Pollack M H, Otto M W, Sachs G S, Leon A, Shear M K, Deltito J A, Keller M B, Rosenbaum J F
Anxiety Disorders Program, Massachusetts General Hospital, Boston 02114.
J Affect Disord. 1994 Apr;30(4):273-81. doi: 10.1016/0165-0327(94)90134-1.
This study examines clinical predictors of outcome for patients with panic disorder and depression in a 16 week, placebo-controlled trial of alprazolam and imipramine (n = 126). Baseline global severity of illness and phobic avoidance were differentially predictive of acute response to treatment. Patients in the mild to moderate range of global distress experienced smaller degrees of improvement on alprazolam than on imipramine at week 4. At endpoint, the relative effectiveness of the active medication versus placebo was diminished in patients with higher levels of phobic avoidance. This relationship was not evident for completers, suggesting that the adverse effects of avoidance on outcome after sustained treatment was reduced.
本研究在一项为期16周、使用阿普唑仑和丙咪嗪的安慰剂对照试验(n = 126)中,考察了惊恐障碍和抑郁症患者预后的临床预测因素。疾病的基线总体严重程度和恐惧回避对治疗的急性反应具有不同的预测作用。在第4周时,处于轻度至中度总体痛苦范围内的患者,服用阿普唑仑后的改善程度小于服用丙咪嗪后的改善程度。在研究终点,恐惧回避水平较高的患者中,活性药物与安慰剂相比的相对疗效有所降低。对于完成治疗的患者,这种关系并不明显,这表明持续治疗后回避对预后的不良影响有所减轻。