Chignon J M, Lepine J P, Ades J
Service de Psychiatrie, Hôpital Louis Mourier, Colombes.
Encephale. 1991 Nov-Dec;17(6):519-23.
Relationships between alcoholism and anxiety disorder are well known by clinicians. Studies have recently shown that the prevalence of alcohol abuse or dependence is very high in patients with panic disorder with or without agoraphobia (Thyer et al., 1986; Bibb and Chambless, 1986). The aims of this study were to determine the prevalence and comorbidity of alcohol abuse and dependence in a population of panic outpatients who were consecutive referrals for treatment of panic disorder (PD) in an anxiety clinic. Patients were interviewed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version Modified for the study of anxiety disorders (SADS-LA) which is a standardized and semi-structured interview allowing to make diagnoses according to RDC, DSM III and DSM III-R criteria. One hundred and three panic patients (39 males and 64 females) were included in the study. Their mean age was 38.5 years (SD: 11.6). In this sample, 24.3% met the DSM III-R criteria for alcohol abuse and 8.7% those for alcohol dependence. Among these patients, 26.2%, abused of benzodiazepines and 16.5% of them of other substances. We found a high comorbidity rate. In fact, 6.8% of the patients met diagnostic criteria for PD alone, 31.0% for one more diagnosis, 29.1% for two more and 33.0% for three or more besides PD. In this study, we found an association between alcohol abuse and the presence of a lifetime diagnosis of major depressive episode and/or other addictive behaviors. Otherwise, alcohol abuse did not occur more often in patients suffering from panic disorder associated with agoraphobia and/or social phobia.
临床医生熟知酒精成瘾与焦虑症之间的关系。近期研究表明,伴有或不伴有广场恐惧症的惊恐障碍患者中,酒精滥用或依赖的患病率非常高(Thyer等人,1986年;Bibb和Chambless,1986年)。本研究的目的是确定在一家焦虑症诊所连续转诊接受惊恐障碍(PD)治疗的惊恐门诊患者人群中,酒精滥用和依赖的患病率及共病情况。采用为焦虑症研究修改的情感障碍与精神分裂症问卷-终生版(SADS-LA)对患者进行访谈,这是一种标准化的半结构化访谈,可根据研究诊断标准委员会(RDC)、《精神疾病诊断与统计手册》第三版(DSM III)和《精神疾病诊断与统计手册》第三版修订版(DSM III-R)标准进行诊断。103名惊恐障碍患者(39名男性和64名女性)纳入研究。他们的平均年龄为38.5岁(标准差:11.6)。在这个样本中,24.3%符合DSM III-R酒精滥用标准,8.7%符合酒精依赖标准。在这些患者中,26.2%滥用苯二氮䓬类药物,16.5%滥用其他物质。我们发现共病率很高。实际上,6.8%的患者仅符合PD诊断标准,31.0%符合一种以上诊断标准,29.1%符合两种以上诊断标准,33.0%符合除PD外三种或更多诊断标准。在本研究中,我们发现酒精滥用与终生诊断为重度抑郁发作和/或其他成瘾行为之间存在关联。此外,酒精滥用在伴有广场恐惧症和/或社交恐惧症的惊恐障碍患者中并不更常见。