重性抑郁症共病焦虑障碍的临床研究

Clinical study of major depression comorbid with anxiety

目的调查重性抑郁症患者共病焦虑障碍的发生率,探讨共病对重性抑郁症症状及预后的影响。方法对125例重性抑郁症患者用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、社会功能缺陷筛选量表(SDSS)和临床疗效总评量表(CGI)评定,3月末进行随访。结果39.2%的重性抑郁症共病焦虑障碍,共病广泛焦虑障碍与惊恐障碍比例最高(分别为20.0%、12.8%);入组及3月末,共病组HAMD、HAMA、CGI及SDSS总分均显著高于抑郁组(P<0.05),3月末共病组HAMA减分率等级表达的疗效显著低于抑郁组(P<0.05),HAMD减分率等级表达的疗效两组差异无显著性。结论重性抑郁症共病焦虑障碍的发生率高,共病患者具有抑郁及焦虑症状重、社会功能损害重,焦虑症状不易缓解的特征。

Objective To investigate the prevalence of anxiety disorder comorbidity in major depression, and study the impacts of comorbidity on symptoms, course and prognosis of major depression. Methods One hundred and twenty-five outpatients were assessed by HAMD, HAMA, CGI-SI and SDSS, and treated by SSRIs. Three month later, 87 patients were assessed by HAMD, HAMA, CGI and SDSS again. Results 39.2% of patients were coexistence of anxiety disorders, 20.0% for general anxiety disorder, 12.8% for panic disorder. Compared with patients without anxiety, patients with anxiety had higher scores in HAMD, HAMA, CGI and SDSS in baseline and three months later,there was significant difference between two group（ P 〈 0.05）. Conclusion The coexistence of anxiety and depression in the clinical setting was quite common ; The patients comorbid with anxiety had more severe symptoms and social function impairment, and their anxiety symptom was more difficult to recover.