Comorbidity as a fundamental feature of generalized anxiety disorders: results from the National Comorbidity Study (NCS)
Comorbidity as a fundamental feature of generalized anxiety disorders: results from the National Comorbidity Study (NCS)
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DOI：
10.1111/j.1600-0447.1998.tb05960.x
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发表时间：
1998-01-01
影响因子：
6.7
通讯作者：
Kunovac, JL
中科院分区：
文献类型：
--
作者：
Judd, LL;Kessler, RC;Kunovac, JL
广泛性焦虑症（GAD）是一种相对常见的精神疾病，在一般人群中，困扰着大约3%的社区居民在他们的一生。这不是一种良性疾病，因为与非CAD受试者相比，GAD受试者的残疾和功能障碍显著增加。几十年来，广泛性焦虑症经常在其他精神和药物滥用障碍的背景下观察到。最初，临床意见的权重表明，CAD是一种残留疾病，只有当其他精神疾病不存在时才能诊断。最近，人们越来越认识到，性别平等是性别与发展的过程和性质的一个基本特征。在对国家科摩罗研究数据库中的受试者进行的一系列次要分析中，我们发现10名终生GAD受试者中有8名在其一生中也患有共病情绪障碍。我们发现，在广泛性焦虑症中，单相情感障碍的发生率是双相情感障碍的4倍（67%比17%），这为先前报道的广泛性焦虑症和重性抑郁症可能具有共同的遗传素质的观察结果提供了间接支持。此外，我们的分析支持这样的结论，即当GAD中存在共病心境障碍时，相关的残疾和功能障碍也会显著增加，因此这种共病关系对临床病程和结局具有重要意义。
Generalized anxiety disorder (GAD) is a relatively common mental disorder in the general population, afflicting approximately 3% of community residents during their lifetime. It is not a benign condition, since significantly increased disability and dysfunction are found in GAD subjects compared to non-CAD subjects. For decades GAD has frequently been observed in the context of other mental and substance abuse disorders. Initially the weight of clinical opinion indicated that CAD was a residual disease which should only be diagnosed when other mental disorders are not present. More recently there has been a growing recognition that comorbidity is a fundamental characteristic of the course and nature of GAD. In a series of secondary analyses conducted in subjects in the National Comorbidity Study database, we found that 8 out of 10 subjects with lifetime GAD also had a comorbid mood disorder during their lifetime. We found unipolar disorders to be four times more common in GAD than bipolar disorders (67% vs. 17%), providing indirect support for the previously reported observation that GAD and major depression may share a common genetic diathesis. In addition, our analyses support the conclusion that when comorbid mood disorders are present in GAD, a significant increase in associated disability and dysfunction is also found. Thus this comorbid relationship has important implications for clinical course and outcome.