The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review.
The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review.
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DOI：
10.1186/1471-244x-14-128
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发表时间：
2014-05-01
期刊：
影响因子：
4.4
通讯作者：
Dobos GJ
中科院分区：
文献类型：
--
作者：
Haller H;Cramer H;Lauche R;Gass F;Dobos GJ
回顾低于诊断阈值的广泛性焦虑症（GAD）的患病率和影响，并探讨在医疗资源稀缺的情况下其治疗需求。使用PUBMED/MEDLINE、PSYCINFO、EMBASE和参考文献列表进行了系统性文献检索，直至2013年1月，以识别阈下GAD（即未达到DSM-III-R、DSM-IV或ICD-10当前阈值的GAD症状）的流行病学研究。评估所有纳入研究的质量，并计算不同亚群的阈下GAD的中位患病率。入选标准导致15项高质量和3项低质量流行病学研究，共审查了48，214名参与者。虽然广泛性焦虑症被证明是一种常见的心理健康障碍，但阈下广泛性焦虑症的患病率是全面综合征的两倍。阈下广泛性焦虑症通常是持续性的，在心理社会和工作功能、苯二氮卓类药物和初级卫生保健使用方面比非焦虑个体造成更多的痛苦和损害。阈下广泛性焦虑症还可增加发病风险，并使一系列共病心理健康、疼痛和躯体疾病的病程恶化;进一步增加成本。由于研究质量较低，结果对偏倚具有稳健性。阈下广泛性焦虑症是一种常见的、复发性的和损害性的疾病，具有可证实的发病率，需要大量的医疗资源。因此，它应该得到更多的研究和临床关注。
To review the prevalence and impact of generalized anxiety disorder (GAD) below the diagnostic threshold and explore its treatment needs in times of scarce healthcare resources. A systematic literature search was conducted until January 2013 using PUBMED/MEDLINE, PSYCINFO, EMBASE and reference lists to identify epidemiological studies of subthreshold GAD, i.e. GAD symptoms that do not reach the current thresholds of DSM-III-R, DSM-IV or ICD-10. Quality of all included studies was assessed and median prevalences of subthreshold GAD were calculated for different subpopulations. Inclusion criteria led to 15 high-quality and 3 low-quality epidemiological studies with a total of 48,214 participants being reviewed. Whilst GAD proved to be a common mental health disorder, the prevalence for subthreshold GAD was twice that for the full syndrome. Subthreshold GAD is typically persistent, causing considerably more suffering and impairment in psychosocial and work functioning, benzodiazepine and primary health care use, than in non-anxious individuals. Subthreshold GAD can also increase the risk of onset and worsen the course of a range of comorbid mental health, pain and somatic disorders; further increasing costs. Results are robust against bias due to low study quality. Subthreshold GAD is a common, recurrent and impairing disease with verifiable morbidity that claims significant healthcare resources. As such, it should receive additional research and clinical attention.