Katerndahl D A, Realini J P
Department of Family Practice, University of Texas Health Science Center at San Antonio 78284-7795.
J Fam Pract. 1995 Mar;40(3):237-43.
Although 40% of people with panic attacks never seek care for their attacks, those who do may use medical settings or mental health settings, or both. The purpose of this study was to examine where people seek care for their panic attacks within and outside the health care system, and to determine what variables predict the choice of a given site.
The Panic Attack Care-Seeking Threshold (PACT) study is a community-based survey of 97 subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) criteria for panic attacks. A structured interview was used to collect information about panic attacks, family characteristics, psychiatric comorbidity, health care access and utilization, illness attitudes and behaviors, quality of life, and symptom perceptions.
Forty-nine percent of the subjects seeking care for panic attacks presented to medical settings, whereas 26% of subjects used mental health settings. The family physician's office was the most frequent site of presentation (35%), followed by a hospital emergency department (32%). Only 13% of subjects sought care from a site outside the health care system. Variables predicting presentation to specific health care sites varied. Subject demographics, panic characteristics, and symptom perceptions were generally significant factors in care-seeking. Illness behaviors, readiness for sick role, health locus of control, and family measures failed to predict the seeking of care specific to any particular site.
When subjects with panic attacks seek care, they most commonly present to a general or family physician's office or a hospital emergency department.
尽管40%的恐慌症患者从未因恐慌发作寻求治疗,但那些寻求治疗的患者可能会选择医疗场所或心理健康场所,或两者皆选。本研究的目的是调查恐慌症患者在医疗保健系统内外寻求治疗的场所,并确定哪些变量可以预测特定场所的选择。
恐慌发作寻求治疗阈值(PACT)研究是一项基于社区的调查,对97名符合《精神障碍诊断与统计手册》第三版修订版(DSM-III-R)恐慌发作标准的受试者进行了调查。采用结构化访谈收集有关恐慌发作、家庭特征、精神疾病共病、医疗保健可及性和利用情况、疾病态度和行为、生活质量以及症状认知的信息。
因恐慌发作寻求治疗的受试者中,49%前往医疗场所,而26%的受试者使用心理健康场所。家庭医生办公室是最常就诊的场所(35%),其次是医院急诊科(32%)。只有13%的受试者在医疗保健系统外的场所寻求治疗。预测在特定医疗保健场所就诊的变量各不相同。受试者的人口统计学特征、恐慌特征和症状认知通常是寻求治疗的重要因素。疾病行为、患病角色准备度、健康控制点和家庭因素未能预测在任何特定场所的就诊情况。
恐慌症患者寻求治疗时,最常前往普通或家庭医生办公室或医院急诊科。