McHugh R Kathryn, Smits Jasper A J, Otto Michael W
Department of Psychology, 648 Beacon Street, 6th Floor, Boston University, Boston, MA 02215, USA.
Psychiatr Clin North Am. 2009 Sep;32(3):593-610. doi: 10.1016/j.psc.2009.05.005.
This article provides an empirical review of the elements and efficacy of both pharmacologic and psychosocial treatments for panic disorder. Both monotherapies and combination treatment strategies are considered. The available evidence suggests that both cognitive behavioral therapy (CBT) and pharmacotherapy (prominently, selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors) are effective first-line agents and that CBT offers particular cost efficacy relative to both pharmacotherapy alone and combined pharmacotherapy and CBT. Predictors of non-response and mechanisms of action are considered, as are novel treatment strategies, including the use of memory enhancers to improve CBT outcome.
本文对惊恐障碍的药物治疗和心理社会治疗的要素及疗效进行了实证综述。文中考虑了单一疗法和联合治疗策略。现有证据表明,认知行为疗法(CBT)和药物疗法(主要是选择性5-羟色胺再摄取抑制剂或5-羟色胺-去甲肾上腺素再摄取抑制剂)都是有效的一线治疗方法,而且相对于单纯药物疗法以及药物疗法与CBT的联合疗法,CBT具有特别的成本效益。文中还考虑了无反应的预测因素和作用机制,以及包括使用记忆增强剂来改善CBT疗效在内的新型治疗策略。