Steffens David C, McQuoid Douglas R
Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry, Duke University Medical Center, Box 3903, Durham, NC 27710, USA.
Am J Geriatr Psychiatry. 2005 Jan;13(1):40-7. doi: 10.1176/appi.ajgp.13.1.40.
The authors sought to examine the effect of symptoms of generalized anxiety disorder (GAD) on acute course of depression in a group of older depressed patients.
Authors assessed GAD symptoms in a sample of 204 patients age 60 and older with unipolar major depression. Patients were treated naturalistically by study geriatric psychiatrists using a treatment guideline for geriatric depression and assessed with the Montgomery-Asberg Depression Rating Scale. They were dichotomized as meeting or not meeting GAD symptom criteria. The groups were analyzed by Cox proportional-hazards models.
There were 138 remitters and 66 non-remitters. After analysis controlled for benzodiazepine use, stressful life events, social support, and functional status, having GAD symptoms was associated with longer time-to-remission.
Older depressed patients with GAD have a worse outcome than those without anxiety. Future studies will need to determine the appropriate role of benzodiazepines and other anxiolytics in the treatment of older depressed patients with symptoms of GAD.
作者试图研究广泛性焦虑障碍(GAD)症状对一组老年抑郁症患者抑郁急性病程的影响。
作者在204名60岁及以上的单相重度抑郁症患者样本中评估了GAD症状。患者由研究老年精神科医生按照老年抑郁症治疗指南进行自然主义治疗,并使用蒙哥马利-艾斯伯格抑郁评定量表进行评估。他们被分为符合或不符合GAD症状标准两组。通过Cox比例风险模型对两组进行分析。
有138名缓解者和66名未缓解者。在对苯二氮䓬类药物使用、应激性生活事件、社会支持和功能状态进行分析控制后,有GAD症状与更长的缓解时间相关。
患有GAD的老年抑郁症患者比没有焦虑症的患者预后更差。未来的研究需要确定苯二氮䓬类药物和其他抗焦虑药在治疗有GAD症状的老年抑郁症患者中的适当作用。