Katerndahl D A, Realini J P
Department of Family Practice, University of Texas Health Science Center, San Antonio 78284, USA.
Depress Anxiety. 1998;8(1):33-8. doi: 10.1002/(sici)1520-6394(1998)8:1<33::aid-da7>3.0.co;2-6.
The purpose of this study was to compare subsyndromal panic--infrequent panic (IP) and limited symptom attacks (LSA)--with panic disorder (PD) in psychiatric comorbidity, quality of life (QOL), and health care utilization and to assess validity of DSM-III-R criteria for panic disorder. Randomly selected adults were screened for the presence of PD, IP, and LSA by using the Structured Clinical Interview of the DSM-IIIR. Subjects with panic symptoms and matched controls completed a structured interview concerning comorbidity, QOL, and utilization. Although PD and IP subjects reported more psychiatric comorbidity than did LSA subjects, LSA subjects had more comorbid conditions than did controls. Differences in utilization were limited to PD subjects. Although subsyndromal panic was associated with poor QOL, panic-related work disability was primarily seen in PD subjects. Regression analyses demonstrated little difference between LSA and IP subjects, but interaction analysis supported the distinction between LSA and full-blown panic attacks. Compared with controls, LSA and IP subjects had more psychiatric comorbidity. PD subjects also had poorer QOL and more utilization. Interaction analysis supports DSM-IV criteria for panic disorder.
本研究的目的是比较亚综合征惊恐——偶发惊恐（IP）和有限症状发作（LSA）——与惊恐障碍（PD）在精神共病、生活质量（QOL）和医疗保健利用方面的差异，并评估DSM-III-R惊恐障碍标准的有效性。通过使用DSM-IIIR的结构化临床访谈，对随机选取的成年人进行PD、IP和LSA存在情况的筛查。有惊恐症状的受试者和匹配的对照组完成了关于共病、生活质量和利用情况的结构化访谈。尽管PD和IP受试者报告的精神共病比LSA受试者更多，但LSA受试者的共病情况比对照组更多。利用情况的差异仅限于PD受试者。尽管亚综合征惊恐与生活质量差有关，但与惊恐相关的工作残疾主要见于PD受试者。回归分析显示LSA和IP受试者之间差异不大，但交互分析支持LSA与全面惊恐发作之间的区别。与对照组相比，LSA和IP受试者有更多的精神共病。PD受试者的生活质量也较差，利用情况更多。交互分析支持DSM-IV惊恐障碍标准。
