Moran C
Br J Med Psychol. 1986 Jun;59(2):187-96. doi: 10.1111/j.2044-8341.1986.tb02684.x.
This paper examines the role of uncontrolled depersonalization associated with marijuana use in the development of agoraphobia. Cases of six people are described, all of whom reported first experiencing depersonalization while using marijuana, and subsequently experiencing depersonalization while not using the drug. A fear of this 'uncontrolled' depersonalization resulted in considerable anticipatory anxiety and panic attacks. Patients ultimately presented for treatment of agoraphobia. A temporal relationship between marijuana use, uncontrolled depersonalization, panic attacks and agoraphobia does not imply causality. Comparison of these cases with other agoraphobia clinic patients provides tentative evidence for a difference between the two types of patients. There were no systematic patterns of stressors in the cases prior to the onset of symptoms. Data obtained before and after treatment indicated the cases were slightly more severe than clinic patients. Males and females were represented equally in the cases, whereas there was a higher incidence of females in the clinic patients. The cases' age of onset was younger than that of the clinic patients. Our standard cognitive-behavioural treatment programme required modification to account for the intensity of the fear of depersonalization in the cases.
本文探讨了与使用大麻相关的失控人格解体在广场恐惧症发展中的作用。描述了6例患者，他们均报告首次在使用大麻时体验到人格解体，随后在未使用毒品时也出现人格解体。对这种“失控”人格解体的恐惧导致了相当程度的预期焦虑和惊恐发作。患者最终因广场恐惧症前来就诊。大麻使用、失控人格解体、惊恐发作和广场恐惧症之间的时间关系并不意味着存在因果关系。将这些病例与其他广场恐惧症门诊患者进行比较，初步证明了这两类患者之间存在差异。在症状出现之前，这些病例中没有系统的应激源模式。治疗前后获得的数据表明，这些病例比门诊患者病情稍重。病例中男性和女性比例相同，而门诊患者中女性发病率较高。这些病例的发病年龄比门诊患者年轻。我们的标准认知行为治疗方案需要进行调整，以应对这些病例中对人格解体的恐惧强度。
