惊恐障碍的早期干预：实用随机对照试验。

Early intervention in panic: pragmatic randomised controlled trial.

机构信息

GGNet, PO Box 2003, 7230 GC Warnsveld, The Netherlands.

出版信息

Br J Psychiatry. 2010 Apr;196(4):326-31. doi: 10.1192/bjp.bp.109.072504.

DOI:10.1192/bjp.bp.109.072504

PMID:20357312

Abstract

BACKGROUND

Many people suffer from subthreshold and mild panic disorder and are at risk of developing more severe panic disorder.

AIMS

This study (trial registration: ISRCTN33407455) was conducted to evaluate the effectiveness of an early group intervention based on cognitive-behavioural principles to reduce panic disorder symptomatology.

METHOD

Participants with subthreshold or mild panic disorder were recruited from the general population and randomised to the intervention (n = 109) or a waiting-list control group (n = 108). The course was offered by 17 community mental health centres.

RESULTS

In the early intervention group, 43/109 (39%) participants presented with a clinically significant change on the Panic Disorder Severity Scale-Self Report (PDSS-SR) v. 17/108 (16%) in the control group (odds ratio (OR) for favourable treatment response 3.49, 95% CI 1.77-6.88, P = 0.001). The course also had a positive effect on DSM-IV panic disorder status (OR = 1.96, 95% CI=1.05-3.66, P = 0.037). The PDSS-SR symptom reduction was also substantial (between-group standardised mean difference of 0.68). The effects were maintained at 6-month follow-up.

CONCLUSIONS

People presenting with subthreshold and mild panic disorder benefit from this brief intervention.

摘要

背景

许多人患有阈下和轻度惊恐障碍，并且有发展为更严重惊恐障碍的风险。

目的

本研究（试验注册：ISRCTN33407455）旨在评估基于认知行为原则的早期团体干预对减少惊恐障碍症状的有效性。

方法

从普通人群中招募患有阈下或轻度惊恐障碍的参与者，并将其随机分配到干预组（n=109）或等待名单对照组（n=108）。该课程由 17 个社区心理健康中心提供。

结果

在早期干预组中，43/109（39%）的参与者在惊恐障碍严重程度自评量表（PDSS-SR）上表现出临床显著变化，而对照组中为 17/108（16%）（有利治疗反应的优势比（OR）为 3.49，95%CI 1.77-6.88，P=0.001）。该课程对 DSM-IV 惊恐障碍状态也有积极影响（OR=1.96，95%CI=1.05-3.66，P=0.037）。PDSS-SR 的症状缓解也很明显（组间标准化均值差异为 0.68）。这些效果在 6 个月的随访中得以维持。