Comorbid anxiety disorders in depressed elderly patients
Comorbid anxiety disorders in depressed elderly patients
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DOI：
10.1176/appi.ajp.157.5.722
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发表时间：
2000-05-01
影响因子：
17.7
通讯作者：
Reynolds, CF
中科院分区：
文献类型：
--
作者：
Lenze, EJ;Mulsant, BH;Reynolds, CF
目的：焦虑症在患有抑郁症的成年人中很常见，但一些研究表明，在老年抑郁症患者中，焦虑症的患病率相对较低。这项横断面研究测量了老年抑郁症患者焦虑障碍的现患率和终身率以及相关的临床特征。方法：使用结构化诊断工具对182名60岁及以上在初级保健和精神科环境中出现的抑郁症患者的焦虑史进行评估。共患焦虑症和基线特征之间的关联性被测量。结果：35%的老年抑郁症患者至少有一次终生焦虑症诊断，23%的患者目前诊断为焦虑症。目前最常见的共病焦虑症是惊恐障碍(9.3%)、特定恐惧症(8.8%)和社交恐惧症(6.6%)。符合广泛性焦虑症纳入标准的症状，单独测量，在27.5%的抑郁症受试者中出现。伴发焦虑症与较差的社会功能和较高水平的躯体症状有关。广泛性焦虑症的症状与较高的自杀水平相关。结论：与以往的报道相反，本研究发现老年抑郁症患者目前和终生焦虑症的发生率相对较高。共患焦虑症和广泛性焦虑症的症状与老年受试者出现更严重的抑郁疾病有关。
Objective: Anxiety disorders are common in adults with depressive disorders, but several studies have suggested a relatively low prevalence of anxiety disorders in older individuals with depression. This cross-sectional study measured current and lifetime rates and associated clinical features of anxiety disorders in depressed elderly patients.Method: History of anxiety disorders was assessed by using a structured diagnostic instrument in 182 depressed subjects aged 60 and older seen in primary care and psychiatric settings. Associations between comorbid anxiety disorders and baseline characteristics were measured. The modified structured instrument allowed detection of symptoms that met inclusion criteria for generalized anxiety disorder in a depressive episode.Results: Thirty-five percent of older subjects with depressive disorders had at least one lifetime anxiety disorder diagnosis, and 23% had a current diagnosis. The most common current comorbid anxiety disorders were panic disorder (9.3%), specific phobias (8.8%), and social phobia (6.6%). Symptoms that met inclusion criteria for generalized anxiety disorder, measured separately, were present in 27.5% of: depressed subjects. Presence of a comorbid anxiety disorder was associated with poorer social function and a higher level of somatic symptoms. Symptoms of generalized anxiety disorder were associated with a higher level of suicidality.Conclusions: Contrary to previous reports, the present study found a relatively high rate of current and lifetime anxiety disorders in elderly depressed individuals. Comorbid anxiety disorders and symptoms of generalized anxiety disorder were associated with a more severe presentation of depressive illness in elderly subjects.