Prevalence of comorbid anxiety disorders in primary care outpatients.
Prevalence of comorbid anxiety disorders in primary care outpatients.
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初级保健门诊患者共病焦虑症的患病率。
DOI：
10.1001/archfami.5.1.27
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Wells,KB
中科院分区：
文献类型：
--
作者：
Sherbourne,CD;Jackson,CA;Meredith,LS;Camp,P;Wells,KB
目的：评估焦虑障碍（如惊恐障碍、恐惧症和广泛性焦虑障碍[GAD]）在患有主要医学和精神疾病的患者中共同发生的程度。设计：观察性研究。环境：美国三个城市的初级保健提供者办公室，包括精神卫生专业提供者以进行比较。患者：患有高血压、糖尿病、心脏病（充血性心力衰竭或心肌梗死）、当前抑郁症或阈下抑郁症的成年患者（N= 2494）。衡量标准：当前（过去12个月）和终生的恐慌症，恐惧症，广泛性焦虑症，感知到对情感或家庭问题的帮助需求，以及未满足的需求（即，未能得到需要的帮助）。方法：比较初级保健提供者的医学疾病非抑郁症患者和初级保健提供者和精神卫生专业提供者的抑郁症患者的焦虑共病患病率。结果：在初级保健患者中，慢性内科疾病或阈下抑郁症患者的终生惊恐障碍发生率（1.5% ~ 3.5%）和当前惊恐障碍发生率（1.0% ~ 1.7%）较低，而当前抑郁障碍患者的终生惊恐障碍发生率（10.9%）和当前惊恐障碍发生率（9.4%）较高。并发恐惧症和广泛性焦虑症更为常见（10.4%至12.4%为当前广泛性焦虑症），尤其是抑郁症患者（25%至54%为当前广泛性焦虑症）。根据医疗疾病或抑郁症的类型，14%至66%的初级保健患者至少同时患有一种焦虑症。在所有初级保健患者中，患者认为未满足个人或情绪问题护理需求的比例很高（54.6%至72.9%）。结论：初级保健临床医生应该意识到慢性疾病患者中可能存在焦虑障碍（特别是广泛性焦虑症），尤其是那些目前患有抑郁症的患者。
Objective: To estimate the extent to which anxiety disorders (eg, panic disorder, phobia, and generalizedanxi-ety disorder [GAD]) co-occur in patientswith major medical and psychiatric conditions.Design: Observational study.Setting: Offices of primary care providers in three US cities, with mental health specialty providers included for comparative purposes.Patients: Adult patients (N= 2494) with hypertension, diabetes, heart disease (congestive heart failure or myocardial infarction), current depressive disorder, or subthreshold depression.Measures: Current (past 12 months) and lifetime panic disorder, phobia, GAD, perceivedneed for help for emo-tional or family problems, and unmet need (ie, failure to get help that was needed).Methods: Comparisons of the prevalence of anxiety comorbidity in medically ill nondepressed patients of primary care providers and in depressed patients of both primary care and mental health specialty providers.Results: Among primary care patients, those with chronic medical illnesses or subthreshold depressionhad low rates of lifetime (1.5% to 3.5%) and current (1.0% to 1.7%) panic disorder, but those with current depressive disorder had much higherrates (10.9% lifetime and 9.4% cur-rent panic disorder). Concurrent phobia and GAD were more common (10.4% to 12.4% current GAD), espe-cially among depressed patients (25% to 54% current GAD). Depending on the type of medical illness or de-pression, 14% to 66% ofprimary care patients had at least one concurrent anxiety disorder. Patient-perceived un-met need for care for personalor emotional problemswas high among all primary care patients (54.6% to 72.9%).Conclusion: Primary care clinicians should be aware of the possible coexistence of anxiety disorders (especially GAD) among their patients with chronic medical con-ditions, but especially among those with current depres-sive disorder.