Defining anxious depression: a review of the literature.
Defining anxious depression: a review of the literature.
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DOI：
10.1017/s1092852913000114
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发表时间：
2013-10
期刊：
影响因子：
3.3
通讯作者：
Zarate CA
中科院分区：
文献类型：
--
作者：
Ionescu DF;Niciu MJ;Henter ID;Zarate CA
焦虑性抑郁症的诊断目前不一致。焦虑性抑郁症的许多不同定义使其诊断复杂化，导致临床混乱和文献不一致。本文回顾了现有文献，以确定焦虑性抑郁的不同定义，然后使用Feighner的诊断标准进行比较。值得注意的是，这表明焦虑性抑郁症患者的临床表现不同。例如，依靠ICD-10或DSM诊断产生相对轻微或短暂性疾病的临床图像；相反，使用维度标准，如DSM标准结合额外的评定量表-最常见的是汉密尔顿抑郁评定量表（HAM-D）的焦虑躯体化因素得分-产生更严重的临床症状。这里回顾的证据表明，以一种维度的方式来定义焦虑性抑郁症，可能是将其与其他类型的情绪和焦虑障碍区分开来的最有用和最有临床意义的方法，也是突出焦虑性抑郁症患者与抑郁或单纯焦虑患者之间最重要的临床差异的方法。
The diagnosis of anxious depression is presently inconsistent. The many different definitions of anxious depression have complicated its diagnosis, leading to clinical confusion and inconsistencies in the literature. This paper reviewed the extant literature in order to identify the varying definitions of anxious depression, which were then compared using Feighner’s diagnostic criteria. Notably, these suggest a different clinical picture of patients with anxious depression. For instance, relying on ICD-10 or DSM diagnoses yields a clinical picture of a comparatively mild or transient disorder; in contrast, using dimensional criteria such as DSM criteria combined with additional rating scales—most commonly the anxiety somatization factor score from the Hamilton Depression Rating Scale (HAM-D)—yields a more serious clinical picture. The evidence reviewed here suggests that defining anxious depression in a dimensional manner may be the most useful and clinically relevant way of differentiating it from other types of mood and anxiety disorders, and of highlighting the most clinically significant differences between patients with anxious depression versus depression or anxiety alone.