Breier A, Charney D S, Heninger G R
Arch Gen Psychiatry. 1986 Nov;43(11):1029-36. doi: 10.1001/archpsyc.1986.01800110015003.
A structured psychiatric interview was used to examine the symptom history of 55 patients meeting DSM-III criteria for agoraphobia with panic attacks and five patients meeting DSM-III criteria for panic disorder. Anticipatory anxiety and generalized anxiety occurred in over 80% of the patients, and these anxiety states together with panic attacks and phobic avoidances had courses that were chronic and unremitting. Major depression occurred in 70% of the patients and had an episodic course that differentiated it from the anxiety states. Other frequently reported disorders were childhood separation disorder (18%), alcoholism (17%), and obsessive compulsive disorder (17%). An initial nonspontaneous first panic attack and separation anxiety was associated with earlier onset and longer duration of agoraphobia and panic disorder. An inaccurate cognitive appraisal of the initial panic attack frequently led to the rapid development of subsequent agoraphobia. Caffeine consumption exacerbated anxiety in 54% of the patients and triggered panic attacks in 17%. Fifty-one percent of female agoraphobics experienced premenstrual exacerbation of anxiety symptoms.
采用结构化精神科访谈来检查55例符合《精神疾病诊断与统计手册》第三版（DSM-III）中伴有惊恐发作的广场恐惧症标准的患者以及5例符合DSM-III中惊恐障碍标准的患者的症状史。80%以上的患者出现预期焦虑和广泛性焦虑，这些焦虑状态与惊恐发作和恐惧回避行为的病程呈慢性且持续不缓解。70%的患者出现重度抑郁症，其发作性病程使其与焦虑状态相区别。其他常见的疾病包括儿童期分离障碍（18%）、酒精中毒（17%）和强迫症（17%）。最初的非自发性首次惊恐发作和分离焦虑与广场恐惧症和惊恐障碍的更早发病及更长病程相关。对最初惊恐发作的认知评估不准确常常导致随后广场恐惧症的迅速发展。54%的患者咖啡因摄入会加重焦虑，17%的患者会引发惊恐发作。51%的女性广场恐惧症患者在经前焦虑症状会加重。
