Space and motion discomfort in Brazilian versus American patients with anxiety disorders.
Space and motion discomfort in Brazilian versus American patients with anxiety disorders.
复制标题
巴西与美国焦虑症患者的空间和运动不适。
DOI：
10.1016/s0887-6185(97)00002-9
复制
发表时间：
1997
影响因子：
10.3
通讯作者：
Lilienfeld,SO
中科院分区：
文献类型：
--
作者：
Romas,RT;Jacob,RG;Lilienfeld,SO
据报道，惊恐障碍患者，尤其是广场恐怖症患者，前庭或平衡功能障碍的患病率较高（Jacob，Furman，Durrant，& Turner，1996; Jacob，Moller，Turner，& Wall，1985;亚德利，B&ton，Lear，Bird，& Luxon，1995;亚德利，Luxon，Lear，B&ton，& Bird，1994）。在前庭功能障碍患者中也有精神并发症，尤其是焦虑症状和焦虑障碍的报道（Clark，Hirsch，Smith，Furman，& Jacob，199.5; Clerger，Luxon，Davies，Coelho，&罗恩，1991; Stein，Asmundson，爱尔兰，&步行者，1994; Sullivan，Clark，Katon，Fischl，Russo，Dobie，& Voorhees，1993）。广场恐惧症和平衡异常之间关系的重要性因“伪广场恐惧症”综合征的报道而得到加强，例如“街道神经症”（Levy & O 'Leary，1947）、“超市综合征”（McCabe，1975; Rudge & Chambers，1982）、“驾车者前庭定向障碍综合征”（Page & Gresty，1985）和“空间恐惧症”（Marks & Bebbington，1976）。有此类主诉的患者报告在以前庭刺激或缺乏非前庭空间线索为特征的情况下感到不适（Jacob，Furman，& Balaban，1996）。这种不适感会引发回避行为并引发恐慌发作，其模式与恐慌症和广场恐惧症非常相似。为了进一步阐明广场恐惧回避和前庭功能障碍之间的相关性，Jacob et al.（1993）创造了术语空间和运动不适（SMD）来描述一种情况，其中焦虑和压力是由无法获得正常空间定向的足够视觉或动觉信息的情况引起的。作者认为，SMD患者有一定程度的前庭功能障碍，因此比其他人更依赖视觉或动觉输入进行空间定向。SMD的识别和测量可以通过情境特征问卷（SitQ）可靠地进行（Jacob等人，最近，拉莫斯、Formigoni、Soares、Demetrio、Oliveira和Gentil（出版中）调查了32名患有惊恐障碍和广场恐怖症的巴西患者的前庭功能障碍的发生情况。31%的患者热量试验异常。为了进一步研究空间和运动不适在巴西人群中恐慌/广场恐怖症和平衡障碍之间的关系中的作用，有必要对葡萄牙的SMD进行测量。因此，本研究报告了我们的初步经验，葡萄牙语版的SitQ，适用于巴西患者的简单的恐慌症，恐慌症与广场恐怖症，或非恐慌性焦虑症。根据Jacob et al.（1993）和Jacob et al.（1996），我们预测巴西和美国的广场恐惧症患者比那些患有恐慌症和其他焦虑症的人有更高水平的SMD。我们还对不同国家之间SMD评分是否存在系统性差异感兴趣。
A high prevalence of vestibular or balance dysfunction has been reported in patients with panic disorder, particularly those with agoraphobia (Jacob, Furman, Durrant, & Turner, 1996; Jacob, Moller, Turner, & Wall, 1985; Yardley, B&ton, Lear, Bird, & Luxon, 1995; Yardley, Luxon, Lear, B&ton, & Bird, 1994). Psychiatric complications, especially anxiety symptoms and anxiety disorders, have also been reported in patients with vestibular dysfunction (Clark, Hirsch, Smith, Furman, & Jacob, 199.5; Eagger, Luxon, Davies, Coelho, & Ron, 1991; Stein, Asmundson, Ireland, & Walker, 1994; Sullivan, Clark, Katon, Fischl, Russo, Dobie, & Voorhees, 1993). The importance of the relationship between agoraphobia and balance abnormalities is reinforced by the report of “pseudoagoraphobic” syndromes such as “street neurosis”(Levy & O’Leary, 1947),“supermarket syndrome”(McCabe, 1975; Rudge & Chambers, 1982),“motorist vestibular disorientation syndrome”(Page & Gresty, 1985), and “space phobia”(Marks & Bebbington, 1976). Patients with such complaints report discomfort in situations characterized by vestibular stimulation or paucity of non-vestibular spatial cues (Jacob, Furman, & Balaban, 1996). Such discomfort can evoke avoidant behavior and trigger panic attacks in a pattern very similar to that seen in panic disorder and agoraphobia. In an attempt to further elucidate the nature of the correlation between agoraphobic avoidance and vestibular dysfunction, Jacob et al.(1993) coined the term space and motion discomfort (SMD) to describe a condition in which anxiety and stress are elicited by situations where adequate visual or kinesthetic information for normal spatial orientation is not available. The authors suggested that individuals with SMD have some degree of vestibular impairment and therefore are more dependent on visual or kinesthetic inputs for spatial orientation than other individuals. Identification and measurement of SMD can be reliably carried out by the Situational Characteristics Questionnaire (SitQ)(Jacob et al., 1993).Recently, Ramos, Formigoni, Soares, Demetrio, Oliveira, and Gentil (in press) investigated the occurrence of vestibular dysfunction in 32 Brazilian patients with panic disorder and agoraphobia. Abnormalities in the caloric test were found in 31% of them. To further examine the role of space and motion discomfort in the relationship between panic/agoraphobia and balance disorders in the Brazilian population, there is a need for a Portuguese measure of SMD. Therefore, the present study reports our initial experiences with the translated Portuguese version of SitQ, as applied to Brazilian patients with uncomplicated panic disorder, panic disorder with agoraphobia, or non-panic anxiety disorders. Based on the results of Jacob et al.(1993) and Jacob et al.(1996), we predicted that Brazilian and American agoraphobics would have higher levels of SMD than those with panic disorder and other anxiety disorders. We were also interested in whether there would be a systematic difference in SMD scores between countries.