Rogers M P, White K, Warshaw M G, Yonkers K A, Rodriguez-Villa F, Chang G, Keller M B
Harvard Medical School, Boston, Massachusetts.
Int J Psychiatry Med. 1994;24(1):83-96. doi: 10.2190/TXM9-EVX8-Q4WT-G03J.
This investigation examines the prevalence and characteristics of medical illness in 711 patients enrolled in the Harvard/Brown Anxiety Disorders Research Program (HARP), a multi-center, longitudinal study of anxiety disorders.
Eligible subjects were those with present or past index anxiety disorders: panic disorder without agoraphobia, panic disorder with agoraphobia, agoraphobia without panic disorder, social phobia, or generalized anxiety disorder. They were assessed by trained raters using structured diagnostic interviews and the Medical History Form II.
Patients with panic disorder and co-morbid major depressive disorder had significantly higher rates of reported medical illness than anxiety disorder patients without depression. When the rates of medical illness for all subjects were compared with those from the Rand Health Insurance Experiment, we found the prevalence of several medical problems to be disproportionately increased.
Although our results are preliminary, it appears that patients with panic disorder have more reported medical problems than the public at large, in particular, more ulcer disease, angina, and thyroid disease. Somatic complaints in patients with panic disorder, therefore, need to be carefully considered.
本研究调查了参与哈佛/布朗焦虑症研究项目(HARP)的711名患者的疾病患病率及特征,该项目是一项关于焦虑症的多中心纵向研究。
符合条件的受试者为患有当前或过去的索引焦虑症患者:无广场恐惧症的惊恐障碍、有广场恐惧症的惊恐障碍、无惊恐障碍的广场恐惧症、社交恐惧症或广泛性焦虑症。由经过培训的评估人员使用结构化诊断访谈和病史表II对他们进行评估。
患有惊恐障碍并伴有共病重度抑郁症的患者报告的疾病发生率显著高于无抑郁症的焦虑症患者。当将所有受试者的疾病发生率与兰德健康保险实验的发生率进行比较时,我们发现几种医疗问题的患病率不成比例地增加。
尽管我们的结果是初步的,但似乎惊恐障碍患者报告的医疗问题比普通大众更多,尤其是溃疡病、心绞痛和甲状腺疾病。因此,需要仔细考虑惊恐障碍患者的躯体主诉。