Gliatto M F
Department of Psychiatry, Philadelphia Veterans Affairs Medical Center, Pennsylvania 19104, USA.
Am Fam Physician. 2000 Oct 1;62(7):1591-600, 1602.
Patients with generalized anxiety disorder experience worry or anxiety and a number of physical and psychologic symptoms. The disorder is frequently difficult to diagnose because of the variety of presentations and the common occurrence of comorbid medical or psychiatric conditions. The lifetime prevalence is approximately 4 to 6 percent in the general population and is more common in women than in men. It is often chronic, and patients with this disorder are more likely to be seen by family physicians than by psychiatrists. Treatment consists of pharmacotherapy and various forms of psychotherapy. The benzodiazepines are used for short-term treatment, but because of the frequently chronic nature of generalized anxiety disorder, they may need to be continued for months to years. Buspirone and antidepressants are also used for the pharmacologic management of patients with generalized anxiety disorder. Patients must receive an appropriate pharmacologic trial with dosage titrated to optimal levels as judged by the control of symptoms and the tolerance of side effects. Psychiatric consultation should be considered for patients who do not respond to an appropriate trial of pharmacotherapy.
广泛性焦虑症患者会经历担忧或焦虑以及一系列身体和心理症状。由于症状表现多样以及常见的合并内科或精神疾病，该疾病常常难以诊断。在普通人群中，终生患病率约为4%至6%，女性比男性更为常见。它通常是慢性的，相较于精神科医生，患有这种疾病的患者更常被家庭医生诊治。治疗包括药物治疗和各种形式的心理治疗。苯二氮䓬类药物用于短期治疗，但由于广泛性焦虑症常常具有慢性性质，可能需要持续使用数月至数年。丁螺环酮和抗抑郁药也用于广泛性焦虑症患者的药物治疗。必须给予患者适当的药物试验，并根据症状控制和副作用耐受性将剂量滴定至最佳水平。对于药物治疗适当试验无反应的患者，应考虑精神科会诊。
