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The development of agoraphobia is associated with the symptoms and location of a patient's first panic attack

机译：恐惧症的发展与患者第一次惊恐发作的症状和部位有关

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Background The place where a patient experiences his/her first panic attack (FPA) may be related to their agoraphobia later in life. However, no investigations have been done into the clinical features according to the place where the FPA was experienced. In particular, there is an absence of detailed research examining patients who experienced their FPA at home. In this study, patients were classified by the location of their FPA and the differences in their clinical features were explored (e.g., symptoms of FPA, frequency of agoraphobia, and severity of FPA). Methods The subjects comprised 830 panic disorder patients who were classified into 5 groups based on the place of their FPA (home, school/office, driving a car, in a public transportation vehicle, outside of home), The clinical features of these patients were investigated. Additionally, for panic disorder patients with agoraphobia at their initial clinic visit, the clinical features of patients who experienced their FPA at home were compared to those who experienced their attack elsewhere. Results In comparison of the FPAs of the 5 groups, significant differences were seen among the 7 descriptors (sex ratio, drinking status, smoking status, severity of the panic attack, depression score, ratio of agoraphobia, and degree of avoidance behavior) and 4 symptoms (sweating, chest pain, feeling dizzy, and fear of dying). The driving and public transportation group patients showed a higher incidence of co-morbid agoraphobia than did the other groups. Additionally, for panic disorder patients with co-morbid agoraphobia, the at-home group had a higher frequency of fear of dying compared to the patients in the outside-of-home group and felt more severe distress elicited by their FPA. Conclusion The results of this study suggest that the clinical features of panic disorder patients vary according to the place of their FPA. The at-home group patients experienced "fear of dying" more frequently and felt more distress during their FPA than did the subjects in the other groups. These results indicate that patients experiencing their FPA at home should be treated with a focus on the fear and distress elicited by the attack.
机译：背景患者第一次经历恐慌发作（FPA）的地方可能与他们晚年的广场恐惧症有关。但是，尚未根据FPA的使用经验对临床特征进行调查。特别是，缺乏详细的研究来检查在家中经历FPA的患者。在这项研究中，按FPA的位置对患者进行分类，并探讨其临床特征的差异（例如FPA的症状，恐惧症的频率和FPA的严重程度）。方法研究对象为830名恐慌症患者，根据其FPA的位置（家庭，学校/办公室，驾驶汽车，公共交通工具，家庭外）分为5组，其临床特征为：调查。此外，对于在初次就诊时患有恐慌症的恐慌症患者，将在家中经历FPA的患者与在其他地方经历过发作的患者的临床特征进行比较。结果与5组的FPA相比，在7个描述符中有显着差异（性别比，饮酒状态，吸烟状态，惊恐发作的严重程度，抑郁评分，广场恐惧症的比率和回避行为的程度）和4症状（出汗，胸痛，头昏眼花和害怕死亡）。与其他组相比，驾驶和公共交通组患者的并存广场恐惧症发生率更高。此外，对于伴有合并症的恐慌症的恐慌症患者，在家中组的死亡恐惧频率要比在家外组中的患者高，并且他们的FPA会引起更严重的困扰。结论这项研究的结果表明，恐慌症患者的临床特征因其FPA的位置而异。与其他组相比，家庭组患者在FPA期间经历“恐惧死亡”的频率更高，并且感到更多的困扰。这些结果表明，应对在家中经历FPA的患者进行治疗时，应侧重于发作引起的恐惧和痛苦。

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