Katerndahl D A
Department of Family Practice, University of Texas Health Science Center, San Antonio 78284.
Fam Pract Res J. 1990 Spring-Summer;9(2):147-55.
Much of the panic literature uses samples that are diagnostically heterogeneous. The panic experience must be homogeneous if we are to combine such heterogeneous groups for research and if we are to use panic characteristics to predict consequences. This study, using the symptom sequences of 21 patients with panic attacks, sought to assess interpatient agreement and compare symptom rankings in patient subgroups. Median polish performed on the symptom sequences suggested interpatient agreement (F = 3.39, p less than or equal to .05). This was further supported by Kendall's coefficient of concordance using symptom runs for various etiologic models (W = 0.338, p less than .0001). The accuracy of the DSM-III to diagnose panic attacks was implied by the lack of association of measures of accuracy--patient effects and diagnostic confidence--with symptom rankings, demographic data, or clinical parameters. In conclusion, this study supports the uniformity of the panic experience.
许多关于惊恐障碍的文献所使用的样本在诊断上是异质性的。如果我们要将这些异质性群体合并进行研究，以及要利用惊恐障碍的特征来预测后果，那么惊恐障碍的体验必须是同质性的。本研究通过21例惊恐发作患者的症状序列，试图评估患者间的一致性，并比较患者亚组中的症状排名。对症状序列进行的中位数平滑分析表明患者间存在一致性（F = 3.39，p≤0.05）。使用各种病因模型的症状序列进行的肯德尔和谐系数分析进一步支持了这一结果（W = 0.338，p < 0.0001）。准确性测量指标（患者效应和诊断置信度）与症状排名、人口统计学数据或临床参数之间缺乏关联，这暗示了《精神疾病诊断与统计手册》第三版（DSM - III）诊断惊恐发作的准确性。总之，本研究支持惊恐障碍体验的一致性。
