Brown T A, Antony M M, Barlow D H
Center for Stress and Anxiety Disorders, University of Albany, State University of New York 12203, USA.
J Consult Clin Psychol. 1995 Jun;63(3):408-18. doi: 10.1037//0022-006x.63.3.408.
The impact and course of additional diagnoses was examined in 126 patients undergoing cognitive-behavioral treatment for panic disorder. With the Anxiety Disorders Interview Schedule--Revised, a high comorbidity rate (51%) was observed at pretreatment. Pretreatment comorbidity was not predictive of premature termination, nor did it have a substantial impact on short-term treatment outcome. However, patients with comorbidity at posttreatment were more likely to have sought additional treatment over the follow-up interval. Although a significant and dramatic decline in the overall comorbidity rate was found at posttreatment (17%), at 24-month follow-up this rate had increased to a level (30.2%) that was no longer significantly different from pretreatment. This was despite the fact that patients maintained or improved on treatment gains for panic disorder over this interval. The implications of these findings for the treatment, conceptualization, and classification of emotional disorders are discussed.
对126名接受惊恐障碍认知行为治疗的患者的附加诊断的影响及病程进行了研究。使用修订版焦虑症访谈量表，在治疗前观察到高共病率（51%）。治疗前的共病不能预测提前终止治疗，对短期治疗结果也没有实质性影响。然而，治疗后存在共病的患者在随访期间更有可能寻求额外治疗。尽管在治疗后发现总体共病率显著大幅下降（17%），但在24个月随访时，该率已升至一个水平（30.2%），与治疗前不再有显著差异。尽管在此期间患者在惊恐障碍的治疗获益方面保持或有所改善。讨论了这些发现对情绪障碍的治疗、概念化和分类的意义。
