Katerndahl D A, Realini J P
University of Texas Health Science Center-San Antonio, Department of Family Practice 78284-7795, USA.
J Clin Psychiatry. 1997 Apr;58(4):153-8. doi: 10.4088/jcp.v58n0403.
Panic disorder is associated with poor quality-of-life (QOL). However, little is known regarding the impact of panic disorder or infrequent panic on work-related disability. The purpose of this study was (1) to document QOL and panic-related work disability in subjects with panic disorder or infrequent panic, (2) to identify independent predictors of QOL and disability, and (3) to compare outcomes in subjects with panic disorder versus infrequent panic.
This cross-sectional community survey included 97 subjects with panic and matched controls. Subjects were screened for panic disorder or infrequent panic using the Structured Clinical Interview for DSM-III-R. The QOL questionnaire addressed life satisfaction as well as panic-related work disability. A structured interview assessed possible predictors of impaired QOL including comorbidity, illness attitudes and behaviors, coping style, family measures, and symptom perceptions.
QOL was significantly (p < or = .001) poorer in subjects with panic than in controls. Comorbid depression, social support, worry, and severity of chest pain predicted QOL. Although subjects with infrequent panic reported a lower QOL than controls, subjects with panic disorder had more panic-related disability and poorer QOL than those with infrequent panic. Predictors of work disability included panic frequency, illness attitudes, family dissatisfaction, and gender.
Although both infrequent panic and panic disorder impact QOL and disability, panic disorder has a greater effect. Using predictors, patient education, provision of support, and focused therapy could potentially improve QOL and disability.
惊恐障碍与生活质量（QOL）较差有关。然而，关于惊恐障碍或偶发惊恐对工作相关残疾的影响知之甚少。本研究的目的是：（1）记录患有惊恐障碍或偶发惊恐的受试者的生活质量和与惊恐相关的工作残疾情况；（2）确定生活质量和残疾的独立预测因素；（3）比较患有惊恐障碍的受试者与偶发惊恐的受试者的结果。
这项横断面社区调查纳入了97名患有惊恐障碍的受试者及匹配的对照组。使用《精神疾病诊断与统计手册第三版修订本》（DSM-III-R）的结构化临床访谈对受试者进行惊恐障碍或偶发惊恐的筛查。生活质量问卷涉及生活满意度以及与惊恐相关的工作残疾情况。结构化访谈评估了生活质量受损的可能预测因素，包括共病情况、疾病态度和行为、应对方式、家庭情况以及症状感知。
患有惊恐障碍的受试者的生活质量显著（p≤0.001）低于对照组。共病抑郁症、社会支持、担忧以及胸痛严重程度可预测生活质量。尽管偶发惊恐的受试者报告的生活质量低于对照组，但患有惊恐障碍的受试者比偶发惊恐的受试者有更多与惊恐相关的残疾且生活质量更差。工作残疾的预测因素包括惊恐发作频率、疾病态度、家庭不满以及性别。
尽管偶发惊恐和惊恐障碍都会影响生活质量和残疾状况，但惊恐障碍的影响更大。利用预测因素，开展患者教育、提供支持以及进行针对性治疗可能会改善生活质量和残疾状况。
