Læknablaðið - 15.11.2011, Page 38

Y F I R L I T
grein nema meðferðaraðilar mæti slíkum skilmerkjum. í annan
stað eru rannsóknir á samþættri meðferð komnar skammt á veg.
í þriðja lagi eru árangursrannsóknir gjarnan gerðar á fremur
einsleitum hópi sjúklinga sem endurspeglar ekki alltaf nægilega
klínískan raunveruleika þar sem vímugjafar, erfiðar félagslegar
aðstæður og persónuleikaröskun getur flækt myndina. Að lokum
er vert að nefna að í sumum samanburðarrannsóknum á HAM
og lyfjameðferð hefur verið notast við þríhringa þunglyndislyf
sem eru ekki lengur fyrsta lyfjameðferð við kvíða og þunglyndi
vegna aukaverkana og hættu á hjartsláttartruflunum, séu þau
tekin í of stórum skömmtum.
Af yfirlitinu má álykta að HAM sé gagnleg meðferð við lyndis-
og kvíðaröskunum. Aukaverkanir eru nær aldrei vandamál og
langtímaárangur að meðferð lokinni oft góður. í þessari grein
leyfir rýmið ekki að fjallað sé um árangur HAM við ýmsum
öðrum vandamálum sem sálfræðingar, geðlæknar, heimilislæknar,
lyflæknar og aðrir heilbrigðisstarfsmenn glíma við í starfi sínu.
Dæmi um slíkt eru persónuleikaraskanir, geðklofi, geðhvarfasýki,
fíknivandamál og átraskanir. Slík umfjöllun er efni í aðra grein.
ENGLISH SUMMARY
Efficacy of cognitive behavioral therapy in the treatment of mood and anxiety disorders in adults
Sighvatsson MB, Kristjánsdóttir H. Sigurðsson E, Sigurðsson JF
Cognitive behavioral therapy (CBT) represents that form of psychotherapy which has most research data to build on in the treatment of mood and
anxiety disorders for adults. In this review we will introduce CBT and present the results of pertinent outcome research. Efficacy at the end of treatment is
discussed, as well as long term effectiveness and the efficacy of combined treatment with medication and CBT. In addition, we discuss the pros and cons
of group CBT compared to CBT in individual format, and comorbidity of mental disorders. According to this review CBT is efficacious for major depressive
disorder, generalized anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive compulsive disorder, social phobia and specific phobia.
Efficacy of CBT is equal to or better than efficacy of drugs in the treatment of the above disorders, but there is less access to CBT. Longterm effectiveness
of CBT appears to be good, but research on combined treatment is yet in its infancy and conclusions are premature on its place in treatment.
Key words: Cognitive behavioral therapy, psychotropic treatment, efíicacy, long-term efíects, combined treatment, mental disorders, adults.
Correspondence: Hafrún Kristjánsdóttir, hafrunkr@landspitali.is
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