Comorbidity Patterns of Anxiety and Depressive Disorders in a Large Cohort Study: the Netherlands Study of Depression and Anxiety (NESDA)
Comorbidity Patterns of Anxiety and Depressive Disorders in a Large Cohort Study: the Netherlands Study of Depression and Anxiety (NESDA)
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DOI：
10.4088/jcp.10m06176blu
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发表时间：
2011-03-01
影响因子：
5.3
通讯作者：
Penninx, Brenda W. J. H.
中科院分区：
文献类型：
--
作者：
Lamers, Femke;van Oppen, Patricia;Penninx, Brenda W. J. H.
背景：抑郁症和焦虑症的共病很常见，并且已被证明是慢性化的一致预测因素。特定抑郁症和焦虑症之间的共病模式尚未广泛报道。本研究探讨合并症的模式和时间序列的独立抑郁症和焦虑症的数据从一个大型psychiatric cohol.Method：基线数据（N = 1,783）的荷兰抑郁症和焦虑症研究，收集2004年9月至2007年2月，被使用。计算抑郁症和焦虑症（DSM-IV-TR标准）的当前和终生共病率。社会人口统计学，脆弱性和临床特征，和时间顺序的障碍的协发病examined.Results：那些抑郁症，67%有一个电流和75%的终身共病焦虑症。在目前患有焦虑症的人中，63%的人目前患有抑郁症，81%的人终生患有抑郁症。抑郁症和焦虑症的共病与更多的童年创伤有关（OR = 1.19; 95%CI，1.06-1.33），神经质较高（OR = 1.05; 95%CI，1.02-1.08），首次发病年龄较早（OR = 1.59; 95%CI，1.22-2.07），抑郁和/或焦虑症状持续时间较长（OR = 1.01; 95%CI，1.01-1.01）和更高的症状严重程度（OR范围为1.01 - 1.03;所有P值<0.05）。在57%的共病病例中，焦虑先于抑郁，而在18%的共病病例中，抑郁先于焦虑。与先前的焦虑相比，先前的抑郁与抑郁和/或焦虑症状的持续时间较短相关（OR = 0.99; 95%CI，0.98-0.99），首次发病年龄较早（OR = 0.46; 95%CI，0.31-0.68），且恐惧症状较少（OR = 0.98; 95%CI，0.97-0.99）。焦虑症和抑郁症的共病率非常高，这表明，无论咨询的主要原因是什么，对这两种疾病进行常规评估是明智的。这是特别重要的，因为共病患者表现出特定的脆弱性模式，更多的童年创伤，神经质，更高的严重性和持续时间的症状。J Clin Psychiatry 2011;72（3）：341-348（C）Copyright 2011 Physicians Postgraduate Press，Inc.
Background: Comorbidity of depressive and anxiety disorders is common and has been shown to be a consistent predictor of chronicity. Comorbidity patterns among specific depressive and anxiety disorders have not been extensively reported. This study examines comorbidity patterns and temporal sequencing of separate depressive and anxiety disorders using data from a large psychiatric cohort.Method: Baseline data (N = 1,783) of the Netherlands Study of Depression and Anxiety, collected between September 2004 and February 2007, were used. Current and lifetime comorbidity rates for depressive and anxiety disorders (DSM-IV-TR criteria) were calculated. Associations of comorbidity with sociodemographic, vulnerability, and clinical characteristics, and temporal sequencing of disorders were examined.Results: Of those with a depressive disorder, 67% had a current and 75% had a lifetime comorbid anxiety disorder. Of persons with a current anxiety disorder, 63% had a current and 81% had a lifetime depressive disorder. Comorbidity of depressive and anxiety disorders was associated with more childhood trauma (OR = 1.19; 95% CI, 1.06-1.33), higher neuroticism (OR = 1.05; 95% CI, 1.02-1.08), earlier age at onset of first disorder (OR = 1.59; 95% CI, 1.22-2.07), longer duration of depressive and/or anxiety symptoms (OR = 1.01; 95% CI, 1.01-1.01), and higher symptom severity (ORs ranging from 1.01 to 1.03; all P values < .05). In 57% of comorbid cases, anxiety preceded depression, and in 18%, depression preceded anxiety. Comorbidity with preceding depression compared to preceding anxiety was associated with a shorter duration of symptoms of depressive and/or anxiety symptoms (OR = 0.99; 95% CI, 0.98-0.99), earlier age at first onset (OR = 0.46; 95% CI, 0.31-0.68), and fewer fear symptoms (OR = 0.98; 95% CI, 0.97-0.99).Conclusions: Comorbidity rates in anxiety and depressive disorders were very high, indicating that it is advisable to assess both disorders routinely regardless of the primary reason for consultation. This is especially important since comorbid patients showed a specific vulnerability pattern, with more childhood trauma, neuroticism, and higher severity and duration of symptoms. J Clin Psychiatry 2011;72(3):341-348 (C) Copyright 2011 Physicians Postgraduate Press, Inc.