Oh Da Hye, Park Doo-Heum, Ryu Seung-Ho, Ha Jee Hyun, Jeon Hong Jun
Department of Psychiatry, Konkuk University Medical Center, Seoul 05030, South Korea.
World J Psychiatry. 2021 Jun 19;11(6):242-252. doi: 10.5498/wjp.v11.i6.242.
Panic disorders frequently occur with affective disorders, particularly bipolar disorder. Patients with panic disorder and bipolar disorder are more likely to present with severe symptoms, such as high rates of suicidal behavior, poor symptomatic and functional recovery, and poor drug responses.
To investigate the psychological characteristics of panic disorder patients related to bipolarity.
A total of 254 patients (136 men and 118 women, mean age = 33.48 ± 3.2 years) who were diagnosed with panic disorder were included in the study. Panic disorder with bipolarity (BP+) was defined as a score of ≥ 7 on the Korean version of the Mood Disorder Questionnaire (K-MDQ), and a score lower than 7 was considered as a panic disorder without bipolarity (BP-). Self-report questionnaires were analyzed to examine their association with bipolarity. Psychological tests used in the study were the Mood Disorder Questionnaire (MDQ), Panic Disorder Severity Scale, Beck Depression Inventory, State-Trait Anxiety Inventory (STAI), Temperament and Character Inventory (TCI), and Minnesota Multiphasic Personality Inventory (MMPI). Statistical analyses were performed to evaluate the correlation between bipolarity of panic disorder patients and various psychological test results indicative of psychological characteristics.
Patients with a K-MDQ score of 7 or more were considered to have a history of manic or hypomanic episodes (BP+ group, = 128), while patients with K-MDQ scores below 7 were defined as those without bipolarity (BP- group, = 126). The BP+ group were more likely to be unmarried (single 56.2% 44.4%, = 0.008) and younger (30.78 ± 0.59 37.11 ± 3.21, 0.001). Additionally, the BP+ group had significantly higher scores on psychological assessment scales, such as the hypochondriasis, psychopathic deviate, masculinity-femininity, psychasthenia, schizophrenia, and hypomania (Ma) in MMPI, and novelty seeking, harm avoidance and self-transcendence in TCI, and STAI (state and trait) compared to the BP- group. In logistic regression analysis, depression in MMPI, self-directedness in TCI, and age were negatively associated with MDQ score, meanwhile, Ma in MMPI and STAI (trait) were positively associated with MDQ score.
The result of this study suggests that almost 50% of patients with panic disorder are likely to have hypomanic or manic symptoms, and certain psychological factors are associated bipolarity in panic disorder.
惊恐障碍常与情感障碍，尤其是双相情感障碍共同出现。患有惊恐障碍和双相情感障碍的患者更易出现严重症状，如自杀行为发生率高、症状和功能恢复不佳以及药物反应差。
探讨与双相性相关的惊恐障碍患者的心理特征。
本研究纳入了总共254例被诊断为惊恐障碍的患者（136例男性和118例女性，平均年龄 = 33.48 ± 3.2岁）。双相性惊恐障碍（BP+）定义为在韩国版心境障碍问卷（K-MDQ）上的得分≥7分，得分低于7分被视为无双相性的惊恐障碍（BP-）。对自我报告问卷进行分析以检查它们与双相性的关联。本研究中使用的心理测试有心境障碍问卷（MDQ）、惊恐障碍严重程度量表、贝克抑郁量表、状态-特质焦虑量表（STAI）、气质与性格问卷（TCI）以及明尼苏达多相人格调查表（MMPI）。进行统计分析以评估惊恐障碍患者的双相性与各种表明心理特征的心理测试结果之间的相关性。
K-MDQ得分7分或更高的患者被认为有躁狂或轻躁狂发作史（BP+组，= 128），而K-MDQ得分低于7分的患者被定义为无双相性的患者（BP-组，= 126）。BP+组更可能未婚（单身56.2% 对44.4%，= 0.008）且更年轻（30.78 ± 0.59对37.11 ± 3.21，= 0.001）。此外，与BP-组相比，BP+组在心理评估量表上的得分显著更高，如在MMPI中的疑病、精神病态偏差、男性化-女性化、精神衰弱、精神分裂症和轻躁狂（Ma），以及在TCI中的新奇寻求、伤害回避和自我超越，还有STAI（状态和特质）。在逻辑回归分析中，MMPI中的抑郁、TCI中的自我导向和年龄与MDQ得分呈负相关，同时，MMPI中的Ma和STAI（特质）与MDQ得分呈正相关。
本研究结果表明，近50%的惊恐障碍患者可能有轻躁狂或躁狂症状，且某些心理因素与惊恐障碍中的双相性相关。
