Goetz R R, Klein D F, Gorman J M
Department of Therapeutics, New York State Psychiatric Institute, NY 10032, USA.
Neuropsychopharmacology. 1996 May;14(5):355-66. doi: 10.1016/0893-133X(95)00147-6.
We report on subjective ratings and symptoms experienced before and during sodium lactate infusion by patients with panic disorder or agoraphobics with panic attack (DMS-III-R criteria). Symptoms were assessed using the Acute Panic Inventory (API). During the lactate infusion 59% of the patients were rated by an attending psychiatrist as having experienced lactate-induced panic attacks. Patients experiencing lactate-induced panic attacks overwhelmingly rated this experience as very similar to their typical naturally occurring attacks. Among the individual API symptoms items at baseline (prelactate) only Afraid in general (r = 0.26) was significantly, but not strongly, correlated with the panic response. Controlling for baseline symptom levels, the most robust partial correlations of symptomatic increment with panic were Desire to flee (0.70), Fear of losing control (0.57), Afraid in general (0.49), and Dyspnea (0.48). Using a dichotomized symptom increment greater than 1, 13 of 29 API items indicated a panic response to lactate infusion; the best were Dyspnea, Feeling confused, Afraid in general, Difficulty speaking, Difficulty concentrating, Desire to flee, and Fear of losing control. A logistic regression analysis showed that among baseline measures, Afraid in general and Feeling confused significantly predicted panic. For dichotomized change scores, Afraid in general, Dyspnea, and Dizziness/lightheadedness significantly indicated panic. In these analyses three symptom items stand out as the most predictive and revealing of panic to lactate infusion: Afraid in general, Dyspnea, and Desire to flee. These results are discussed in the context of Klein's (1993) suffocation false alarm theory of panic.
我们报告了惊恐障碍患者或伴有惊恐发作的广场恐惧症患者（依据《精神疾病诊断与统计手册》第三版修订版标准）在输注乳酸钠之前及期间的主观评分和经历的症状。使用急性惊恐量表（API）评估症状。在输注乳酸钠期间，59%的患者被主治精神科医生评定为经历了乳酸诱发的惊恐发作。经历乳酸诱发惊恐发作的患者绝大多数将这种经历评定为与他们典型的自然发作非常相似。在基线（输注乳酸前）时的各个API症状项目中，只有“总体害怕”（r = 0.26）与惊恐反应存在显著但不强的相关性。在控制基线症状水平的情况下，症状增加与惊恐之间最强的偏相关性为“想要逃离”（0.70）、“害怕失控”（0.57）、“总体害怕”（0.49）和“呼吸困难”（0.48）。使用大于1的二分法症状增加量，29个API项目中的13个表明对乳酸输注有惊恐反应；最佳的是呼吸困难、感到困惑、总体害怕、说话困难、注意力难以集中、想要逃离和害怕失控。逻辑回归分析表明，在基线测量中，总体害怕和感到困惑显著预测惊恐。对于二分法变化分数，总体害怕、呼吸困难和头晕/眩晕显著表明惊恐。在这些分析中，有三个症状项目最为突出，对乳酸输注惊恐反应最具预测性和揭示性：总体害怕、呼吸困难和想要逃离。将在克莱因（1993年）的惊恐窒息假警报理论背景下讨论这些结果。
