Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Pettenkoferstr. 10, D-80336, Munich, Germany.
Institute of General Practice and Family Medicine, Jena University Hospital, Bachstrasse 18, D-07743, Jena, Germany.
Sci Rep. 2019 May 9;9(1):7170. doi: 10.1038/s41598-019-43487-x.
This analysis aims to identify and characterize symptom trajectories in primary care patients with panic disorder with/without agoraphobia (PD/AG) who participated in a primary care team based training involving elements of cognitive behavioural therapy (CBT). Growth Mixture Modeling was used to identify different latent classes of change in patients with PD/AG (N = 176) who underwent treatment including CBT elements. We identified three patient classes with distinct similar trajectories. Class 1 (n = 58, mean age: 46.2 years ± 13.4 years, 81% women) consisted of patients with an initially high symptom burden, but symptoms declined constantly over the intervention period. Symptoms of patients in class 2 (n = 89, mean age: 44.2 years ± 14.5 years, 67.4% women) declined rapidly at the beginning, then patients went into a plateau-phase. The third class (n = 29, mean age: 47.0 years ± 12.4 years, 65.5% women) was characterized by an unstable course and had the worse outcome. Our findings show that only a minority did not respond to the treatment. To identify this minority and refer to a specialist would help patients to get intensive care in time.
本分析旨在识别和描述在初级保健环境中接受包含认知行为疗法（CBT）元素的初级保健团队培训的伴有/不伴有广场恐惧症的惊恐障碍（PD/AG）患者的症状轨迹。采用增长混合模型来识别接受包括 CBT 元素在内的治疗的 PD/AG 患者（N=176）中不同的变化潜在类别。我们确定了具有不同相似轨迹的三个患者类别。类别 1（n=58，平均年龄：46.2 岁±13.4 岁，81%为女性）由最初症状负担高的患者组成，但症状在干预期间持续下降。类别 2 患者的症状（n=89，平均年龄：44.2 岁±14.5 岁，67.4%为女性）在开始时迅速下降，然后进入平台期。第三类（n=29，平均年龄：47.0 岁±12.4 岁，65.5%为女性）的特征是不稳定的病程，预后最差。我们的发现表明，只有少数患者对治疗无反应。识别出这一小部分患者并转介给专家将有助于患者及时获得强化护理。
