Masdrakis Vasilios G, Papakostas Yiannis G, Vaidakis Nikos, Papageorgiou Charalambos, Pehlivanidis Artemios
Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece.
Depress Anxiety. 2008;25(9):E72-9. doi: 10.1002/da.20333.
A proportion of patients with panic disorder (PD) display an increased sensitivity to the anxiogenic/panicogenic properties of caffeine. The aim of this study is to identify probable baseline differences between PD patients who panic and those who do not, after caffeine administration. In a randomized, double-blind, cross-over experiment performed in two occasions 3-7 days apart, 200 and 400 mg of caffeine, respectively, were administered in a coffee form to 23 patients with PD with or without Agoraphobia. Evaluations included the State-Trait Anxiety Inventory, the DSM-IV 'panic attack' symptoms (visual analogue scale form), the Symptom Checklist-90-Revised (SCL-90-R), as well as breath-holding (BH) duration, heartbeat perception accuracy and heart rate. Only those patients who did not present a panic attack after both challenges ('no panic group', N=14, 66.7%), and those who presented a panic attack after at least one challenge ('panic group', n=7, 33.3%) were included in the analysis. The panickers, compared to the non-panickers, presented at baseline: significantly higher total score of the SCL-90-R; significantly higher scores on all the SCL-90-R clusters of symptoms, except that of 'paranoid ideation'; significantly lower BH duration. The present preliminary findings indicate that PD patients who panic after a 200 mg or a 400 mg caffeine challenge, compared to the PD patients who do not panic after both of these challenges, may present at baseline significantly higher non-specific general psychopathology--as reflected in the SCL-90-R--and significantly shorter BH duration.
一部分惊恐障碍（PD）患者对咖啡因的致焦虑/致惊恐特性表现出更高的敏感性。本研究的目的是确定在给予咖啡因后，惊恐的PD患者与不惊恐的PD患者之间可能存在的基线差异。在两次间隔3 - 7天进行的随机、双盲、交叉实验中，分别以咖啡形式向23例有或无广场恐惧症的PD患者给予200毫克和400毫克咖啡因。评估包括状态 - 特质焦虑量表、DSM - IV“惊恐发作”症状（视觉模拟量表形式）、症状自评量表90修订版（SCL - 90 - R），以及屏气（BH）持续时间、心跳感知准确性和心率。仅将在两次激发试验后均未出现惊恐发作的患者（“无惊恐组”，N = 14，66.7%）和至少在一次激发试验后出现惊恐发作的患者（“惊恐组”，n = 7，33.3%）纳入分析。与非惊恐者相比，惊恐者在基线时表现出：SCL - 90 - R总分显著更高；除“偏执观念”外，SCL - 90 - R所有症状簇的得分均显著更高；BH持续时间显著更短。目前的初步研究结果表明，与在200毫克或400毫克咖啡因激发试验后不惊恐的PD患者相比，在这些激发试验后惊恐的PD患者在基线时可能表现出显著更高的非特异性一般精神病理学——如SCL - 90 - R所反映的——以及显著更短的BH持续时间。
