OBJECTIVE: The authors experienced that cognitive begavioral therapy(CBT) could replace medication for controlling panic attacks and anticipatory anxiety symptoms. The objective of this study was finding out predicting factors of discontinuation of medication after CBT for patients with panic disorder. METHOD: A hundred forty-eight patients who met DSM-IV criteria for panic disorder with or without agoraphobia for at least 3 months had completed 12 weekly sessions of Panic Control Therapy(CT ; Barlow et al). Eighty-one patients who could discontinue medication and sixty-seven patients who could not discontinue medication were measured with several scales as the pre- and post-treatment assessment. The scales were Beck Depression Inventory(BDI), Clinical Global Impression(CGI), Spiellberger State Anxiety Inventory(STAI-state), Anxiety Sensitivity Index(ASI), Body Sensation Questionnaire(BSQ), Panic Belief Questionnaire(PBQ), Agoraphobic Cognition Questionnaire(ACQ), Fear Questionnaire(FG), Toronto Alexithymia Scale(TAS). RESULTS: At the pre-treatment assessment, the scores of BDI, CGI, STAI-state, ACQ, BSQ were higher in the patients who could discontinue medication than in the patients who could not discontinue medication(t=-2.68, t=-4.88, t=-3.07, t=-3.68, t=-3.35, p<0.01). CONCLUSION: Patients with panic disorder who were less depressed, less anxious, less agoraphobic and who had less negative cognitions for the bodily sensation and who had higher scores in the therapist's assessment could discontinue their medications.
Affective Symptoms ; Agoraphobia ; Anxiety ; Cognition ; Cognitive Therapy* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Panic Disorder* ; Panic* ; Sensation ; Weights and Measures

PURPOSE: To conduct a nationwide survery on the principles in radiotherapy for rectal cancer, and develop the framework of a database of Korean Patterns of Care Study. MATERIALS AND METHODS: A consensus committee was established to develop a tool for measuring the patterns in radiotherapy protocols for rectal cancer. The panel was composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area. The committee developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer. The survey items developed for measuring the treatment principles were composed of 1) 8 eligibility criteria, 2) 20 items for staging work-ups and prognostic factors, 3) 7 items for principles of combined surgery and chemotherapy, 4) 9 patient set-ups, 5) 19 determining radiation fields, 6) 5 radiotherapy treatment plans, 7) 4 physical/laboratory examination to monitor a patient's condition during treatment, and 8) 10 follow-up evaluations. These items were sent to radiation oncologists in charge of gastrointestinal malignancies in all hospitals (48 hospitals) in Korea to which 30 replies were received (63%). RESULTS: Most of the survey items were replied to without no major differences between the repliers, but with the following items only 50% of repliers were in agreement:1) indications of preoperative radiation, 2) use of endorectal ultrasound, CT scan, and bone scan for staging work-ups, 3) principles of combining chemotherapy with radiotherapy, 4) use of contrast material for small bowel delineation during simulation, 5) determination of field margins, and 6) use of CEA and colonoscopy for follow-up evaluations. CONCLUSION: The items where considerable disagreement was shown among the radiation oncologists seemed to make no serious difference in the treatment outcome, but a practical and reasonable consensus should be reached by the committee, with logical processes of agreement. These items can be used for a basic database for the Patterns of Care Study, which will survey the practical radiotherapy patterns for rectal cancer in Korea.
Colonoscopy ; Consensus ; Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Logic ; Radiotherapy ; Rectal Neoplasms* ; Seoul ; Tomography, X-Ray Computed ; Treatment Outcome ; Ultrasonography