Xhenseval B
Acta Psychiatr Belg. 1985 Jul-Aug;85(4):480-508.
An accumulation of research results, laboratory and clinic, leads to revise the classification of disorders of anxious nature (anxiety disorders according to the DSM-III). An empirical confirmation allows to separate anxious states from panic attack and phobic behavior constituting a component separated from generalized anxiety, exaggerated emotional reactions to stress agents and obsessive-compulsive disorders. The response to pharmacotherapeutic agents and the important number of anxiety depression and mixed depression tends to make permeable the separating line between the nosological entities anxiety and depression. The observations of subjects suffering from endogenous anxiety obliges to revise the classification by introducing three varieties of neurotic anxiety: phobic endogenous anxiety, endogenous anxiety without phobic formation, and exogenous anxiety. Endogenous anxiety is close to the concept of anxious thymopathy. By its pragmatic conception, modifications obtained by psychoactive agents are used (antidepressants of the group imipramine and IMAO, classical benzodiazepines and alprazolam, provocation controlled in laboratory) in order to strengthen innovating hypotheses and allow to elaborate useful treatment strategies for neuroses.
大量的研究成果,包括实验室研究和临床研究,促使人们对焦虑性疾病(根据《精神疾病诊断与统计手册》第三版的焦虑症)的分类进行修订。实证研究证实,可以将焦虑状态与惊恐发作及恐惧行为区分开来,惊恐发作及恐惧行为构成了与广泛性焦虑、对压力源的过度情绪反应以及强迫症相分离的一个组成部分。对药物治疗的反应以及焦虑抑郁和混合性抑郁的大量存在,使得焦虑和抑郁这两种疾病实体之间的分界线变得模糊。对患有内源性焦虑症患者的观察促使人们通过引入三种神经性焦虑类型来修订分类:恐惧性内源性焦虑、无恐惧形成的内源性焦虑和外源性焦虑。内源性焦虑与焦虑性胸腺病的概念相近。从实用角度来看,使用精神活性药物(丙咪嗪和单胺氧化酶抑制剂类抗抑郁药、经典苯二氮䓬类药物和阿普唑仑,并在实验室进行控制性激发)所产生的变化,以强化创新假设,并为神经症制定有效的治疗策略。