Schmidt Norman B, Santiago Helen T, Trakowski John H, Kendren J Michael
The Ohio State University, Columbus 43210, USA.
Pain Res Manag. 2002 Fall;7(3):134-41. doi: 10.1155/2002/543837.
Although there has been a link between certain types of pain, notably chest pain, and panic disorder, the relation between pain and panic disorder has not been systematically evaluated. In the present study, the relation between pain symptoms (headache, chest pain, stomach pain, joint pain) and the clinical presentation of patients with panic disorder was evaluated.
Pain was generally hypothesized to be related to increased symptoms of anxiety, panic-relevant cognitive domains and treatment outcome. In terms of specific pain domains, headache and chest pain were expected to be more closely related to anxiety-related symptoms.
Patients (n=139) meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition for panic disorder completed a set of standardized clinician-rated and self-reported measures. Moderator analyses were used in a subset of these patients completing a treatment outcome study.
Approximately two-thirds of the participants endorsed at least one current pain symptom. The hypotheses were partially supported, with pain being associated with higher levels of anxiety and depression symptoms, as well as panic frequency. Pain was also related to several cognitive features, including anxiety sensitivity and panic appraisals. Headache and chest pain were more highly associated with anxiety symptoms than was joint pain. Cognitive measures did not mediate the relation between anxiety and pain, and pain did not significantly moderate outcome in response to cognitive-behavioural therapy.
Co-occurring pain symptoms appear to be more highly related to phenomenology than to treatment response in patients with panic disorder.
尽管某些类型的疼痛，尤其是胸痛，与惊恐障碍之间存在联系，但疼痛与惊恐障碍之间的关系尚未得到系统评估。在本研究中，评估了疼痛症状（头痛、胸痛、胃痛、关节痛）与惊恐障碍患者临床表现之间的关系。
一般假设疼痛与焦虑症状增加、与惊恐相关的认知领域及治疗结果有关。就特定疼痛领域而言，预计头痛和胸痛与焦虑相关症状的关系更为密切。
符合《精神障碍诊断与统计手册》第四版惊恐障碍标准的患者（n = 139）完成了一组标准化的临床医生评定和自我报告测量。在这些完成治疗结果研究的患者子集中进行了调节分析。
约三分之二的参与者认可至少一种当前疼痛症状。假设得到部分支持，疼痛与更高水平的焦虑和抑郁症状以及惊恐发作频率相关。疼痛还与多种认知特征有关，包括焦虑敏感性和惊恐评估。与关节痛相比，头痛和胸痛与焦虑症状的关联更为密切。认知测量并未介导焦虑与疼痛之间的关系，并且在认知行为疗法治疗中，疼痛对治疗结果没有显著的调节作用。
在惊恐障碍患者中，并发的疼痛症状似乎与现象学的关系比与治疗反应的关系更为密切。
