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综合医疗实践中的惊恐障碍——一篇叙述性综述。

Panic disorder in general medical practice- A narrative review.

作者信息

Manjunatha Narayana, Ram Dushad

机构信息

Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangluru, Karnataka, India.

Department of Medicine (Psychiatry), College of Medicine, Shaqra University, Shaqra, KSA.

出版信息

J Family Med Prim Care. 2022 Mar;11(3):861-869. doi: 10.4103/jfmpc.jfmpc_888_21. Epub 2022 Mar 10.

Abstract

The under-or misdiagnosis, and symptomatic treatment of the panic disorder (PD), despite high prevalent medical illness, is common among non-psychiatric physicians. The non-psychiatrist physician's role is vital in the care of PD as most patients initially approach general medical settings for medical help, including primary care. However, a significant proportion is undiagnosed and undergoes either unnecessary investigation, misdiagnosed, or mismanaged even among post-Coronary Artery Bypass Grafting patients, which profoundly affects the patients functioning and quality of life. This article aims to provide overviews of relevant epidemiological aspects, presenting features across medical specialties with respective diagnostic dilemmas, assessment, and management of the PD in their general medical settings, including emergency visits. Apart from psychiatrists, this will also assist non-psychiatrist physicians across all medical specialties, including general practitioners, to understand, identify, and provide the first line evidence-based pharmacotherapy and address the unmet need of patients with PD in their day-to-day busy clinical practice. This paper also provides a referral guide for non-psychiatrist physicians to refer to psychiatrists for further management after their first-line management.

摘要

尽管惊恐障碍(PD)在医学疾病中普遍存在,但在非精神科医生中,该疾病的漏诊、误诊以及对症治疗的情况却很常见。非精神科医生在PD的治疗中起着至关重要的作用,因为大多数患者最初会前往综合医疗科室寻求医疗帮助,包括初级保健。然而,即使在冠状动脉旁路移植术后的患者中,仍有相当一部分患者未被诊断出来,他们要么接受了不必要的检查,要么被误诊或管理不当,这严重影响了患者的功能和生活质量。本文旨在概述相关的流行病学方面,介绍各医学专科中PD的表现特征以及相应的诊断困境、评估和管理,包括在急诊就诊等综合医疗环境中的情况。除精神科医生外,这也将帮助所有医学专科的非精神科医生,包括全科医生,在日常繁忙的临床实践中理解、识别并提供一线循证药物治疗,满足PD患者未被满足的需求。本文还为非精神科医生提供了一份转诊指南,以便他们在一线治疗后将患者转诊给精神科医生进行进一步管理。

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