Anxiety Disorder焦慮症(一)

Anxiety Disorder焦慮症(一)

Because Panic Attacks and Agoraphobia occur in the context of several disorders in this section, criteria sets for a Panic Attack and for Agoraphobia are listed separately at the beginning. They do not, however, have their own diagnostic codes and can not be diagnosed as separate entities.
因為恐慌發作和廣場恐懼發生在焦慮症的多種情況下出現,二者的診斷標準分別列於本節的開始.然而他們隻是一個症狀,不是一個獨立的疾病,不能被單獨診斷,總是和其它的情況共同診斷.

Panic Attack恐慌發作

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:
突然發生強烈的恐懼或不舒服,可見以下四種或更多的症狀快速發生,並且在十分鍾內達到頂點:

(1) palpitations, pounding heart, or accelerated heart rate心悸,心跳過速

(2) sweating冒冷汗

(3) trembling or shaking顫抖,哆嗦

(4) sensations of shortness of breath or smothering氣短,窒息

(5) feeling of choking感覺喉頭有異物阻塞

(6) chest pain or discomfort 胸痛,或難受

(7) nausea or abdominal distress惡心,腹部不舒服

(8) feeling dizzy, unsteady, light-headed, or faint眩暈,站立不穩,頭重腳輕或暈倒

(9) derealisation (feelings of unreality) or depersonalization (being detached from oneself)
不真實感,恍惚在夢中

(10) fear of losing control of going crazy害怕會精神失控而發瘋

(11) fear of dying會死亡的恐懼感

(12) paresthesias (numbness or tingling sensations)手指或腳指感覺麻痹(或針刺感)

(13) chills or hot flushes發冷或發熱


Agoraphobia廣場恐懼症

A. Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge. And traveling in a bus, train, or automobile.
A.患者害怕處於某些地方,怕如果有意外發生時,自己不容易逃脫,也怕自己發生恐慌發作或類似症狀時得不到幫助.廣場恐懼的害怕主要發生在患者感覺一些難以避免和難以逃脫的情況下,如:患者獨自在家以外的地方;在人群中或站在隊列中;在橋上.患者獨自坐公車,火車,或開車.

Note: Consider the diagnosis of Specific Phobia if the avoidance is limited to one or only a few specific situations, or Social Phobia if the avoidance is limited to social situations.
注意:如果有意回避某種或有限的幾種情況,可以考慮診斷為特定的恐懼症;如果有意回避社交的場合可診斷為社交恐懼症.

B. The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion.
患者回避某些場合(如:不旅行),如果必須出席這些場合而沒有人陪伴的話,會出現明顯的障礙,並擔心會發生恐慌發作或恐慌樣症狀.

C. The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as Social Phobia (e.g., avoidance limited to social situations because of fear of embarrassment), Specific Phobia (e.g., avoidance limited to a single situation like elevators), Obsessive-Compulsive Diorder (e.g., avoidance of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor), or Separation anxiety Disorder (e.g., avoidance of leaving home or relatives).
以上焦慮或恐懼不能診斷為其它的精神疾病,如社交恐懼症(僅僅回避社交場合,因為害怕受羞辱),特定恐懼症(回避某種特定場合,如電梯內),強迫症(如害怕沾染細菌而避免肮髒),創傷後應激症(如回避引起嚴重創傷的刺激),或分離焦慮症(如:害怕離開家或親屬).