Kolek Antonín, Prasko Jan, Ociskova Marie, Vanek Jakub, Holubova Michaela, Hodny Frantisek, Minarikova Kamila, Zmeková Jana
Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, 77520 Olomouc, Czech Republic.
Department of Psychiatry, Regional Hospital in Liberec, Czech Republic.
Neuro Endocrinol Lett. 2020 Dec;41(7-8):370-384.
In the new millennium, a growing focus on human rights and preserving individual autonomy urges the promotion of needs of the psychiatric patients. The topic of human needs takes its place also in patients with panic disorder. This review intended to explore current facts concerning the needs of the patients and present a broader understanding of patients' needs, due to the complexity of problems of patients with panic disorder. The text also focuses on psychosocial well-being and the quality of life of patients with panic disorder.
The PubMed was used to search for articles published between January 2000 and February 2020 using the following keywords: "panic disorder" or "agoraphobia" and "unmet needs" in combination with "pharmacotherapy" or "psychotherapy" or "cognitive behavioural therapy" or "family" or "quality of life." A total of 264 articles were selected by primary keyword picking in different combinations. Altogether 182 articles were reviewed.
We identified the most important unmet needs of patients with panic disorder connected to symptoms, treatment and help-seeking, stigma and self-stigma, family and quality of life. To help the patients to improve the unmet needs connected with: (1) symptoms is to increase the awareness of treatment steps for patients and their families, good cooperation with therapists, and management of persistent symptoms, alleviation or elimination of anxiety symptoms, avoidance and safety behaviour. (2) treatment is the quick approach, effective one, not too difficult, without side effects and harmless, not requiring hospitalization and not disturbing the daily routine, increasing treatment compliance, improving patient self-confidence and an active social network, affordable health and social services and more suitable information for families; (3) stigma is to change of public opinion about people with mental health problems and to create effective antistigma programs; (4) family is to include the support for a functional and independent life, helping to manage everyday tasks and stop excessive protection, while reducing the stigmatization of the whole family. (5) the quality of life is to help to integrate into the community and improve the factors that affect the quality of life; like esteem, self-acceptance, social acceptance etc. CONCLUSIONS: This review aimed to explore the unmet needs in patients with panic disorder or agoraphobia. In selected articles we identified 5 basic unmet needs and described the basic strategies to cope with them. It is essential for every clinician to understand those needs as it can substantially help to alleviate patients' symptoms and improve their quality of life. The importance of this understanding further highlights that unmet needs described for panic disorder overlap with unmet needs of other psychiatric disorder and thus have broader utility.
在新千年，对人权和维护个人自主权的日益关注促使人们重视精神科患者的需求。人类需求这一主题在惊恐障碍患者中也备受关注。由于惊恐障碍患者问题的复杂性，本综述旨在探讨有关患者需求的当前事实，并更全面地理解患者的需求。本文还聚焦于惊恐障碍患者的心理社会幸福感和生活质量。
利用PubMed搜索2000年1月至2020年2月发表的文章，使用以下关键词：“惊恐障碍”或“广场恐惧症”以及“未满足的需求”，并与“药物治疗”或“心理治疗”或“认知行为疗法”或“家庭”或“生活质量”相结合。通过以不同组合选取主要关键词，共筛选出264篇文章。总共对182篇文章进行了综述。
我们确定了惊恐障碍患者在症状、治疗与求助、污名与自我污名、家庭以及生活质量方面最重要的未满足需求。为帮助患者改善与以下方面相关的未满足需求：（1）症状方面，要提高患者及其家人对治疗步骤的认识，与治疗师良好合作，管理持续症状，减轻或消除焦虑症状，避免和减少安全行为。（2）治疗方面，要采用快速、有效、不太困难、无副作用且无害、无需住院且不干扰日常生活的方法，提高治疗依从性，增强患者自信心并建立活跃的社交网络，提供可负担得起的健康和社会服务以及为家庭提供更合适的信息；（3）污名方面，要改变公众对有心理健康问题者的看法，并制定有效的反污名计划；（4）家庭方面，要提供对功能性和独立生活的支持，帮助处理日常事务并停止过度保护，同时减少整个家庭的污名化。（5）生活质量方面，要帮助融入社区并改善影响生活质量的因素，如自尊、自我接纳、社会接纳等。结论：本综述旨在探讨惊恐障碍或广场恐惧症患者未满足的需求。在所选文章中，我们确定了5项基本未满足需求并描述了应对这些需求的基本策略。每位临床医生理解这些需求至关重要，因为这能极大地帮助减轻患者症状并提高其生活质量。这种理解的重要性进一步凸显出，惊恐障碍所描述的未满足需求与其他精神障碍的未满足需求重叠，因此具有更广泛的实用性。
