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焦虑症中的共病现象:对治疗及《精神疾病诊断与统计手册第四版》的启示

Comorbidity among anxiety disorders: implications for treatment and DSM-IV.

作者信息

Brown T A, Barlow D H

机构信息

Center for Stress & Anxiety Disorders, State University of New York, Albany 12203.

出版信息

J Consult Clin Psychol. 1992 Dec;60(6):835-44. doi: 10.1037//0022-006x.60.6.835.

Abstract

Research on comorbidity among psychological disorders is relatively new. Yet, comorbidity data have fundamental significance for classification and treatment. This significance is particularly apparent in the anxiety disorders, which, prior to DSM-III-R, were subsumed under disorders considered more significant (e.g., psychotic and depressive disorders). After considering definitional, methodological, and theoretical issues of comorbidity, data on comorbidity among the anxiety disorders are reviewed as well as data on comorbidity of anxiety disorders with the depressive, personality, and substance use disorders. Treatment implications are presented with preliminary data on the effects of psychosocial treatment of panic disorder on co-morbid generalized anxiety disorder. Implications of comorbidity for research on the nature of psychopathology and the ultimate integration of dimensional and categorical features in our nosology are considered.

摘要

心理障碍共病的研究相对较新。然而,共病数据对分类和治疗具有根本意义。这种意义在焦虑症中尤为明显,在《精神疾病诊断与统计手册》第三版修订本(DSM-III-R)之前,焦虑症被归入被认为更严重的疾病(如精神病性和抑郁性障碍)之下。在考虑了共病的定义、方法和理论问题之后,本文回顾了焦虑症之间的共病数据,以及焦虑症与抑郁性、人格和物质使用障碍的共病数据。文中还呈现了关于惊恐障碍的心理社会治疗对共病广泛性焦虑症影响的初步数据及其治疗意义。同时也探讨了共病对精神病理学本质研究以及我们疾病分类学中维度特征和类别特征最终整合的影响。

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