Simon Naomi M, Weiss Alexander M, Kradin Richard, Evans Karleyton C, Reese Hannah E, Otto Michael W, Oppenheimer Julia E, Smoller Jordan W, Zalta Alyson, Worthington John J, Pollack Mark H
Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Nerv Ment Dis. 2006 Dec;194(12):951-7. doi: 10.1097/01.nmd.0000249062.25829.53.
Little is known about factors that mediate the relationship between anxiety and respiratory-related distress and disability. We hypothesized that elevations in anxiety sensitivity would be associated with greater severity of dyspnea, greater dyspnea-related avoidance, and poorer subjective assessment of health in patients with dyspnea referred for pulmonary function testing, regardless of objective evidence of pulmonary dysfunction. A total of 182 consecutive patients receiving pulmonary function tests to evaluate dyspnea were screened with a patient-rated Primary Care Evaluation of Mental Disorders and completed the Anxiety Sensitivity Index and questionnaires assessing symptom severity and avoidance. Anxiety Sensitivity Index score predicted more severe subjective dyspnea and greater dyspnea-related avoidance, even after adjustment for anxiety disorders and pulmonary dysfunction. Despite some limitations, these data provide preliminary support that strategies to identify, measure, and address high levels of anxiety sensitivity should be examined to reduce subjective distress and improve functioning for patients with dyspnea.
关于介导焦虑与呼吸相关窘迫和残疾之间关系的因素，人们知之甚少。我们假设，对于因呼吸困难前来接受肺功能测试的患者，无论有无肺功能障碍的客观证据，焦虑敏感性的升高都将与更严重的呼吸困难、更多与呼吸困难相关的回避行为以及更差的健康主观评估相关。总共182名连续接受肺功能测试以评估呼吸困难的患者，使用患者自评的《初级保健精神障碍评估》进行筛查，并完成焦虑敏感性指数以及评估症状严重程度和回避行为的问卷。即使在对焦虑症和肺功能障碍进行调整之后，焦虑敏感性指数得分仍能预测更严重的主观呼吸困难和更多与呼吸困难相关的回避行为。尽管存在一些局限性，但这些数据提供了初步支持，即应研究识别、测量和应对高焦虑敏感性水平的策略，以减轻主观痛苦并改善呼吸困难患者的功能。
