Psychiatric treatment received by primary care patients with panic disorder with and without agoraphobia.
Psychiatric treatment received by primary care patients with panic disorder with and without agoraphobia.
复制标题
患有或不患有广场恐惧症的惊恐障碍初级保健患者接受的精神治疗。
DOI：
10.1176/ps.2009.60.6.823
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Keller,MartinB
中科院分区：
文献类型：
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作者：
Marcks,BrookA;Weisberg,RisaB;Keller,MartinB
虽然大多数患有惊恐障碍的人首先出现在初级保健环境中，但对患有该障碍的初级保健患者通常接受的精神治疗知之甚少。本研究的目的是探讨接受治疗的惊恐障碍与广场恐怖症患者和那些没有广场恐怖症的惊恐障碍的特点，研究人口统计学和临床预测接受治疗，并探讨treatmentbarriers.MethodsThis研究使用的数据从初级保健焦虑项目（PCAP），这是一个自然的，纵向研究的初级保健患者之间的焦虑障碍。本研究提供了235 PCAP参与者诊断为惊恐障碍与广场恐怖症（N= 150）或广场恐怖症（N= 85）在研究摄入量评估的数据。结果许多患者惊恐障碍没有接受精神科治疗的研究摄入量（38%），与那些没有广场恐怖症不太可能接受治疗。精神药物是治疗的首选，选择性5-羟色胺再摄取抑制剂或5-羟色胺和去甲肾上腺素再摄取抑制剂是最常接受的药物类别（34%）。只有38%的惊恐障碍伴广场恐怖症患者和24%的惊恐障碍不伴广场恐怖症患者接受心理治疗，并且很少使用经验支持的干预措施。最常见的治疗障碍是不相信使用药物或治疗的情绪问题，而不是从一个人的provider.ConclusionsThe研究结果表明，需要更好的治疗传播，除了使干预措施更方便或适应他们的特殊需求的初级保健患者的治疗建议。（精神病学服务60：823-830，2009）
ObjectiveAlthough the majority of individuals with panic disorder first present to the primary care setting, little is known about the psychiatric treatment that primary care patients with the disorder typically receive. The purpose of this study was to explore characteristics of treatment received by patients with panic disorder with agoraphobia and by those with panic disorder without agoraphobia, examine demographic and clinical predictors of receiving treatment, and explore treatment barriers.MethodsThis study used data from the Primary Care Anxiety Project (PCAP), which is a naturalistic, longitudinal study of anxiety disorders among primary care patients. This study presents data for 235 PCAP participants diagnosed at the study intake assessment as having panic disorder with agoraphobia (N= 150) or without agoraphobia (N= 85).ResultsMany patients with panic disorder were not receiving psychiatric treatment at study intake (38%), with those without agoraphobia being less likely to receive treatment. Psychotropic medications were the treatment of choice, with selective serotonin reuptake inhibitors or serotonin and norepinephrine reuptake inhibitors being the most commonly received class of medications (34%). Only 38% of those with panic disorder with agoraphobia and 24% of those with panic disorder without agoraphobia were receiving psychotherapy, and the use of empirically supported interventions was rare. The most common treatment barriers were not believing in using medication or therapy for emotional problems and not receiving a treatment recommendation from one’s provider.ConclusionsThe findings suggest a need for better treatment dissemination, in addition to making interventions more accessible or adapting them to the particular needs of primary care patients.(Psychiatric Services 60: 823–830, 2009)