Pollard C A, Detrick P, Flynn T, Frank M
Department of Psychiatry and Human Behavior, St. Louis University School of Medicine, Missouri 63104.
J Nerv Ment Dis. 1990 Mar;178(3):180-5. doi: 10.1097/00005053-199003000-00005.
Although several studies have indicated that a substantial portion of alcoholics have an anxiety disorder, relatively little information exists specifically regarding panic disorders. In addition, prior studies have been marred by the absence of appropriate contrast groups. The present investigation compared the lifetime prevalence of panic attacks and panic-related disorders diagnosed according to DSM-III criteria in a group of 79 alcohol-dependent patients, 64 depressed patients, and 70 nonclinical subjects. Panic attacks, panic disorder, and agoraphobia with panic attacks were more prevalent in the alcohol-dependent and depressed samples than among nonclinical subjects. Men in both clinical samples were more likely than women to have had nonagoraphobic panic disorder, but male alcoholics were less likely to have developed agoraphobia than were female alcoholics or depressed patients of either sex. No consistent chronological relationship between onset of panic attacks and alcohol abuse was found. Results indicate that there is an unusually high prevalence of panic attacks and panic-related disorders among alcoholics, but comparable prevalence rates can be found in depressed and perhaps some other psychiatric populations. Implications for the assessment and treatment of alcohol-dependent and panic-disordered patients are discussed.
尽管多项研究表明,相当一部分酗酒者患有焦虑症,但关于惊恐障碍的具体信息相对较少。此外,以往的研究因缺乏合适的对照组而存在缺陷。本研究比较了根据《精神疾病诊断与统计手册》第三版(DSM-III)标准诊断的一组79名酒精依赖患者、64名抑郁症患者和70名非临床受试者中惊恐发作及与惊恐相关障碍的终生患病率。酒精依赖组和抑郁症组的惊恐发作、惊恐障碍以及伴有惊恐发作的广场恐惧症比非临床受试者更为普遍。两个临床样本中的男性比女性更易患非广场恐惧症的惊恐障碍,但男性酗酒者患广场恐惧症的可能性低于女性酗酒者或任何性别的抑郁症患者。未发现惊恐发作的起始与酒精滥用之间存在一致的时间顺序关系。结果表明,酗酒者中惊恐发作及与惊恐相关障碍的患病率异常高,但在抑郁症患者以及或许其他一些精神科人群中也能发现类似的患病率。文中讨论了对酒精依赖患者和惊恐障碍患者进行评估和治疗的意义。