Tully Phillip J
Heart Failure Support Service, The Queen Elizabeth Hospital, Woodville South, SA, and; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, SA, Australia, and; Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
Australas Psychiatry. 2015 Apr;23(2):124-7. doi: 10.1177/1039856214568211. Epub 2015 Jan 27.
The authors sought to identify characteristics associated with premorbid and postmorbid panic disorder onset in relation to heart failure (HF) onset, and examine the effect on unplanned hospital admissions.
In a two-stage screening process, 404 HF patients admitted to three hospitals in South Australia were referred for structured psychiatric interview when any of the following four criteria were met: (a) Patient Health Questionnaire≥10; (b) Generalized Anxiety Disorder Questionnaire≥7); (c) positive response to one-item panic attack screener; (d) or evidence of suicidality.
A total of 73 referred HF patients (age 60.6±13.4, 47.9% female) were classified into three groups: premorbid panic disorder (27.4%), postmorbid panic disorder (24.7%), and no panic disorder (47.9%). Postmorbid panic disorder was associated with more psychiatric admissions and longer hospital stay in the 6 months prior to the index psychiatric assessment, and also in the 6 months after the index psychiatric assessment (all p<.05 unadjusted). In sensitivity analysis, years since panic disorder onset were associated with longer cardiac length of stay (β=.34, p=.03).
Panic disorder onset in relation to HF diagnosis was associated with discrete patterns of hospital admissions for cardiac and psychiatric causes.
作者试图确定与心力衰竭（HF）发病相关的病前和病后惊恐障碍发作的特征，并研究其对非计划住院的影响。
在一个两阶段筛查过程中，南澳大利亚三家医院收治的404例HF患者，若符合以下四项标准中的任何一项，即被转介接受结构化精神科访谈：（a）患者健康问卷≥10；（b）广泛性焦虑障碍问卷≥7；（c）单项惊恐发作筛查呈阳性反应；（d）或有自杀倾向的证据。
总共73例被转介的HF患者（年龄60.6±13.4，47.9%为女性）被分为三组：病前惊恐障碍（27.4%）、病后惊恐障碍（24.7%）和无惊恐障碍（47.9%）。病后惊恐障碍与在首次精神科评估前6个月以及首次精神科评估后6个月内更多的精神科住院次数和更长的住院时间相关（所有p<0.05，未调整）。在敏感性分析中，惊恐障碍发病后的年限与更长的心脏住院时间相关（β=0.34，p=0.03）。
与HF诊断相关的惊恐障碍发作与因心脏和精神原因导致的不同住院模式相关。
