Relation between depression and anxiety in dystonic patients: Implications for clinical management
Relation between depression and anxiety in dystonic patients: Implications for clinical management
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DOI：
10.1002/da.10039
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发表时间：
2002-01-01
影响因子：
7.4
通讯作者：
Auff, E
中科院分区：
文献类型：
--
作者：
Moraru, E;Schnider, P;Auff, E
过去的临床研究已经确定抑郁症是与颈肌张力障碍（CD）相关的最常见的精神障碍。我们研究的目的是记录不同类型的精神病理，精神障碍的频率，以及与乳糜泻患者神经系统疾病的可能相关性。我们调查了40名乳糜泻患者，以评估两种自评量表的精神病理水平。贝克抑郁量表（BDI）和症状检查表（SCL-90）。为了确定精神障碍的存在，使用DSM-III-R（结构化临床访谈表，SCID）中的标准工具对患者进行评估。一小部分肌张力障碍患者（12%）有较高的精神病理水平，在BDI和SCL-90上伴有显著的焦虑和抑郁。22例（55%）患者符合至少一种精神障碍的SCID标准，包括终生和当前诊断。最常见的诊断类别是焦虑（40%）和重度抑郁症（37.5%）。在17名患者（42.5%）中，至少有一项终生诊断的标准在乳糜泻发病前得到了满足。精神病学评估没有表明一种与乳糜泻相关的特定疾病。在肌张力障碍之前和过程中出现焦虑和抑郁症状，没有可能的因果关系，可能意味着中枢神经系统生理事件链的改变可能不会导致单一的临床症状。对于局灶性肌张力障碍患者，相对较高的焦虑和抑郁障碍的总体终生患病率可能表明需要更广泛的诊断和治疗方法。(C) 2002 Wiley-Liss, Inc。
Past clinical research has identified depression as the most common psychiatric disorder associated with cervical dystonia (CD). The purpose of our study is to document different patterns of psychopathology, the frequency of psychiatric disorders, and possible correlation with the neurological disorder in patients with CD. Forty patients with CD were investigated to assess levels of psychopathology on two self-rated scales. the Beck Depression Inventory (BDI) and Symptom Check List (SCL-90). To determine the presence of psychiatric disorders, the patients were evaluated using the standard instrument in the DSM-III-R (Structured Clinical Interview Schedule, SCID). A small group of dystonic patients (12%) bad higher levels of psychopathology, with significant amounts of concomitant anxiety and depression on the BDI and SCL-90. SCID criteria for at least one psychiatric disorder were fulfilled in 22 patients (55%), including both the lifetime and current diagnoses. The most frequent diagnostic categories were anxiety (40%) and major depressive disorders (37.5%). In 17 patients (42.5%), criteria for at least one lifetime diagnosis were fulfilled prior to the onset of CD. Psychiatric evaluation does not indicate one specific disorder associated with CD. The presence of anxiety and depression symptoms before and during the course of dystonia, without a possible causal relationship, could mean that the alteration of a chain of physiological events in the central nervous system may not lead to a single clinical picture. The relatively high overall lifetime prevalence of anxiety and depressive disorders may indicate the need for a broader diagnostic and therapeutic approach, to patients with focal dystonia. (C) 2002 Wiley-Liss, Inc.