Anxiety Disorder焦虑症(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.
因为恐慌发作和广场恐惧发生在焦虑症的多种情况下出现,二者的诊断标准分别列于本节的开始.然而他们只是一个症状,不是一个独立的疾病,不能被单独诊断,总是和其它的情况共同诊断.

Panic Attack恐慌发作

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:
突然发生强烈的恐惧或不舒服,可见以下四种或更多的症状快速发生,并且在十分钟内达到顶点:

(1) palpitations, pounding heart, or accelerated heart rate心悸,心跳过速

(2) sweating冒冷汗

(3) trembling or shaking颤抖,哆嗦

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

(5) feeling of choking感觉喉头有异物阻塞

(6) chest pain or discomfort 胸痛,或难受

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

(8) feeling dizzy, unsteady, light-headed, or faint眩晕,站立不稳,头重脚轻或晕倒

(9) derealisation (feelings of unreality) or depersonalization (being detached from oneself)
不真实感,恍惚在梦中

(10) fear of losing control of going crazy害怕会精神失控而发疯

(11) fear of dying会死亡的恐惧感

(12) paresthesias (numbness or tingling sensations)手指或脚指感觉麻痹(或针刺感)

(13) chills or hot flushes发冷或发热


Agoraphobia广场恐惧症

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.患者害怕处于某些地方,怕如果有意外发生时,自己不容易逃脱,也怕自己发生恐慌发作或类似症状时得不到帮助.广场恐惧的害怕主要发生在患者感觉一些难以避免和难以逃脱的情况下,如:患者独自在家以外的地方;在人群中或站在队列中;在桥上.患者独自坐公车,火车,或开车.

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:如果有意回避某种或有限的几种情况,可以考虑诊断为特定的恐惧症;如果有意回避社交的场合可诊断为社交恐惧症.

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.
患者回避某些场合(如:不旅行),如果必须出席这些场合而没有人陪伴的话,会出现明显的障碍,并担心会发生恐慌发作或恐慌样症状.

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).
以上焦虑或恐惧不能诊断为其它的精神疾病,如社交恐惧症(仅仅回避社交场合,因为害怕受羞辱),特定恐惧症(回避某种特定场合,如电梯内),强迫症(如害怕沾染细菌而避免肮脏),创伤后应激症(如回避引起严重创伤的刺激),或分离焦虑症(如:害怕离开家或亲属).