Margraf J, DeVries-Wehrhahn E, Sonnentag S
Fachereich Psychologie, Philipps-Universität Marburg.
Psychother Psychosom Med Psychol. 1991 Jan;41(1):31-4.
Cardiovascular manifestations of anxiety have long been known. A particularly intriguing problem even today is the differentiation between real and false "heart attacks". We compared 20 patients with functional cardiac complaints and 20 patients with myocardial infarction with respect to their "heart attacks" and psychological disorders. In spite of methodological problems our results indicate much more dramatic symptoms in the functional group. Their localization of "cardiac" pain resembled the generally accepted picture for myocardial infarction much more than that of the patients with an actual infarction. Functional patients showed more help seeking behavior and were less able to describe triggers for their attacks than patients with myocardial infarction. Functional patients largely met DSM-III-R diagnostic criteria for panic disorder and had a higher prevalence of other psychological disorders.
焦虑的心血管表现早已为人所知。即使在今天,一个特别引人关注的问题仍是区分真正的和假性“心脏病发作”。我们比较了20例有功能性心脏主诉的患者和20例心肌梗死患者的“心脏病发作”及心理障碍情况。尽管存在方法学问题,但我们的结果显示功能性组的症状更为显著。他们“心脏”疼痛的部位比实际梗死患者的疼痛部位更符合心肌梗死的普遍认知情况。与心肌梗死患者相比,功能性患者表现出更多寻求帮助的行为,且更难以描述发作的诱因。功能性患者在很大程度上符合《精神疾病诊断与统计手册》第三版修订本中惊恐障碍的诊断标准,且其他心理障碍的患病率更高。