The early-onset fearful panic attack as a predictor of severe psychopathology
The early-onset fearful panic attack as a predictor of severe psychopathology
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DOI：
10.1016/s0165-1781(01)00357-2
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发表时间：
2002-01-31
影响因子：
11.3
通讯作者：
Hamilton, SP
中科院分区：
文献类型：
--
作者：
Goodwin, RD;Hamilton, SP
本研究的目的是重复以前的研究结果，表明早发性惊恐发作（小于或等于20年）与恐惧代表了早发性严重精神病理学的可能前驱症状。数据来自流行病学集水区调查（ECA）（n=20 291），家庭样本的成年人年龄在18岁及以上，来自美国的五个城市。采用多变量logistic回归分析，区分早发性惊恐发作伴恐惧与其他惊恐发作（早发性无恐惧、晚发性无恐惧、晚发性伴恐惧）的精神共病、共病精神障碍发作时的年龄、自杀意念和自杀企图。统计分析结果显示，早发性恐惧性惊恐发作（n = 368）与主要情感障碍和物质使用障碍的可能性增加，共病精神障碍的发病时间明显提前，自杀意念和自杀企图的发生率较高，与其他亚型的惊恐发作相比，反社会人格障碍的发生率较高。多因素Logistic回归分析显示，早发性恐惧与抑郁症的发生率增加独立相关[OR= 3.0（2.6，3.5）]、双相情感障碍[OR=7.9（5.7，10.8）]、反社会人格障碍[OR=1.5（1.3，1.7）]、广场恐怖[OR=1.2（1.1，1.4）]、单纯恐怖[OR=1.6（1.4，1.8）]和酒精依赖[OR = 1.3（1.2，1.5）]。这些发现与以前的流行病学数据一致，并提供了新的证据表明，早发性恐惧性恐慌发作可能是严重和持续性精神病理学易感性增加的标志，并与自杀率高相关，（C）2002年爱思唯尔科学爱尔兰有限公司保留所有权利。
The objective of this study was to replicate previous findings indicating that early-onset panic attack (less than or equal to 20 years) with fear represents a possible prodrome of early-onset severe psychopathology. Data were drawn from the Epidemiologic Catchment Area Survey (ECA) (n=20 291), a household sample of adults aged 18 and older drawn from five cities in the United States. Multivariate logistic regression analyses were used to differentiate those with early-onset panic attacks with fear from those with other panic attacks (early-onset without fear, late-onset without fear, late-onset with fear) with regard to psychiatric comorbidity, age at onset of comorbid mental disorders, and suicidal ideation and suicide attempts. Results of statistical analyses revealed that early-onset fearful panic attack (n = 368) was associated with increased likelihood of major affective and substance use disorders, significantly earlier onset of comorbid mental disorders, higher rates of suicidal ideation and suicide attempt, and higher rates of antisocial personality disorder compared with those with other subtypes of panic attacks. Multiple logistic regression analyses showed that early-onset fearful panic was independently associated with increased odds of major depression [OR= 3.0 (2.6, 3.5)], bipolar disorder [OR=7.9 (5.7, 10.8)], antisocial personality disorder [OR=1.5 (1.3, 1.7)], agoraphobia [OR=1.2 (1.1, 1.4)], simple phobia [OR=1.6 (1.4, 1.8)], and alcohol dependence [OR = 1.3 (1.2, 1.5)], compared with those with all other panic attacks. These findings are consistent with previous epidemiologic data and provide new evidence to suggest that early-onset fearful panic attack may be a marker of increased vulnerability to severe and persistent psychopathology and associated with high rates of suicidality, (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.