老年期焦虑障碍
Anxiety disorders in late life.
作者信息
Flint A J
机构信息
Department of Psychiatry, University of Toronto, Ont.
出版信息
Can Fam Physician. 1999 Nov;45:2672-9.
OBJECTIVE
To review the epidemiology, clinical characteristics, and treatment of anxiety disorders in late life.
QUALITY OF EVIDENCE
Epidemiologic and comorbidity data are derived from well designed random-sample community surveys. There are virtually no controlled data specific to treatment of anxiety in the elderly. Guidelines for treating anxiety disorders in late life, therefore, must be extrapolated from results of randomized controlled trials conducted in younger patients.
MAIN MESSAGE
Generalized anxiety disorder and agoraphobia account for most cases of anxiety disorder in late life. Late-onset generalized anxiety is usually associated with depressive illness and, in this situation, the primary pharmacologic treatment is antidepressant medication. Most elderly people with agoraphobia do not give a history of panic attacks; exposure therapy is the preferred treatment for agoraphobia without panic.
CONCLUSIONS
Physicians need to make more use of antidepressant medication and behavioural therapy and less use of benzodiazepines in treating anxiety disorders in late life.
目的
回顾老年期焦虑症的流行病学、临床特征及治疗方法。
证据质量
流行病学和共病数据来源于设计良好的随机抽样社区调查。几乎没有专门针对老年人焦虑症治疗的对照数据。因此，老年期焦虑症的治疗指南必须从针对年轻患者进行的随机对照试验结果中推断得出。
主要信息
广泛性焦虑症和广场恐惧症占老年期焦虑症的大多数病例。迟发性广泛性焦虑通常与抑郁症有关，在这种情况下，主要的药物治疗是抗抑郁药物。大多数患有广场恐惧症的老年人没有惊恐发作史；暴露疗法是无惊恐症状的广场恐惧症的首选治疗方法。
结论
医生在治疗老年期焦虑症时，应更多地使用抗抑郁药物和行为疗法，减少使用苯二氮䓬类药物。
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