Drug-mental Treatment On Patients With Panic Disorder: A Perspective Study

Background: As an acute anxiety disorder , panic disorder ( PD) is a common disease in general hospital. It can affect psycho-mental health level of patients who suffered in PD severely, harm their social function and quality of life extremely , and lead to big waste of medical resources . As similar as many other diseases , the etiology of PD seem to be the interaction between biological factor and environmental factor (social and psychic factor extrinsic) . Biomedicine research indicated that the pathophysiology of PD was probably involved with the fear-network of brain and the change of related transmitter system(5-HT , NA, GABA). And from the aspect of psychology, the occurrence of PD was related to the catastrophic cognition and biases. Personality is inherent behaveior mode and accustomed cognitive manner in daily life of a person . And possibly, it was related to the catastrophic cognition of PD patients and involved the etiology of PD. Recently , the hotspot was focused on the effect of personality in the etiology of PD. Nowadays the drug treatment is major therapy in general hospital . Scholars overseas suggested that drug combining psychotherapy would be better . But there is rarely dynamic comparetion between drug treatment and drug combining psychotherapy , further biomedic and psychologic mechanism would be discussed .Objective: Compare personality characteristics and psycho-mental health level between patients with panic disorder and healthy controls . Investigate the relationship between personality character and psycho-mental health level in this two group . Explore the etiology of panic disorder and the position which psychotherapy act on . Observe and compare the therapeutic effect between drugtherapy group and drugcombining psychotherapy group dynamically.Methods: PD group were divided into drugtherapy group (36 patients) and drug combining psychotherapy group (32 patients) according to their visiting time and the treatment they got . Meanwhile , 32 health volunteers were chose as the control group .Patients in PD group and healthy controls were assessed and compared by Eysenck Personality Questionnaire (EPQ), Symptom Checklist 90 (SCL-90) and Hamilton Anxiety Scale (HAMA) from the aspects of personality character and psycho-mental health level . The relationship between personality character and psycho-mental health level was analyzed respectively in PD group and control group . Scores of SCL-90 and HAMA ,as intermedial index , were recorded before the therapy ( 0 week) and 4 weeks, 12 weeks , 24 weeks after the therapy respectively. And the differences between drugtherapy group and drug combining psychotherapy group were analyzed according to the scores . Scores of Generic Quality of Life Inventory Questionaire(GQOLI-74) , as final index , were recorded before the therapy ( 0 week) and 24 weeks after the therapy, and the differences were analyzed in this two group .Result: The population distribution of EPQ'N score and L score in panic disorder group was significantly different from that in control group . The population distribution of SCL-90 score (Total average score, Positive symptom average score, Somatization score, Obsessive-Compulsive score, Depression score, Anxiety score and Phobic anxiety score) and HAMA score in panic disorder group was significantly different from that in control group . In panic disorder group, the N score displayed significantly positive Spearman-correlation with Somatization score, Depression score, Anxiety score and HAMA score. Whereas, in control group, the N score just displayed significantly positive Spearman-correlation with Depression score and Anxiety score of SCL-90. The total average scores of SCL-90 and HAMA in drug combining psychotherapy group were significantly lower than that in drugtherapy group (HAMA:F1,54 =5.62,P=0.036;SCL-90:F1,54 =6.12,P=0.021). At different time point, ( 0 week, 4 weeks, 12 weeks and 24 weeks) the total average scores of SCL-90 and HAMA distributed differently, and seemed to become lower and lower in both of the two group(HAMA:F3,162 =4.18,P=0.028;SCL-90:F3,162 =3.09,P=0.032). Afterand from 4 weeks on, the total average scores of SCL-90 and HAMA in drug combining psychotherapy group decreased to a larger extent . The total average score of GQOLI-74 in drugtherapy group was significantly lower than that in drug combining psychotherapy group(F1,54 =5.31,P=0.041). Before and after the treatment (0 week and 24 weeks), the total average scores of GQOLI-74 were different and became higher in both of the two group(F1,54 =7.72,P=0.018). After the treatment, the total average scores of GQOLI-74 increased to a larger extent in drug combining psychotherapy group than that in drugtherapy group.Conclusion1. PD patients displayed highly neuroticism and instability of emotion . This probebly correlate with the etiology of PD .2. There was significantly positive correlation between personality character and level of psycho-mental health in patients with panic disorder .3. Both drug single and drug combining psychotherapy can reform the level of psycho-mental health in patients with PD. However , drug combining psychotherapy is likely to have better long-dated curative effect and improve the quality of life than drug single.