç: Çocukluk çağı kaygı bozukluğunun gerek birincil gerekse de ikincil (yaşam kalitesi, depresyon, olumsuz otomatik düşünceler gibi) belirtilerinin tedavisinde anlamlı iyiye gidişler sağladığı için “Korku Avcısı” terapi programının etkili bir tedavi yöntemi olduğu düşünülmektedir.
The Effectiveness of Cognitive Behavioral Therapy, Medication, or Combined Treatment for Child Hood Anxiety Disorders
Objective: The aims of this study were to evaluate the effectiveness of the Fear Hunter cognitive behavioral therapy program, which was developed for the treatment of childhood anxiety disorders, and to compare its effectiveness with standard medication treatment. Method: A total of 46 participants (aged 8 to 12) that applied to the Ege University, Faculty of Medicine, Child and Adolescent Psychiatry clinic and had a diagnosis of anxiety disorder were recruited for the study. The participants were randomly assigned to cognitive behavioral therapy (CBT), standard drug treatment (ST), or combined treatment (CBT+ ST) groups according to the order of application. Subjects were evaluated using pretest, posttest and 3 months follow-up measurements. The participants were assessed by the researcher using The Screen for Child Anxiety Related Emotional Disorders (SCARED), The Children’s Negative Cognitive Errors Questionnaire (CNCEQ), Health Related Quality of Life in Children (Kid-KINDL), and Children’s Depression Inventory (CDI). Results: The results of repeated measures ANOVA showed that, although general anxiety scores of all treatment conditions significantly decreased at posttest and follow up, a combination of two therapies (CBT+ST) had a significantly superior response rate. Moreover, all treatment conditions including CBT (CBT+ST and CBT) were superior to ST in terms of negative cognitive errors, quality of life, and depression. Conclusion: It is thought that The Fear Hunter Therapy Program is an effective treatment technique because; it provides significant improvement in the primary and secondary symptoms (e.g. quality of life, depression, negative automatic thoughts) of childhood anxiety disorders.

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