Roy-Byrne P P, Uhde T W
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle 98195.
J Clin Psychiatry. 1988 Feb;49(2):56-61.
Because panic disorder has an underlying biologic and probably genetic basis, the role of factors outside the organism in initiating and sustaining panic is often overlooked. The authors review certain exogenous factors that seem capable of triggering attacks and/or increasing their frequency and intensity: self-administered pharmacologic agents (caffeine, alcohol, nicotine, over-the-counter cold preparations, cannabis, cocaine); habits (sleep deprivation, diet, exercise, relaxation, hyperventilation); and aspects of the environment (fluorescent lighting, life stressors). There may be a specificity to the action of some of these factors, because certain factors previously thought to trigger panic attacks (e.g., pain, hypoglycemia) have been proved not to have this effect. Although the clinical significance of many of the exogenous factors discussed still awaits empirical confirmation, attention to such factors during the initial evaluation of a patient with panic disorder may be helpful in formulating a successful treatment plan.
由于惊恐障碍具有潜在的生物学基础且可能存在遗传因素，机体外部因素在引发和维持惊恐方面的作用常常被忽视。作者回顾了某些似乎能够触发惊恐发作和/或增加其发作频率及强度的外部因素：自我服用的药物制剂（咖啡因、酒精、尼古丁、非处方感冒药、大麻、可卡因）；习惯（睡眠剥夺、饮食、运动、放松、过度换气）；以及环境因素（荧光灯、生活应激源）。其中一些因素的作用可能具有特异性，因为某些先前被认为会触发惊恐发作的因素（如疼痛、低血糖）已被证明并无此作用。尽管所讨论的许多外部因素的临床意义仍有待实证确认，但在对惊恐障碍患者进行初步评估时关注这些因素可能有助于制定成功的治疗方案。
