Associations between anxiety disorders and physical illness
Associations between anxiety disorders and physical illness
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DOI：
10.1007/s00406-003-0449-y
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发表时间：
2003-12-01
影响因子：
4.7
通讯作者：
Merikangas, KR
中科院分区：
文献类型：
--
作者：
H채rter, MC;Conway, KP;Merikangas, KR
目的与抑郁症与内科疾病相关的文献相比，对焦虑与躯体疾病的共病知之甚少。尽管已有报道称焦虑症与医学疾病之间存在联系，但之前的研究尚未调整性别、药物滥用/依赖和抑郁症的影响。本研究探讨焦虑症与躯体疾病共病的模式。方法从治疗机构或社区随机招募262例先证者。DSM-III-R诊断是基于直接访谈（SADS）或家族史信息获得的，并获得了许多医学疾病的终身史。结果终生焦虑症患者报告的几种内科疾病的发病率高于没有焦虑症的人。在控制了性别、共病药物滥用/依赖和/或抑郁的影响后，发现焦虑症与心脏疾病（OR = 4.6）、高血压（OR = 2.4）、胃肠道问题（OR = 2.4）、泌尿生殖系统疾病（OR = 3.5）和偏头痛（OR = 5.0）之间存在显著关联。在惊恐或广泛性焦虑障碍（GAD）的先证者中也观察到类似的模式。结论焦虑症与心脏疾病、高血压、胃肠道问题、泌尿生殖困难和偏头痛的特定模式相关;因此，需要仔细评估患有焦虑症或内科疾病的患者的合并症。
Objective In contrast to the literature on the association of depression with medical illness, less is known about the comorbidity among anxiety and somatic disorders. Although associations between anxiety disorders and medical illnesses have been reported, prior studies have not adjusted for the effects of gender, substance abuse/dependence, and depression. This study examined the patterns of comorbidity of anxiety disorders and physical illnesses. Method A total of 262 probands were selected from treatment settings or were randomly recruited from the community. DSM-III-R diagnoses were obtained based on direct interview (SADS) or family history information, and lifetime history of numerous medical illnesses were obtained. Results Patients with a lifetime anxiety disorder reported higher rates of several medical illnesses than did persons without anxiety. After controlling for the effects of gender, comorbid substance abuse/dependence and/or depression, significant associations were found between anxiety disorder and cardiac disorders (OR = 4.6), hypertension (OR = 2.4), gastrointestinal problems (OR = 2.4), genitourinary disorders (OR = 3.5), and migraine (OR = 5.0). A similar pattern was observed for probands with panic or generalized anxiety disorder (GAD). Conclusions Anxiety disorders were associated with a specific pattern of cardiac disorders, hypertension, gastrointestinal problems, genitourinary difficulties, and migraine; individuals presenting with anxiety disorders or medical illness need therefore to be evaluated carefully for comorbidity.