조기 발병과 후기 발병 공황장애의 임상적 특징 비교 : 예비 연구
Comparison of Clinical Characteristics between Early-Onset and Late-Onset Panic Disorder : A Preliminary Study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective：The objective of this study is to clarify the clinical characteristics of late-onset panic disorder (PD) compared to early-onset PD in symptoms frequency, severity, and quality of life. Methods：516 patients with PD were included in this study. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with onset at 20 or earlier (early-onset). The following instruments were applied : Beck Depression Inventory, Beck Anxiety Inventory, Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Inventory- Revised, and Medical Outcomes Study 36-item Short-Form Health Survey. SPSS version 21.0 was used for statistical analysis. Results：Late-onset PD was 4.84% of all PD patients, and the mean age was 64.68±4.36 years. Late-onset PD exhibited fewer panic symptoms and scored lower on most scales assessing clinical severity. However, the panic-related symptoms severity showed significant negative correlations with scores of quality of life, especially in physical functioning subscale, among the late-onset PD patients. Conclusion：These findings suggest that less severe panic symptoms may contribute to underdiagnosing PD in this elderly population. However, the panic-related symptoms severity plays an important role in quality of life among the late-onset PD patients. It suggests to implement specific strategies considering the age at onset in clinical approach among patients with PD.
Abstract
Objective：The objective of this study is to clarify the clinical characteristics of late-onset panic disorder (PD) compared to early-onset PD in symptoms frequency, severity, and quality of life. Methods：516 patients with PD were included in this study. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with onset at 20 or earlier (early-onset). The following instruments were applied : Beck Depression Inventory, Beck Anxiety Inventory, Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Inventory- Revised, and Medical Outcomes Study 36-item Short-Form Health Survey. SPSS version 21.0 was used for statistical analysis. Results：Late-onset PD was 4.84% of all PD patients, and the mean age was 64.68±4.36 years. Late-onset PD exhibited fewer panic symptoms and scored lower on most scales assessing clinical severity. However, the panic-related symptoms severity showed significant negative correlations with scores of quality of life, especially in physical functioning subscale, among the late-onset PD patients. Conclusion：These findings suggest that less severe panic symptoms may contribute to underdiagnosing PD in this elderly population. However, the panic-related symptoms severity plays an important role in quality of life among the late-onset PD patients. It suggests to implement specific strategies considering the age at onset in clinical approach among patients with PD.
참고문헌 (35)
- Manela M, "How common are the anxiety disorders in old age?", Int J Geriatr Psychiatry, 11, pp.65~70 (1996)
- Lenze EJ, "Anxiety disorders : new developments in old age", Am J Geriatr Psychiatry, 19, pp.301~304 (2011)
- Blay SL, "Anxiety disorders in old age", Curr Opin Psychiatry, 25, pp.462~467 (2012)
- Gum AM, "Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication", Am J Geriatr Psychiatry, 17, pp.769~781 (2009)
- Flint AJ, "Epidemiology and comorbidity of anxiety disorders in the elderly", Am J Psychiatry, 151, pp.640~649 (1994)
- Eaton WW, "Panic and panic disorder in the United States", Am J Psychiatry, 151, pp.413~420 (1994)
- Dick CL, "Epidemiology of psychiatric disorders in Edmonton. Panic disorder", Acta Psychiatr Scand Suppl, 376, pp.45~53 (1994)
- Weissman MM, "The cross-national epidemiology of panic disorder", Arch Gen Psychiatry, 54, pp.305~309 (1997)
- Blazer D, "Anxiety in the Elderly: Treatment and Research", pp.17~30 (1991), Springer Pub. Co.
- Parmelee PA, "Anxiety and its association with depression among institutionalized elderly", Am J Geriatr Psychiatry, 1, pp.46~58 (1994)
- Beitman BD, "Late onset panic disorder : evidence from a study of patients with chest pain and normal cardiac evaluations", Int J Psychiatry Med, 21, pp.29~35 (1991)
- Hassan R, "Late-life-onset panic disorder : clinical and demographic characteristics of a patient sample", J Geriatr Psychiatry Neurol, 7, pp.84~88 (1994)
- Sheikh JI, "Aging and panic disorder: phenomenology, comorbidity, and risk factors", Am J Geriatr Psychiatry, 12, pp.102~109 (2004)
- Davidoff J, "Quality of life in panic disorder : looking beyond symptom remission", Qual Life Res, 21, pp.945~959 (2012)
- Ehlers A, "A 1-year prospective study of panic attacks : clinical course and factors associated with maintenance", J Abnorm Psychol, 104, pp.164~172 (1995)
- Carrera M, "Quality of life in early phases of panic disorder : predictive factors", J Affect Disord, 94, pp.127~134 (2006)
- Lee MK, "A Standardization Study of Beck Depression Inventory 2-Korean Version(K-BDI) : Validity-I", J Korean Soc Pathol, 4, pp.77~95 (1995)
- Yook SP, "A clinical study on the Korean version of Beck Anxiety Inventory : comparative study of patient and non-patient", Korea J Clin Psychol, 16, pp.185~197 (1997)
- Lim YJ, "Korean panic disorder severity scale : construct validity by confirmatory factor analysis", Depress Anxiety, 24, pp.95~102 (2007)
- Brown TA, "A psychometric reanalysis of the Albany Panic and Phobia Questionnaire", Behav Res Ther, 43, pp.337~355 (2005)
- Lim YJ, "Korean Anxiety Sensitivity Index-Revised:its factor structure, reliability, and validity in clinical and nonclinical samples.", Depress Anxiety, 24, pp.331~341 (2007)
- Nam BH, "Testing the validity of the Korean SF-36 health survey", J Kor Society of Health Statics, 28, pp.3~24 (2003)
- Katon W, "Panic disorder in the medically ill", J Clin Psychiatry, 50, pp.299~302 (1989)
- Raj BA, "The clinical characteristics of panic disorder in the elderly : a retrospective study", J Clin Psychiatry, 54, pp.150~155 (1993)
- Luchins DJ, "Late-life onset of panic disorder with agoraphobia in three patients", Am J Psychiatry, 146, pp.920~921 (1989)
- Seguí J, "Differential clinical features of late-onset panic disorder", J Affect Disord, 57, pp.115~124 (2000)
- Tibi L, "Examining determinants of early and late age at onset in panic disorder : an admixture analysis", J Psychiatr Res, 47, pp.1870~1875 (2013)
- Lim SW, "Clinical symptoms associated with suicidality in patients with panic disorder", Psychopathology, 48, pp.137~144 (2015)
- Zugliani MM, "Laboratory, clinical and therapeutic features of respiratory panic disorder subtype", CNS Neurol Disord Drug Targets, 14, pp.627~635 (2015)
- Briggs AC, "Subtyping of panic disorder by symptom profile", Br J Psychiatry, 163, pp.201~209 (1993)
- Charney DS, "Noradrenergic function in panic disorder", J Clin Psychiatry, 51(Suppl A), pp.5~11 (1990)
- Krystal JH, "Effects of age and alcoholism on the prevalence of panic disorder", Acta Psychiatr Scand, 85, pp.77~82 (1992)
- Flint AJ, "Effect of aging on cholecystokinin-induced panic", Am J Psychiatry, 155, pp.283~285 (1998)
- Waszczuk MA, "Genetic and environmental influences on relationship between anxiety sensitivity and anxiety subscales in children", J Anxiety Disord, 27, pp.475~484 (2013)
- Zavos HM, "Longitudinal genetic analysis of anxiety sensitivity", Dev Psychol, 48, pp.204~212 (2012)