ASSESSING THE EFFICACY OF TREATMENTS FOR PANIC DISORDER AND AGORAPHOBIA .1. METHODOLOGICAL PROBLEMS
ASSESSING THE EFFICACY OF TREATMENTS FOR PANIC DISORDER AND AGORAPHOBIA .1. METHODOLOGICAL PROBLEMS
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DOI：
10.1097/00004850-199506000-00004
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发表时间：
1995-06-01
影响因子：
2.6
通讯作者：
RUTHER, E
中科院分区：
文献类型：
--
作者：
BANDELOW, B;HAJAK, G;RUTHER, E
惊恐障碍和广场恐怖症（PDA）的治疗效果的评估是复杂的方法问题，这些疾病的复杂性。在本文中，常用的焦虑量表进行了讨论，其相关性评估PDA。虽然已经有许多评估焦虑和广场恐怖症的量表，但仍然缺乏一个合格的工具来测量PDA的严重程度。对最近PDA治疗研究中使用的工具的调查显示，应用了相当不均匀的疗效标准。大多数情况下，惊恐发作频率被视为严重程度标准，尽管该指标几乎没有显示出区分治疗的能力。针对PDA的特点，通常采用一组不同的量表，有时也使用非标准化量表。介绍了一种新的评定量表，旨在克服与PDA严重程度评估相关的方法学问题。精神科医生评定的惊恐和广场恐怖症（P & A）量表在DSM-III-R惊恐障碍和/或广场恐怖症患者（n = 235）中的使用表明，与其他常用的焦虑量表相比，该量表与精神科医生对PDA患者的临床总体印象具有最高的相关性（r = 0.79，p < 0.0001）。P & A的自评版本与患者评定的临床总体印象的相关性最高（r = 0.82，p < 0.0001），而其他患者评定的焦虑问卷仅中度或较差相关。通过logistic回归，表明量表的五个子评分对PDA严重程度的预测独立且几乎相等。
An assessment of the efficacy of treatments in panic disorder and agoraphobia (PDA) is complicated by methodological problems resulting from the complexity of these disorders. In this paper, commonly used anxiety scales are discussed with regard to their relevance in the assessment of PDA. Although there are already many scales for assessing anxiety and agoraphobia, a qualified instrument for measuring the severity of PDA is still lacking. A survey of the instruments used in recent treatment studies of PDA shows that rather inhomogeneous efficacy criteria were applied. Most often, panic attack frequency was taken as a severity criterion, although this measure showed little power to differentiate between treatments. To deal with the special features of PDA, a battery of different scales was usually employed and non-standardized scales were sometimes used additionally. A new rating scale designed to overcome the methodological problems associated with the assessment of severity in PDA was introduced. The use of the psychiatrist-rated Panic and Agoraphobia (P & A) scale in patients with DSM-III-R panic disorder and/or agoraphobia (n = 235) shows that this scale has the highest correlation with the psychiatrists' clinical global impression of PDA patients (r = 0.79, p < 0.0001), compared with other commonly used observer-rated anxiety scales. The self-rating version of the P & A again had the highest correlation with a patient-rated clinical global impression (r = 0.82, p < 0.0001), whereas the other patient-rated anxiety questionnaires correlated only moderately or poorly, By means of logistic regression, it was shown that the five subscores of the scale contribute independently and almost equally to the prediction of PDA severity.