Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands.
Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia.
Depress Anxiety. 2019 Jun;36(6):499-510. doi: 10.1002/da.22885. Epub 2019 Feb 6.
The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re-examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM-IV criteria for AG (AG without a history of panic disorder [PD] and PD with AG) but not DSM-5 criteria, DSM-5 but not DSM-IV criteria, or both sets of criteria.
Population-based surveys from the World Mental Health Survey Initiative including adult respondents (n = 136,357) from 27 countries across the world. The Composite International Diagnostic Interview was used to assess AG and other disorders.
Lifetime and 12-month prevalence estimates of DSM-5 AG (1.5% and 1.0%) were comparable to DSM-IV (1.4% and 0.9%). Of respondents meeting criteria in either system, 57.1% met criteria in both, while 24.2% met criteria for DSM-5 only and 18.8% for DSM-IV only. Severe role impairment due to AG was reported by a lower proportion of respondents who met criteria only for DSM-IV AG (30.4%) than those with both DSM-5 and DSM-IV AG (44.0%; χ = 4.7; P = 0.031). The proportion of cases with any comorbidity was lower among respondents who met criteria only for DSM-IV AG (78.7%) than those who met both sets (92.9%; χ = 14.5; P < 0.001).
This first large survey shows that, compared to the DSM-IV, the DSM-5 identifies a substantial group of new cases with AG, while the prevalence rate remains stable at 1.5%. Severity and comorbidity are higher in individuals meeting DSM-5 AG criteria compared with individuals meeting DSM-IV AG criteria only.
《精神障碍诊断与统计手册》第五版（DSM-5）将广场恐惧症（AG）定义为一个独立的诊断实体，因此及时重新检查 AG 的流行病学情况是很有必要的。研究目的是提供符合 DSM-IV 标准的 AG 患者（无惊恐障碍[PD]病史的 AG 和 PD 伴 AG）但不符合 DSM-5 标准、符合 DSM-5 标准但不符合 DSM-IV 标准或同时符合两套标准的个体特征的代表性数据。
该研究使用来自世界心理健康调查倡议的基于人群的调查数据，包括来自全球 27 个国家的成年受访者（n=136357）。使用复合国际诊断访谈来评估 AG 和其他障碍。
DSM-5 AG 的终生和 12 个月患病率估计值（1.5%和 1.0%）与 DSM-IV 相似（1.4%和 0.9%）。在符合任何一个系统标准的受访者中，57.1%的人同时符合两个系统的标准，24.2%仅符合 DSM-5 的标准，18.8%仅符合 DSM-IV 的标准。仅符合 DSM-IV AG 标准的受访者报告因 AG 导致严重角色障碍的比例（30.4%）低于同时符合 DSM-5 和 DSM-IV AG 标准的受访者（44.0%；χ 2=4.7；P=0.031）。仅符合 DSM-IV AG 标准的受访者中，有任何共病的病例比例（78.7%）低于同时符合两套标准的受访者（92.9%；χ 2=14.5；P<0.001）。
这是第一项大型调查，表明与 DSM-IV 相比，DSM-5 确定了一个相当数量的新 AG 病例，而患病率仍保持在 1.5%。与仅符合 DSM-IV AG 标准的个体相比，符合 DSM-5 AG 标准的个体的严重程度和共病率更高。
