Juvenile mental health histories of adults with anxiety disorders.
Juvenile mental health histories of adults with anxiety disorders.
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患有焦虑症的成年人的青少年心理健康史。
DOI：
10.1176/ajp.2007.164.2.301
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Poulton,Richie
中科院分区：
文献类型：
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作者：
Gregory,AliceM;Caspi,Avshalom;Moffitt,TerrieE;Koenen,Karestan;Eley,ThaliaC;Poulton,Richie
目的了解成人焦虑症患者的精神病史，为进一步开展病因学和预防工作提供依据。方法作者采用前瞻性纵向研究数据，对年龄在11岁至32岁之间的有代表性的出生队列（N= 1037）进行研究，并根据DSM标准进行精神病诊断。对于32岁患有焦虑症的成年人，随访分析确定了焦虑症和其他青少年疾病的首次诊断。结果：在患有各种焦虑症的成年人中，大约一半的人在15岁之前被诊断为精神障碍（三分之一的人患有焦虑症）。患有不同类型焦虑症的成年人在青少年时期的精神病史在很大程度上是非特异性的，部分反映了32岁时的合并症。焦虑和抑郁史最为常见。也有特异性。例如，患有惊恐障碍的成年人没有青少年障碍病史，而患有其他焦虑症的成年人却有。患有创伤后应激障碍的成年人有行为障碍的历史，而患有其他焦虑症的人则没有。患有特殊恐惧症的成年人有青少年恐惧症病史，但没有其他焦虑症。结论：不同焦虑障碍之间存在强烈的共病性，且成人焦虑障碍的发育历史缺乏特异性，这支持了一种分层分类方法，即广泛的焦虑障碍类别中存在个体障碍。焦虑症患者的早期首次精神障碍诊断表明，有必要针对焦虑症的病因进行研究，并在生命早期进行预防。
ObjectiveInformation about the psychiatric histories of adults with anxiety disorders was examined to further inform nosology and etiological/ preventive efforts.MethodThe authors used data from a prospective longitudinal study of a representative birth cohort (N=1,037) from ages 11 to 32 years, making psychiatric diagnoses according to DSM criteria. For adults with anxiety disorders at 32 years, follow-back analyses ascertained first diagnosis of anxiety and other juvenile disorders.ResultsOf adults with each type of anxiety disorder, approximately half had been diagnosed with a psychiatric disorder (one-third with an anxiety disorder) by age 15. The juvenile histories of psychiatric problems for adults with different types of anxiety disorders were largely nonspecific, partially reflecting comorbidity at 32 years. Histories of anxiety and depression were most common. There was also specificity. For example, adults with panic disorder did not have histories of juvenile disorders, whereas those with other anxiety disorders did. Adults with posttraumatic stress disorder had histories of conduct disorder, whereas those with other anxiety disorders did not. Adults with specific phobia had histories of juvenile phobias but not other anxiety disorders.ConclusionsStrong comorbidity between different anxiety disorders and lack of specificity in developmental histories of adults with anxiety disorders supports a hierarchical approach to classification, with a broad class of anxiety disorders having individual disorders within it. The early first diagnosis of psychiatric difficulties in individuals with anxiety disorders suggests the need to target research examining the etiology of anxiety disorders and preventions early in life.