Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder
Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder
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DOI：
10.1016/j.jpsychires.2005.09.006
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发表时间：
2006-09-01
影响因子：
4.8
通讯作者：
Brown, Timothy A.
中科院分区：
文献类型：
--
作者：
Meuret, Alicia E.;White, Kamila S.;Brown, Timothy A.
通过主要症状群（例如认知或呼吸系统）对惊恐障碍进行亚型分类已经进行了一段时间，但不同研究的标准存在很大差异。我们试图从 343 名恐慌患者的 13 种 DSM-IV 恐慌症状的强度评级中确定统计症状维度，这些患者接受了 DSM-IV 终身版焦虑症访谈时间表的访谈。然后我们探讨了症状维度与选定疾病特征的关系。通过 Promax 轮换将评级提交给探索性最大似然因子分析。发现三因素解决方案最能解释方差。第一个因素中负荷最高的症状是心悸、气短、窒息、胸痛和麻木，这些症状定义为心肺类型（害怕死亡）。第二个因素中负荷最高的症状是出汗、颤抖、恶心、发冷/潮热和头晕，这定义了混合躯体亚型。第三个因素中最严重的症状是不真实感、害怕发疯和害怕失去控制，这定义了认知亚型。基于这些因素的子量表显示出中等的相互相关性。在一系列分层多元回归分析中，心肺分量表是恐慌严重程度、恐慌发作频率和广场恐惧回避的有力预测因子，而认知分量表主要预测因恐慌而引起的担忧。此外，患有哮喘共病的患者在心肺分量表上得分较高。我们的结论是，可以确定部分独立的恐慌症状维度，这些维度对恐慌症的严重程度和控制具有不同的影响。 (c) 2005 Elsevier Ltd. 保留所有权利。
Subtyping panic disorder by predominant symptom constellations, such as cognitive or respiratory, has been done for some time, but criteria have varied considerably between studies. We sought to identify statistically symptom dimensions from intensity ratings of 13 DSM-IV panic symptoms in 343 panic patients interviewed with the Anxiety Disorders Interview Schedule for DSM-IV Lifetime Version. We then explored the relation of symptom dimensions to selected illness characteristics. Ratings were submitted to exploratory maximum likelihood factor analysis with a Promax rotation. A three-factor solution was found to account best for the variance. Symptoms loading highest on the first factor were palpitations, shortness of breath, choking, chest pain, and numbness, which define a cardio-respiratory type (with fear of dying). Symptoms loading highest on the second factor were sweating, trembling, nausea, chills/ hot flashes, and dizziness, which defines a mixed somatic subtype. Symptoms loading highest on the third factor were feeling of unreality, fear of going crazy, and fear of losing control, which defines a cognitive subtype. Subscales based on these factors showed moderate intercorrelations. In a series of hierarchical multiple regression analyses, the cardio-respiratory subscale was a strong predictor of panic severity, frequency of panic attacks, and agoraphobic avoidance, while the cognitive subscale mostly predicted worry due to panic. In addition, patients with comorbid asthma had higher scores on the cardio-respiratory subscale. We conclude that partly independent panic symptom dimensions can be identified that have different implications for severity and control of panic disorder. (c) 2005 Elsevier Ltd. All rights reserved.