Liebowitz M R
Department of Psychiatry of Columbia University, New York, N.Y. 10032, USA.
J Clin Psychiatry. 1997;58 Suppl 13:5-8.
Panic disorder is a chronic illness that waxes and wanes, and the prognosis is worse with comorbid agoraphobia, depression, or personality disorder. Both medication and cognitive-behavioral therapy have been found helpful in acute treatment trials of panic disorder. However, recent studies suggest that therapeutic gains are lost in many instances when treatment is stopped after short-term medication or cognitive-behavioral therapy. Thus, maintenance treatment appears necessary for many panic patients. Patients appear relatively stable during medication maintenance, but studies of maintenance psychosocial treatment for panic disorder have not yet been reported. Whether combined medication and psychosocial treatment lead to more durable effects after treatment discontinuation than are seen with individual treatments also remains to be determined.
惊恐障碍是一种病情有起伏的慢性疾病,若合并场所恐惧症、抑郁症或人格障碍,预后会更差。在惊恐障碍的急性治疗试验中,药物治疗和认知行为疗法均被证明是有效的。然而,最近的研究表明,在短期药物治疗或认知行为疗法后停止治疗,在很多情况下治疗效果会丧失。因此,许多惊恐症患者似乎需要维持治疗。在药物维持治疗期间,患者病情相对稳定,但关于惊恐障碍维持性心理社会治疗的研究尚未见报道。与单一治疗相比,药物和心理社会联合治疗在治疗中断后是否能产生更持久的效果,仍有待确定。