Noyes R, Reich J, Christiansen J, Suelzer M, Pfohl B, Coryell W A
Department of Psychiatry, University of Iowa, Iowa City 52242.
Arch Gen Psychiatry. 1990 Sep;47(9):809-18. doi: 10.1001/archpsyc.1990.01810210017003.
Eighty-nine subjects with panic disorder, who had been naturalistically treated, and 46 nonanxious controls were followed up after 3 years. Although they remained symptomatic, most subjects with panic disorder reported relatively little distress or social maladjustment. The course of panic disorder was characterized by fluctuating anxiety and depressive symptoms. Panic subtypes (uncomplicated, limited phobic avoidance, and extensive phobic avoidance) and Axis I and II comorbidity (major depression and personality disorders) were highly predictive of symptoms and social adjustment after 3 years. Abnormal personality was, in fact, the strongest predictor of social maladjustment in both subjects with panic disorder and controls. The results showed that while panic disorder has a favorable outcome, the illness is a chronic one that may require continuing treatment. They also show that subtypes and comorbid disturbances are important predictors of outcome.
对89名接受过自然疗法的惊恐障碍患者和46名无焦虑对照组进行了3年的随访。尽管他们仍有症状，但大多数惊恐障碍患者报告的痛苦或社会适应不良相对较少。惊恐障碍的病程特点是焦虑和抑郁症状波动。惊恐障碍亚型（单纯型、有限恐惧回避型和广泛恐惧回避型）以及轴I和轴II共病（重度抑郁和人格障碍）对3年后的症状和社会适应具有高度预测性。事实上，异常人格是惊恐障碍患者和对照组中社会适应不良的最强预测因素。结果表明，虽然惊恐障碍有较好的预后，但该疾病是一种慢性疾病，可能需要持续治疗。研究结果还表明，亚型和共病障碍是预后的重要预测因素。
