Krystal J H, Woods S W, Hill C L, Charney D S
Psychiatry Service, West Haven Veterans Administration Medical Center, CT 06516.
Compr Psychiatry. 1991 Nov-Dec;32(6):474-80. doi: 10.1016/0010-440x(91)90026-9.
We report the analyses of daily journal descriptions of 790 self-defined panic attacks from 59 patients meeting DSM-III criteria for panic disorder or agoraphobia with panic attacks. The DSM-III-R specified symptoms occurred with frequencies ranging from choking (17% of attacks) to palpitations (63% of attacks). The mean weekly panic attack severity correlated significantly with the number of symptoms per attack, but not their weekly frequency. Within a given person, situational and spontaneous panic attacks did not significantly differ over a number of characteristics, including severity, duration, frequency per week, diurnal distribution, and the number of symptoms per attack. Limited symptom attacks were less severe, but were otherwise similar to panic attacks. Also, panic attacks during sleep were less frequent than panic attacks in the awake state, but did not significantly differ on other descriptive characteristics. These data support the validity of the symptoms specified for panic attacks by DSM-III-R. They also suggest that within an individual, panic attacks of various subtypes may be descriptively similar, despite the differing contexts in which they arise. In addition, these data question the diagnostic significance of the limited symptom attack-panic attack distinction.
我们报告了对59名符合DSM-III惊恐障碍或伴有惊恐发作的广场恐惧症标准患者的790次自行定义的惊恐发作的日常记录分析。DSM-III-R规定的症状出现频率从窒息感（占发作的17%）到心悸（占发作的63%）不等。平均每周惊恐发作的严重程度与每次发作的症状数量显著相关，但与每周发作频率无关。在同一个人身上，情境性和自发性惊恐发作在包括严重程度、持续时间、每周发作频率、昼夜分布以及每次发作的症状数量等多个特征方面没有显著差异。症状有限的发作不太严重，但在其他方面与惊恐发作相似。此外，睡眠期间的惊恐发作比清醒状态下的惊恐发作频率更低，但在其他描述性特征上没有显著差异。这些数据支持了DSM-III-R规定的惊恐发作症状的有效性。它们还表明，在个体内部，尽管不同亚型的惊恐发作产生的背景不同，但在描述上可能相似。此外，这些数据对症状有限的发作与惊恐发作区分的诊断意义提出了质疑。
