《中国焦虑障碍防治指南》第二版解读

Interpretation of Chinese guideline for the prevention and treatment of anxiety disorders(the second edition)

《中国焦虑障碍防治指南》第二版在相隔第一版13年后于2023年8月正式出版。第二版的修订原则是:保持第一版框架,在原有框架基础上结合研究进展,进行必要的修订,补充国内外最新成果的内容。参照DSM-5和ICD-11精神障碍分类和国内临床实际情况,第二版的焦虑障碍包括惊恐障碍、广泛性焦虑障碍、社交焦虑障碍、分离焦虑障碍、躯体疾病所致焦虑障碍。增加了国内近期的焦虑障碍流行病学资料。参照国际指南,增加了第一版未纳入的药物。根据中国特点和治疗方法的发展,补充了中成药治疗、物理治疗和基于网络的心理治疗。在查阅文献的基础上,补充了孕产妇使用抗抑郁药风险的最新资料。焦虑障碍的治疗原则贯彻全病程治疗理念,分为急性期、巩固期、维持期治疗。治疗药物均采用一线、二线等推荐方法。

The second edition of the Chinese guideline for the prevention and treatment of anxiety disorders was published in August 2023,13 years after the first edition.The revision principles for the second edition were maintaining the first edition's framework,and based on that framework,making necessary revisions by incorporating research progress and supplementing the latest research findings from the domestic studies and the overseas literature.Referring to the DSM-5 and ICD-11 classifications of mental disorders and the actual clinical situation in China,the anxiety disorders in the second edition were panic disorder,generalized anxiety disorder,social anxiety disorder,separation anxiety disorder,and anxiety disorder due to another medical condition.The latest epidemiological data on anxiety disorders in China were added.Following the international guidelines,medications not included in the first edition have been added.Chinese traditional medicines,physical therapy,and internet web-based psychotherapy were also supplemented to fit Chinese clinical settings.Based on a literature review,the latest information on the risks of using antidepressants during pregnancy has been added.A whole course of treatment across the acute phase,consolidation phase,and maintenance phase was further addressed as the treatment principle.First-line and second-line recommendations are provided for medication selections.