Smalbrugge Martin, Jongenelis Lineke, Pot Anne Margriet, Beekman Aartjan T F, Eefsting Jan A
Department of Nursing Home Medicine, VU University Medical Center in Amsterdam, The Netherlands.
Int J Geriatr Psychiatry. 2005 Mar;20(3):218-26. doi: 10.1002/gps.1269.
To assess the occurrence and risk indicators of depression, anxiety, and comorbid anxiety and depression among nursing home patients and to determine whether depression and anxiety are best described in a dimensional or in a categorical classification system.
DSM and subthreshold anxiety disorders, anxiety symptoms, major and minor depression and depressive symptoms were assessed in 333 nursing home patients of somatic wards of 14 nursing homes in the north west of the Netherlands with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Geriatric Depression Scale (GDS). Comorbidity was studied along a severity gradient. Logistic regression analyses were carried out to identify demographic, health-related, psychosocial and care-related correlates of anxiety and depression.
The prevalence of pure depression (PD) was 17.1%, of pure anxiety (PA) 4.8%, and of comorbid anxiety and depression (CAD) 5.1%. Comorbidity increased dependent on severity of both anxiety and depression. Different patterns of risk indicators were demonstrated for PA, PD and CAD for the investigated baseline characteristics.
Comorbidity of anxiety and depression is most prevalent in the more severe depressive and anxious nursing home patients. The gradual increase of comorbidity of anxiety and depression dependent on the levels of severity of depression and anxiety suggests that for nursing home patients a dimensional classification of depression and anxiety is more appropriate than a categorical one. The observed differences in patterns of risk indicators for PA, PD and CAD support a distinguishing of anxiety and depression. Future studies are needed to assess the effect of treatment of PA, PD and CAD in nursing home patients.
评估疗养院患者中抑郁、焦虑以及焦虑抑郁共病的发生率和风险指标，并确定抑郁和焦虑采用维度分类系统还是类别分类系统描述更佳。
采用神经精神科临床评估量表（SCAN）和老年抑郁量表（GDS），对荷兰西北部14家疗养院躯体病房的333名患者进行DSM及阈下焦虑障碍、焦虑症状、重度和轻度抑郁及抑郁症状的评估。沿着严重程度梯度研究共病情况。进行逻辑回归分析以确定焦虑和抑郁在人口统计学、健康相关、心理社会和护理相关方面的关联因素。
单纯抑郁（PD）的患病率为17.1%，单纯焦虑（PA）为4.8%，焦虑抑郁共病（CAD）为5.1%。共病情况随焦虑和抑郁的严重程度增加而增加。对于所研究的基线特征，PA、PD和CAD呈现出不同的风险指标模式。
焦虑抑郁共病在抑郁和焦虑程度较重的疗养院患者中最为普遍。焦虑抑郁共病情况随抑郁和焦虑严重程度的增加而逐渐上升，这表明对于疗养院患者，抑郁和焦虑采用维度分类比类别分类更为合适。观察到的PA、PD和CAD风险指标模式差异支持对焦虑和抑郁进行区分。未来需要开展研究评估对疗养院患者PA、PD和CAD的治疗效果。
