Shear M Katherine, Cassano Giovanni B, Frank Ellen, Rucci Paola, Rotondo Alessandro, Fagiolini Andrea
Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
Psychiatr Clin North Am. 2002 Dec;25(4):739-56. doi: 10.1016/s0193-953x(02)00032-1.
The results of the authors' research efforts to date support the idea that the panic-agoraphobic spectrum is a robust and culturally transferable construct with important clinical implications for patients with mood and anxiety disorders. In particular, their findings suggest the need for alternate treatment strategies to treat mood patients with comorbid panic features [50,52]. They maintain that the spectrum approach could add to the knowledge of course and outcome of mood and anxiety disorders and inform treatment decisions. The spectrum concept has other potential implications. For the purposes of neurobiologic research, reliable identification of phenotypes that map [Figure 3: see text] onto specific brain processes in crucial. The definition of the diathesis phenotype is also important if we are to elucidate the cause and pathophysiology of mental disorders at a molecular level. A panic-agoraphobic spectrum assessment incorporate temperamental features and trait-like manifestations into a comprehensive symptom assessment to provide a detailed picture of the clinical features of PD. Such an approach holds some promise for progress in studies of neurobiologic basis of panic and may be useful in further efforts to overcome the nagging problem of the ambiguous boundaries of DSM diagnostic categories [53].
作者迄今为止的研究成果支持这样一种观点,即惊恐-场所恐惧症谱系是一个强有力且可在文化间转换的概念,对患有心境障碍和焦虑症的患者具有重要的临床意义。尤其是,他们的研究结果表明,需要采用替代治疗策略来治疗伴有惊恐特征的心境障碍患者[50,52]。他们坚持认为,谱系方法可以增加对心境障碍和焦虑症病程及转归的认识,并为治疗决策提供依据。谱系概念还有其他潜在意义。对于神经生物学研究而言,可靠地识别与特定脑过程相对应的表型[图3:见正文]至关重要。如果我们要在分子水平阐明精神障碍的病因和病理生理学,素质表型的定义也很重要。惊恐-场所恐惧症谱系评估将气质特征和特质样表现纳入全面的症状评估中,以提供惊恐障碍临床特征的详细情况。这种方法有望在惊恐障碍神经生物学基础的研究中取得进展,并且可能有助于进一步解决DSM诊断类别界限模糊这一棘手问题[53]。