Wittchen H U, Krause P, Hoyer J, Beesdo K, Jacobi F, Höfler M, Winter S
Institut für Klinische Psychologie und Psychotherapie der TU Dresden, Max-Planck-Institut für Psychiatrie, München.
Fortschr Med Orig. 2001;119 Suppl 1:17-25.
The investigators evaluated the (target-day) point prevalence and correlates of generalized anxiety and depression in German primary care practices.
The study used a representative national sample of more than 500 primary care practices. On a target day, all primary care patients were examined by questionnaires (GAS-Q and DSQ).
Conservatively estimated, 5.3% of all primary care patients met criteria for generalized anxiety disorder (GAD). Similar prevalence estimations were found for Major Depression. Only 30% of all GAD patients met criteria for depression cross-sectionally. Patients with GAD (whether comorbid with depression or not) were more frequently female, reported an onset of GAD mostly between ages of 25 and 45 years, had increased rates of disability and impairment in major social roles and high utilization rates of all health care resources. They also revealed a predominantly chronic course of illness over a period of several years and an increased suicide rate. The presence of physical illness increased rates of handicap/impairment days in the past month. Associated negative outcomes were found to be similar to those observed in depressive disorders. Patients with GAD reported significantly more frequently sleep, anxiety and depressive problems as primary reasons for contact.
The GAD-P study highlights the significance of GAD in primary care as a condition that occurs at about the same frequency as major depression. Further, the relatively high proportion of pure GAD suggests that the frequency of depression-comorbidity of GAD has previously been overestimated.
研究人员评估了德国初级保健机构中广泛性焦虑症和抑郁症的(目标日)时点患病率及其相关因素。
该研究采用了一个具有代表性的全国性样本,包含500多家初级保健机构。在目标日,通过问卷(GAS-Q和DSQ)对所有初级保健患者进行检查。
保守估计,所有初级保健患者中有5.3%符合广泛性焦虑症(GAD)的标准。重度抑郁症的患病率估计与之相似。所有GAD患者中,只有30%在横断面检查中符合抑郁症标准。GAD患者(无论是否合并抑郁症)女性更为常见,报告的GAD发病年龄大多在25至45岁之间,在主要社会角色中的残疾和功能障碍发生率增加,所有医疗资源的利用率都很高。他们还显示出在数年时间里疾病主要呈慢性病程,自杀率增加。身体疾病的存在增加了过去一个月的残疾/功能障碍天数。发现相关的负面结果与在抑郁症中观察到的结果相似。GAD患者报告因睡眠、焦虑和抑郁问题作为就诊主要原因的频率明显更高。
GAD-P研究强调了GAD在初级保健中的重要性,其发生频率与重度抑郁症大致相同。此外,纯GAD的比例相对较高表明,之前对GAD合并抑郁症的频率估计过高。