Zitrin C M, Klein D F, Woerner M G
Arch Gen Psychiatry. 1978 Mar;35(3):307-16. doi: 10.1001/archpsyc.1978.01770270057005.
In a controlled outcome study of phobias, 111 adult patients (69% women, 31% men) received a course of 26 weekly treatment sessions consisting of (1) behavior therapy and imipramine hydrochloride (2) behavior therapy and placebo, or (3) supportive psychotherapy and imipramine. Patients were classified as agoraphobic, mixed phobic, or simple phobic. The great majority of patients in all groups showed moderate to marked global improvement (70% to 86%, depending on rater). In agoraphobics and mixed phobics (both groups experiencing spontaneous panic attacks), imipramine was significantly superior to placebo. There was no difference between behavior therapy and supportive therapy, both resulting in high improvement rates (76% to 100%, depending on rater). In simple phobic patients, there was a high rate of improvement with all treatment regimens (72% to 93%, depending on rater), with no significant difference between imipramine and placebo or between behavior therapy and supportive therapy. Of 88 moderately to markedly improved patients followed up for one year after completing treatment, 83% maintained their gains and 17% relapsed. No patients showed symptom substitution. Eighteen percent of the patients receiving imipramine hydrochloride showed marked stimulant side effects on from 5 to 75 mg/day.
在一项针对恐惧症的对照结果研究中，111名成年患者（69%为女性，31%为男性）接受了为期26周的治疗课程，包括：（1）行为疗法和盐酸丙咪嗪；（2）行为疗法和安慰剂；或（3）支持性心理治疗和丙咪嗪。患者被分为广场恐惧症、混合恐惧症或单纯恐惧症。所有组中的绝大多数患者都有中度至显著的整体改善（70%至86%，取决于评估者）。在广场恐惧症患者和混合恐惧症患者（两组均经历自发性惊恐发作）中，丙咪嗪明显优于安慰剂。行为疗法和支持性疗法之间没有差异，两者的改善率都很高（76%至100%，取决于评估者）。在单纯恐惧症患者中，所有治疗方案的改善率都很高（72%至93%，取决于评估者），丙咪嗪与安慰剂之间或行为疗法与支持性疗法之间没有显著差异。在完成治疗后对88名中度至显著改善的患者进行了一年的随访，83%的患者维持了改善效果，17%的患者复发。没有患者出现症状替代。接受盐酸丙咪嗪治疗的患者中有18%在每天5至75毫克的剂量下出现明显的兴奋副作用。
