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区分伴有和不伴有抑郁共病症状的惊恐障碍的因素。

Factors differentiating panic disorder with and without comorbid symptoms of depression.

机构信息

Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain.

Faculty of Psychology, Complutense University of Madrid, Spain.

出版信息

Psychol Psychother. 2021 Sep;94(3):523-540. doi: 10.1111/papt.12327. Epub 2021 May 16.

Abstract

The aim of this study was to examine the sociodemographic and clinical differences between people with a probable diagnosis of panic disorder (PD) and those with PD and a probable comorbid diagnosis major depressive disorder (PD + MDD). We also sought to explore the potential contribution of cognitive variables to help differentiate between PD and PD + MDD. This was a subgroup analysis of 331 patients with PD symptoms who were included in the PsicAP clinical trial. All participants completed scales to evaluate panic, depression, somatization, cognitive and performance variables. A univariate analysis showed significant differences (p < .01) between the groups (PD vs PD + MDD) in clinical variables. Somatization was the best predictor of comorbid PD + MDD (β = .346; p < .01). Cognitive variables do not appear to play an essential role in predicting the presence of depressive symptoms in people with a screen positive for PD. These findings appear to support a transdiagnostic treatment approach for PD, which may be useful regardless of whether comorbid depression is present or not. PRACTITIONER POINTS: Somatic symptoms were associated with a higher probability of be in the PD + MDD group. Cognitive variables do not play a relevant role in the differentiation of both groups. A transdiagnostic approach can be useful for the treatment of PD or PD + MDD group.

摘要

本研究旨在探讨可能患有惊恐障碍(PD)的人群与 PD 合并可能诊断为重度抑郁障碍(PD+MDD)的人群之间在社会人口学和临床方面的差异。我们还试图探讨认知变量对帮助区分 PD 和 PD+MDD 的潜在贡献。这是在 PsicAP 临床试验中纳入的 331 名有 PD 症状的患者的亚组分析。所有参与者都完成了评估惊恐、抑郁、躯体化、认知和表现变量的量表。单变量分析显示,在临床变量方面,两组(PD 与 PD+MDD)之间存在显著差异(p<.01)。躯体化是 PD+MDD 合并症的最佳预测因子(β=.346;p<.01)。认知变量似乎在预测对 PD 筛查阳性人群中抑郁症状的出现方面没有起到重要作用。这些发现似乎支持 PD 的跨诊断治疗方法,无论是否存在合并抑郁,这种方法都可能有用。临床医生要点:躯体症状与更有可能属于 PD+MDD 组相关。认知变量在两组的区分中没有起到相关作用。跨诊断方法对 PD 或 PD+MDD 组的治疗可能有用。

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