Ballenger J C
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
Biol Psychiatry. 1999 Dec 1;46(11):1579-94. doi: 10.1016/s0006-3223(99)00220-6.
The progress in developing effective treatments for the five principal anxiety disorders (ADs) in adults--panic disorder (PD), social phobia (SP), obsessive compulsive disorder (OCD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD)--has been rapid in the past 15 years. There are now well-controlled clinical trials documenting effective pharmacological and psychological treatments for all of these disorders, although generally the evidence is better developed for some disorders than for others. Both the pharmacological treatments and the effective psychological treatments for each disorder will be briefly reviewed. The available data for combination treatment will be reviewed and comparisons of the two types of treatment will be made. This review will contain at least brief reviews of what the treatments involve and attempt to describe how well they work. Many studies unfortunately report only the percentage of patients who "improve" without quantifying the clinical significance of those responses. Data underlining clinical response in terms of the percentage of patients who have an "excellent," "marked," or "moderate" response, and the percentage of patients with a "clinically significant" response will be reported whenever available. Other clinically relevant issues such as length of treatment-relapse rates upon discontinuation and side effects will be presented. As such, this article should provide a brief but comprehensive review of the treatment of these disorders in adults.
在过去15年里,针对成人的五种主要焦虑症(惊恐障碍(PD)、社交恐惧症(SP)、强迫症(OCD)、广泛性焦虑症(GAD)、创伤后应激障碍(PTSD))开发有效治疗方法取得了快速进展。现在有严格对照的临床试验记录了针对所有这些疾病的有效药物和心理治疗方法,尽管一般来说,某些疾病的证据比其他疾病的证据更充分。每种疾病的药物治疗和有效的心理治疗将进行简要回顾。将回顾联合治疗的现有数据,并对这两种治疗方法进行比较。本综述将至少简要回顾治疗方法的内容,并试图描述它们的疗效如何。遗憾的是,许多研究只报告了“改善”患者的百分比,而没有对这些反应的临床意义进行量化。只要有数据,将报告以“优秀”、“显著”或“中度”反应的患者百分比以及具有“临床显著”反应的患者百分比来强调临床反应的数据。还将介绍其他临床相关问题,如治疗时间、停药后的复发率和副作用。因此,本文应能对成人这些疾病的治疗进行简要而全面的综述。