Cottraux J
Encephale. 1984;10(1):13-9.
Behavioral and biological issues in agoraphobia are reviewed. New classifications of agoraphobia based on longitudinal studies appear promising. Genetical studies bring some data suggesting that agoraphobia and panick attacks may be a familial and genetical disease. The effects of antidepressants on agoraphobia and panick attacks are still a disputed issue. Exposure in vivo appears as the effective component of behavioral treatment of anticipatory anxiety and allows a significant withdrawal of medication (eg antidepressant and/or benzodiazepine). A personal study on 27 agoraphobia cases is reported showing a significant rate of withdrawal after behavior therapy (p less than .05). Some examples of single case designs are reported to study the covariation of depression, phobia and panick attacks. Multicenter studies are needed to clarify the problem of effectiveness and specificity of antidepressant action on agoraphobia and panick attacks.
本文综述了广场恐惧症的行为和生物学问题。基于纵向研究的广场恐惧症新分类似乎很有前景。遗传学研究提供了一些数据，表明广场恐惧症和惊恐发作可能是一种家族性和遗传性疾病。抗抑郁药对广场恐惧症和惊恐发作的影响仍然是一个有争议的问题。现场暴露似乎是预期焦虑行为治疗的有效组成部分，并允许大量减少药物治疗（如抗抑郁药和/或苯二氮䓬类药物）。报告了一项对27例广场恐惧症病例的个人研究，显示行为治疗后有显著的停药率（p小于0.05）。报告了一些单病例设计的例子，以研究抑郁症、恐惧症和惊恐发作的共变情况。需要进行多中心研究来阐明抗抑郁药对广场恐惧症和惊恐发作作用的有效性和特异性问题。
