首发广泛性焦虑障碍临床特征分析

Analysis of the clinical characters of first episode generalized anxiety disorder

目的分析首发广泛性焦虑障碍(GAD)患者的临床特征及相互关系。方法采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD17)、社会功能缺陷筛选量表(SDSS)、生活事件量表(LES)及健康状况调查问卷(SF-36)对102名首发广泛性焦虑障碍患者的临床特征进行评估。结果GAD患者有两个高发年龄段,最常见的症状为焦虑心境(99.0%)、紧张(97.1%)和心血管系统症状(95.1%);女性患者的感觉系统症状和生殖泌尿系统症状较男性明显(P<0.05);61.8%的患者病前有重大生活事件,22.5%的患者存在消极观念;SDSS平均分(13.46±8.54),68.7%的患者报告有躯体疼痛症状,疼痛症状对生活的影响程度与社会功能缺陷相关(r=0.304,P<0.01)。结论首发广泛性焦虑障碍以焦虑心境、紧张和心血管系统症状多见,躯体疼痛是影响社会功能的重要因素。

Objective： To investigate the clinical characters for first episode generalized anxiety disorder （GAD） and the internal relationships. Methods： 102 first episode GAD subjects were involved in this study. Hamilton depression Scale （HAMD）, Hamilton Anxiety Scale （HAMA）, Social Disability Screening Schedule （SDSS） and Body Pain subscale of the Short- Form- 36 Health Survey （SF- 36） were used to assess clinical characters. Results：The GAD patients had shown two separated age peaks of onset. The more frequent symptoms were anxious mood （99.0%）, tension （ 97.1% ） and cardiovascular symptoms （ 95.1% ）. Females had more severe genitourinary symptoms and sensory somatic complaints than male. 61.8% of the patients had significant life events before GAD onset and 22.5 % appeared to have suicide idea. The mean score of SDSS was （ 13.46±8.54）. 68.7% of the patients reported somatic pain and the degree of its life affect had a significant correlation with social disability （ r = 0.304, P 〈 0.01 ）. Conclusion： Anxious mood, tension and cardiovascular symptoms were the most frequent symptoms of first episode GAD. Several dimensions of the clinical characters of fist episode GAD show similar to major depression. Somatic pain may have significant affect on patient social functions.