Department of Psychiatry, Samsung Biomedical Research Institute, Seoul, South Korea.
Psychiatry Res. 2012 May 30;197(3):237-41. doi: 10.1016/j.psychres.2011.11.001. Epub 2012 Feb 26.
We aimed to examine whether anxiety sensitivity and agoraphobic fear could affect the time taken to remission after 24 weeks of open-label escitalopram treatment of patients with panic disorder (PD). We recruited 158 patients, and 101 patients completed the study. Clinical severity and psychological characteristics were assessed at baseline and 4, 12, and 24 weeks after the treatment, using the Clinical Global Impression-Severity (CGI-S), the Hamilton Rating Scales for Anxiety and Depression, the Anxiety Sensitivity Index-Revised (ASI-R), the Albany Panic and Phobia Questionnaire (APPQ), and the Panic Disorder Severity Scale (PDSS). Remission was defined as the absence of full panic attacks and PDSS scores of 7 or less. Completing patients were stratified according to the time taken to remit: early (n=20) and late (n=58) remission and non-remission groups (n=23). There were no significant differences among the three groups at baseline on the CGI-S and the PDSS mean scores. However, early remitters had significantly lower scores than late remitters and non-remitters on the ASI-R and APPQ. In conclusion, anxiety sensitivity and agoraphobic fear can affect the time to remission after pharmacotherapy, and clinicians should consider the psychological characteristics of PD patients in order to achieve an optimal response to pharmacotherapy.
我们旨在研究焦虑敏感和广场恐惧是否会影响惊恐障碍（PD）患者接受依地普仑开放标签治疗 24 周后的缓解时间。我们招募了 158 名患者，其中 101 名患者完成了研究。在治疗前、治疗后 4、12 和 24 周时，使用临床总体印象严重程度量表（CGI-S）、汉密尔顿焦虑和抑郁量表、修订版焦虑敏感指数（ASI-R）、奥尔巴尼惊恐和恐惧症问卷（APPQ）和惊恐障碍严重程度量表（PDSS）评估临床严重程度和心理特征。缓解定义为完全无惊恐发作和 PDSS 评分 7 分或以下。完成治疗的患者根据缓解时间分为：早期（n=20）和晚期（n=58）缓解组和未缓解组（n=23）。在 CGI-S 和 PDSS 平均评分上，三组在基线时没有显著差异。然而，早期缓解者在 ASI-R 和 APPQ 上的评分显著低于晚期缓解者和未缓解者。总之，焦虑敏感和广场恐惧可以影响药物治疗后的缓解时间，临床医生应考虑 PD 患者的心理特征，以实现对药物治疗的最佳反应。
