Chee K T
Department of General Psychiatry, Woodbridge Hospital/Institute of Mental Health, Singapore.
Singapore Med J. 1995 Dec;36(6):664-5.
Symptoms of panic attack can be found in both medical disease and mental disorder. At least 4 of 13 diagnostic symptoms need to be present to constitute an attack which onset is sudden and unpredictable. The duration of attack usually lasts minutes but sometimes longer. In panic disorder there is recurrent attacks of severe anxiety which are unprovoked and unexpected. Dominant symptoms vary from person to person. The syndrome is likely to be heterogeneous as the biological aetiology may be related to abnormalities in the function of a number of neurotransmitters ie serotonin, noradrenaline, gamabutyric acid, dopamine and cholecystokinin. As such different benzodiazepines and anti-depressants are efficacious in the treatment of the disorder. Medications should be titrated to prevent attacks and restore confidence. Maintenance therapy needs to be balanced with premature termination of treatment. Reassurance is important and there is a place for cognitive behavioural therapy, relaxation exercise and breathing control technique.
惊恐发作的症状在医学疾病和精神障碍中均可见。13种诊断症状中至少需要出现4种才能构成一次发作，其发作突然且不可预测。发作持续时间通常为几分钟，但有时更长。在惊恐障碍中，会出现反复发作的严重焦虑，这些发作是无端且意外的。主要症状因人而异。该综合征可能具有异质性，因为生物学病因可能与多种神经递质（即血清素、去甲肾上腺素、γ-氨基丁酸、多巴胺和胆囊收缩素）功能异常有关。因此，不同的苯二氮䓬类药物和抗抑郁药对该疾病的治疗有效。药物应进行滴定以预防发作并恢复信心。维持治疗需要与过早终止治疗相平衡。给予安慰很重要，认知行为疗法、放松练习和呼吸控制技术也有一席之地。
