Márquez M, Seguí J, Canet J, García L, Ortiz M
Hospital Parc Taulí, Psychiatric Unit, Sabadell, Barcelona, Spain.
J Affect Disord. 2003 Aug;75(3):237-45. doi: 10.1016/s0165-0327(02)00054-x.
Though panic disorder (PD) and alcoholism have been found in epidemiologic studies to often co-occur, the influence of cultural factors on the order of onset of the disorders has not been frequently addressed.
A sample of 274 patients with PD was assessed and compared according to the presence of alcohol use disorder (AUD) (alcohol abuse or dependence), employing several clinical scales.
A total of 26 subjects were diagnosed from AUD. In 73.1% of patients, onset of alcohol use was previous to PD onset. PD subjects with AUD were found to have an earlier age at PD onset. They were more likely to be males, to have a family history of alcoholism, to abuse other drugs and to experience a more severe PD (more attacks in the last month, higher scores in anticipatory anxiety).
Patients with PD and alcoholism may represent a distinct clinical subgroup. Our finding of an uncommon order of onset for both disorders may reflect cultural influences.
(i)The study of panic disorder patients with comorbid alcoholism may help to better characterize this subgroup of patients. (ii) Patterns of alcohol use and the order of onset of both disorders may be influenced by cultural factors, with important practical implications. (iii) Patients with panic disorder and alcoholism may represent a distinct clinical subgroup, with an earlier age at panic disorder onset and greater clinical severity of anxiety.
(i) Our results refer to a clinical sample, which may not be representative of the general population. (ii) Alcoholic patients with a history of other drug abuse or dependence were not excluded. (iii) Owing to the small sample size, patients with alcohol dependence and with alcohol abuse were not separated.
尽管在流行病学研究中发现惊恐障碍（PD）和酒精中毒常常同时出现，但文化因素对这些疾病发病顺序的影响却很少得到探讨。
对274名惊恐障碍患者的样本进行评估，并根据是否存在酒精使用障碍（AUD）（酒精滥用或依赖），使用多种临床量表进行比较。
共有26名受试者被诊断为酒精使用障碍。在73.1%的患者中，酒精使用的开始时间早于惊恐障碍的发病时间。发现患有酒精使用障碍的惊恐障碍患者惊恐障碍发病年龄更早。他们更有可能是男性，有酒精中毒家族史，滥用其他药物，并且经历更严重的惊恐障碍（过去一个月发作次数更多，预期焦虑得分更高）。
患有惊恐障碍和酒精中毒的患者可能代表一个独特的临床亚组。我们发现这两种疾病不常见的发病顺序可能反映了文化影响。
（i）对伴有酒精中毒的惊恐障碍患者的研究可能有助于更好地描述这一患者亚组。（ii）酒精使用模式和两种疾病的发病顺序可能受到文化因素的影响，具有重要的实际意义。（iii）患有惊恐障碍和酒精中毒的患者可能代表一个独特的临床亚组，惊恐障碍发病年龄更早，焦虑的临床严重程度更高。
（i）我们的结果基于一个临床样本，可能不代表一般人群。（ii）有其他药物滥用或依赖史的酒精中毒患者未被排除。（iii）由于样本量小，酒精依赖患者和酒精滥用患者未分开。
