Bruijn J A, Moleman P, van den Broek W W, Mulder P G
Department of Psychiatry, University Hospital Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
J Psychiatr Res. 2001 Nov-Dec;35(6):331-7. doi: 10.1016/s0022-3956(01)00035-8.
In this cross-sectional study we explored in 101 depressive in-patients (DSM III-R) the association between level of trait anxiety and variables that have been investigated previously to discern primary and secondary depression, respectively. Besides, we explored the influence of trait anxiety level on difference in treatment response to either imipramine or mirtazapine. Trait anxiety was measured interviewing a close relative of the patient using a questionnaire related to aspects of psychic anxiety and to aspects of somatic anxiety. The interviewer focussed on fluctuating anxiety symptoms without persistent mood disturbance during the patient's normal lifelong functioning before developing a depressed mood. We found no relation between trait anxiety level and treatment response to either imipramine or mirtazapine. The most important finding of this study is the significant differential response to the diazepam test: depressive patients with high trait anxiety showed, predominantly, a disappearance of depressive symptoms without sedation and depressive patients with low trait anxiety showed, predominantly, sedation without disappearance of depressive symptoms. The opposite response to the diazepam test in patients with a different history of trait anxiety in spite of similar depressive symptomatology suggests differences in underlying pathophysiologic mechanisms.
在这项横断面研究中，我们对101名住院抑郁症患者（DSM III-R）进行了探究，分析特质焦虑水平与此前分别用于鉴别原发性和继发性抑郁症的变量之间的关联。此外，我们还探究了特质焦虑水平对患者使用丙咪嗪或米氮平治疗反应差异的影响。通过使用一份与精神焦虑和躯体焦虑方面相关的问卷，对患者的一位近亲进行访谈来测量特质焦虑。访谈者关注的是在患者出现抑郁情绪之前其正常生活功能中波动的焦虑症状，且无持续性情绪障碍。我们发现特质焦虑水平与丙咪嗪或米氮平的治疗反应之间没有关联。本研究最重要的发现是地西泮试验的显著差异反应：特质焦虑水平高的抑郁症患者主要表现为抑郁症状消失且无镇静作用，而特质焦虑水平低的抑郁症患者主要表现为有镇静作用但抑郁症状未消失。尽管抑郁症状相似，但特质焦虑病史不同的患者对地西泮试验有相反的反应，这表明潜在的病理生理机制存在差异。
