Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401, USA.
Gen Hosp Psychiatry. 2011 Sep-Oct;33(5):482-8. doi: 10.1016/j.genhosppsych.2011.06.005. Epub 2011 Aug 3.
Although panic disorder (PD) is a highly prevalent condition in both community and community primary care settings, little is known about PD in veteran populations, especially in comparison to posttraumatic stress disorder (PTSD). The present study investigated prevalence, comorbidity, physical and mental health impairment, and health care utilization of veterans with PD and PTSD.
A total of 884 veterans participated in a cross-sectional investigation in primary care clinics in four Veteran Affairs Medical Centers (VAMCs). Participants completed diagnostic interviews and self-report questionnaires, and a chart review was completed to assess their VAMC health care utilization.
A large number of veterans (8.3%) met the diagnostic criteria for PD and reported significantly more severe physical health impairment (pain, general health), mental health impairment (emotional well-being, role limitations) and social functioning than veterans without PD. Veterans with PD also had increased health care utilization for mental health. Further, PD was highly comorbid with PTSD, with similar symptoms across all measures.
These findings demonstrate the high prevalence and severe impairment associated with PD in veterans and highlight the need for improved recognition, assessment and specialized treatments for PD in VAMCs and other care settings.
尽管惊恐障碍(PD)在社区和社区初级保健环境中是一种高度流行的疾病,但人们对退伍军人中的 PD 知之甚少,特别是与创伤后应激障碍(PTSD)相比。本研究调查了患有 PD 和 PTSD 的退伍军人的患病率、共病、身心健康受损和卫生保健利用情况。
共有 884 名退伍军人参加了在四个退伍军人事务医疗中心(VAMC)的初级保健诊所进行的横断面调查。参与者完成了诊断访谈和自我报告问卷,并且进行了病历审查以评估他们在 VAMC 的卫生保健利用情况。
大量退伍军人(8.3%)符合 PD 的诊断标准,并报告了更严重的身体健康受损(疼痛、一般健康)、心理健康受损(情绪健康、角色限制)和社会功能障碍,比没有 PD 的退伍军人更严重。患有 PD 的退伍军人也增加了心理健康方面的卫生保健利用。此外,PD 与 PTSD 高度共病,所有测量指标的症状相似。
这些发现表明 PD 在退伍军人中患病率高且严重受损,强调了在 VAMC 和其他护理环境中提高对 PD 的认识、评估和专门治疗的必要性。