Lydiard R B, Greenwald S, Weissman M M, Johnson J, Drossman D A, Ballenger J C
Institute of Psychiatry, Medical University of South Carolina, Charleston 29425.
Am J Psychiatry. 1994 Jan;151(1):64-70. doi: 10.1176/ajp.151.1.64.
Clinical experience and recent reports suggest that there is a high prevalence of gastrointestinal symptoms in patients with panic disorder and that there is a high prevalence of panic disorder in patients with irritable bowel syndrome, a functional gastrointestinal disorder. To assess gastrointestinal symptoms in a nonpatient, community-based sample, the authors surveyed the prevalence of gastrointestinal symptoms in individuals with panic disorder and other or no psychiatric disorders obtained in a national community survey.
Subjects were 13,537 respondents at four sites of the National Institute of Mental Health (NIMH) Epidemiological Catchment Area project. DSM-III diagnoses were determined by using the NIMH Diagnostic Interview Schedule (DIS). Gastrointestinal symptoms were assessed from the somatization disorder section of the DIS.
Individuals with panic disorder had a significantly higher rate of endorsing gastrointestinal symptoms, including those typically associated with irritable bowel syndrome, than those with other or no psychiatric diagnosis.
Findings suggest a diagnostic overlap between panic disorder and irritable bowel syndrome, with similar demographic and clinical characteristics of patients. Limitations of the study are discussed in terms of medical assessment and self-report inventories. Practical and theoretical implications are discussed.
临床经验及近期报告表明，惊恐障碍患者中胃肠道症状的患病率较高，且在肠易激综合征（一种功能性胃肠疾病）患者中惊恐障碍的患病率也较高。为了评估非患者社区样本中的胃肠道症状，作者在一项全国性社区调查中，对患有惊恐障碍以及患有其他精神障碍或无精神障碍的个体的胃肠道症状患病率进行了调查。
研究对象为美国国立精神卫生研究所（NIMH）流行病学集水区项目四个地点的13537名受访者。使用NIMH诊断访谈表（DIS）确定《精神疾病诊断与统计手册》第三版（DSM-III）的诊断。通过DIS中的躯体化障碍部分评估胃肠道症状。
与患有其他精神障碍或无精神障碍的个体相比，患有惊恐障碍的个体认可胃肠道症状（包括那些通常与肠易激综合征相关的症状）的比例显著更高。
研究结果表明惊恐障碍与肠易激综合征之间存在诊断重叠，患者具有相似的人口统计学和临床特征。从医学评估和自我报告量表方面讨论了该研究的局限性。探讨了实际意义和理论意义。
