Starcevic V, Bogojevic G
Belgrade University School of Medicine and the Institute of Mental Health, Yugoslavia.
Compr Psychiatry. 1997 Nov-Dec;38(6):315-20. doi: 10.1016/s0010-440x(97)90926-3.
The study objectives were to determine comorbidity rates for various subtypes of specific phobia (SP) in a sample of patients with the principal diagnosis of panic disorder with agoraphobia (PDA) and to examine the possible etiologic relatedness of these SP subtypes to PDA. Ninety consecutive day clinic patients with PDA were administered the Structured Clinical Interview for DSM-III-R (SCID) modified for DSM-IV. The overall comorbidity rate for SP was 65.6%. The most frequent subtypes of SP were situational phobia and dental phobia, followed by natural environment phobia, phobia of funerals, cemeteries, dead bodies, and other death-related phenomena and objects (referred to as death-related phobia), and blood-injection-injury phobia. Except for death-related phobia, other subtypes of SP clearly tended to precede the onset of PDA, often by many years. The smallest difference between the age of onset for PDA and particular subtypes of SP (temporal distance) was found for death-related phobia, whereas the temporal difference was longer for situational phobia, hospital phobia, and blood-injection-injury phobia. The frequency and temporal distance data suggest that death-related phobia may constitute a risk factor for developing PDA or that it is a prodrome of PDA, whereas situational phobia, hospital phobia, and blood-injection-injury phobia appear to predispose to PDA to a lesser degree. Of the three broadly conceived groups of SP, mutilation phobias (which include death-related phobia, hospital phobia, blood-injection-injury phobia, and dental phobia) appear most etiologically relevant for PDA, with the group of situational phobias (which also includes the natural environment subtype of SP) being less relevant, and animal phobias showing a negligible etiologic relatedness to PDA.
本研究的目的是确定以广场恐怖症伴惊恐障碍（PDA）为主诊断的患者样本中特定恐惧症（SP）各亚型的共病率，并探讨这些SP亚型与PDA可能的病因相关性。对90例连续的PDA日间门诊患者进行了针对DSM-IV修改的DSM-III-R结构化临床访谈（SCID）。SP的总体共病率为65.6%。SP最常见的亚型是情境性恐惧症和牙科恐惧症，其次是自然环境恐惧症、葬礼、墓地、尸体及其他与死亡相关的现象和物体恐惧症（称为死亡相关恐惧症），以及血液-注射-损伤恐惧症。除死亡相关恐惧症外，其他SP亚型明显倾向于在PDA发病之前出现，通常提前很多年。PDA发病年龄与特定SP亚型之间的最小差异（时间间隔）在死亡相关恐惧症中被发现，而情境性恐惧症、医院恐惧症和血液-注射-损伤恐惧症的时间差异更长。频率和时间间隔数据表明，死亡相关恐惧症可能构成PDA发病的危险因素或它是PDA的前驱症状，而情境性恐惧症、医院恐惧症和血液-注射-损伤恐惧症似乎在较小程度上易患PDA。在SP的三大类中，毁伤恐惧症（包括死亡相关恐惧症、医院恐惧症、血液-注射-损伤恐惧症和牙科恐惧症）在病因上似乎与PDA最相关，情境性恐惧症组（其中也包括SP的自然环境亚型）相关性较小，而动物恐惧症与PDA的病因相关性可忽略不计。
