パニック性不安とその治療

出版社： 先端医学社
著者：
発行日： 1995-08-10
分野： 臨床医学：内科  >  精神医学
ISBN： 9784915892226
電子書籍版： 1995-08-10 （第1版第1刷）
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パニック障害に関して、これまでに国際的に得られてきた情報を集約し、さらに病因･病態･治療法について詳細に解説。
世界精神医学会(WPA)による、パニック障害とその治療についての国際的共同研究を集約した報告書｢Panic Anxiety and Its Treatments｣(American Psychiatric Press、1993年)の日本語版。国際的な広い視野からパニック障害について解説し、その適切な診断と治療について、より正しい理解を求める神経内科ならびに精神科医、および広く日常臨床に携わる臨床医にとって必読の書。

目次

  • 表紙
  • Gerald L. Klerman医学博士に捧げる
  • 謝意
  • 世界精神医学会会長教育プログラム特別作業部会の構成員
  • まえがき
  • 日本語版へのまえがき
  • 日本語版によせて
  • 目次
  • 1 序
  • 2 パニック性不安とパニック障害
  • [1] 臨床症状と診断
  • 1. パニック性不安
  • 2. パニック発作
  • 3. 不全発作
  • 4. パニック障害
  • 5. 恐怖をともなわないパニック障害
  • 6. DSMとICDの診断基準の関連
  • 7. 臨床的特色
  • [2] 臨床評価
  • 1. 評価
  • 2. 鑑別診断
  • 1) 精神医学的障害
  • 2) 内科的疾患
  • [3] 身体診療科における不安障害
  • 1. 医療希求行動と身体化
  • 2. 診断上の問題と不十分な治療
  • [4] 疫学と家族内発症危険率
  • 1. 有病率
  • 2. 危険因子
  • 3. 危険因子としての家族歴
  • 4. 多国間・多文化間比較
  • [5] パニック障害の合併症の有無
  • 1. 合併症のないパニック障害
  • 2. 広場恐怖の合併
  • 3. ほかの不安障害との合併
  • 4. うつ病との合併
  • 5. 人格障害との合併
  • 6. アルコール症との合併
  • 7. 身体疾患との合併
  • 8. 臨床経過と追跡調査
  • 9. 身体疾患と死亡率
  • 10. 自殺企図・既遂
  • 11. quality of life (QOL)
  • 3 パニック障害の原因 : 病因と病態発生
  • [1] 病因
  • 1. 遺伝的および家族要因
  • 2. 心理学的理論
  • 1) 精神力動的および精神分析理論
  • 2) 学習および行動理論
  • 3) 認知理論
  • 3. 発達理論
  • 1) 幼児期分離不安
  • 2) 幼児期の行動抑制
  • 3) 親の養育態度とふるまい
  • 4. 結論
  • [2] 病態発生と病態生理学 : 実験モデルと生物学的仮説
  • 1. 誘発負荷試験
  • 1) 乳酸ナトリウム
  • 2) 二酸化炭素, yohimbine, そのほかの物質
  • 2. 神経内分泌およびそのほかの生物学的マーカー
  • 3. 動物モデルの不安と覚醒状態
  • 4. 機能的脳画像研究
  • 5. 夜間パニック発作
  • 6. 神経化学的および神経伝達物質理論
  • 1) ノルアドレナリン仮説
  • 2) セロトニン仮説
  • 3) ベンゾジアゼピン - γアミノ酪酸 (GABA) 受容体理論
  • 4) 異常な内因性リガンドの理論
  • 7. てんかん性障害の一型としてのパニック障害
  • 8. 今日のパニック障害の作業仮説
  • [3] 病態発生と病態生理学:心理学的および心理社会学理論
  • 1. 要因としてのライフイベント
  • 2. 思春期と青年期における病前性格
  • 4 疾病分類学上の単位としてのパニック障害の妥当性
  • [1] パニック障害の臨床記述
  • [2] 臨床検査
  • [3] ほかの障害との鑑別
  • [4] 追跡調査
  • [5] 家族研究と双生児研究
  • 5 パニック性不安の治療 : 臨床知見
  • [1] 概説
  • [2] 精神薬理学的治療
  • 1. 歴史的背景
  • 2. モノアミン酸化酵素 (MAO) 阻害薬
  • 3. 三環系抗うつ薬
  • 1) 概説
  • 2) Imipramine
  • 3) Clomipramine
  • 4) 三環系抗うつ薬の副作用
  • 5) 臨床上の注意
  • 6) 長期治療中の用量
  • 4. ベンゾジアゼピン系薬剤
  • 1) 概説
  • 2) Alprazolam
  • 3) ほかのベンゾジアゼピン系薬剤
  • 4) 副作用
  • 5) 乱用の危険性
  • 6) 物質乱用にともなう併発効果
  • 7) 依存
  • 8) 断薬反応の臨床
  • 9) 反跳
  • 10) パニック障害の患者でベンゾジアゼピン系薬剤離脱に影響する要因
  • 5. セロトニン再取り込み阻害薬
  • 6. うつ病と薬物療法に対する反応
  • 7. 薬物療法の比較研究
  • 8. パニック障害の長期的な薬物療法
  • 1) 長期的治療と三環系抗うつ薬
  • 2) Alprazolamとほかのベンゾジアゼピン系薬剤
  • [3] 心理的治療法
  • 1. 概説
  • 2. 精神分析法と精神分析志向性の精神療法
  • 3. 曝露療法
  • 4. 弛緩訓練法
  • 5. 認知行動療法
  • 6. 心理社会的治療法の比較試験研究
  • 7. 長期的な心理的治療法
  • [4] 薬物療法と心理的治療法の比較研究
  • [5] 心理的治療法と薬物療法の併用
  • [6] 結論
  • 6 パニック障害の臨床実践のパターン
  • [1] 処方例と抗パニック薬の使用法
  • 1. ベンゾジアゼピン系薬剤の投与方法
  • 2. パニック障害
  • 3. 臨床実践における治療についての考察
  • 7 要約・結論・提言
  • [1] 結果の要約
  • [2] 臨床実践の含蓄と指針
  • [3] 将来の研究
  • 参考文献
  • 推薦文献
  • 索引
  • あとがき
  • 奥付

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参考文献

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