The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication
The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication
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DOI：
10.1001/archpsyc.63.4.415
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发表时间：
2006-04-01
影响因子：
--
通讯作者：
Walters, EE
中科院分区：
文献类型：
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作者：
Kessler, RC;Chiu, WT;Walters, EE
背景：关于DSM-IV惊恐发作（PAs）和惊恐障碍（PD）的流行病学信息有限。目的：在美国国家共病调查的基础上，提供有或没有广场恐怖症（AG）的PAs和PD的流行病学的全国代表性数据。设计和环境：采用完全结构化的世界卫生组织综合国际诊断访谈进行的具有全国代表性的面对面家庭调查。参与者：说英语的受访者（N = 9282） 18岁或以上。主要结果测量：满足DSM-IV的PAs和PD伴或不伴AG的终身标准的受访者。结果：孤立性恐慌无AG（仅PA）的终生患病率估计为22.7%，PA伴AG伴PD （PA-AG）的终生患病率为0.8%，PD伴AG（仅PD）的终生患病率为3.7%，PD伴AG （PD-AG）的终生患病率为1.1%。在这4个子组中，持久性、攻击的生命周期次数和攻击的年数单调增加。所有4个亚组与其他终生DSM-IV障碍均有显著合并症，PD-AG的发生率最高，仅PA的发生率最低。PD-AG的恐慌障碍严重程度量表得分也最高（86.3%为中度或重度），而PA最低（6.7%为中度或重度）。广场恐怖症与严重程度、损害和合并症有关。终生治疗是高的（从PD-AG的96.1%到PA的61.1%），但12个月的治疗符合公布的治疗指南是低的（从PD-AG的54.9%到PA的18.2%）。结论：虽然PD和PA-AG是造成恐慌的主要社会负担，但孤立性pa也具有较高的患病率和有意义的角色损害。
Context: Only limited information exists about the epidemiology of DSM-IV panic attacks (PAs) and panic disorder (PD).Objective: To present nationally representative data about the epidemiology of PAs and PD with or without agoraphobia (AG) on the basis of the US National Comorbidity Survey Replication findings.Design and Setting: Nationally representative face-to-face household survey conducted using the fully structured World Health Organization Composite International Diagnostic Interview.Participants: English-speaking respondents ( N = 9282) 18 years or older.Main Outcome Measures: Respondents who met DSM-IV lifetime criteria for PAs and PD with and without AG.Results: Lifetime prevalence estimates are 22.7% for isolated panic without AG ( PA only), 0.8% for PA with AG without PD (PA-AG), 3.7% for PD without AG ( PD only), and 1.1% for PD with AG (PD-AG). Persistence, lifetime number of attacks, and number of years with attacks increase monotonically across these 4 subgroups. All 4 subgroups are significantly comorbid with other lifetime DSM-IV disorders, with the highest odds for PD-AG and the lowest for PA only. Scores on the Panic Disorder Severity Scale are also highest for PD-AG (86.3% moderate or severe) and lowest for PA only (6.7% moderate or severe). Agoraphobia is associated with substantial severity, impairment, and comorbidity. Lifetime treatment is high ( from 96.1% for PD-AG to 61.1% for PA only), but 12-month treatment meeting published treatment guidelines is low ( from 54.9% for PD-AG to 18.2% for PA only).Conclusion: Although the major societal burden of panic is caused by PD and PA-AG, isolated PAs also have high prevalence and meaningful role impairment.