Shores M M, Glubin T, Cowley D S, Dager S R, Roy-Byrne P P, Dunner D L
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
Compr Psychiatry. 1992 Jul-Aug;33(4):237-44. doi: 10.1016/0010-440x(92)90047-t.
This study examined the relationship between the chronic disorders, generalized anxiety disorder (GAD) and dysthymic disorder (DD), and the more acute disorders, panic disorder (PD) and major depressive disorder (MDD) in 110 psychiatric outpatients with diagnoses of either PD, MDD, GAD, or DD. Pure, mixed, and early-/late-onset forms of the chronic disorders were compared with each other and then with PD and MDD on clinical measures and psychiatric history. Minimal differences were found between pure GAD and mixed GAD or between pure DD and mixed DD. The chronic disorders, DD and GAD, had distinct clinical symptom profiles when compared with each other and appeared more closely related to their parent disorders than to each other. However, despite these similarities, there were significant differences between DD and MDD in contrast to the minimal differences between GAD and PD, providing less support for GAD as a valid diagnostic category separate from PD. Comparisons of early-/late-onset DD and GAD showed more severe symptoms in late-onset DD, in contrast to more severe symptoms in early-onset GAD. These varying patterns of symptom severity may warrant study for further syndromal delineation.
本研究调查了110名被诊断患有惊恐障碍（PD）、重度抑郁症（MDD）、广泛性焦虑症（GAD）或心境恶劣障碍（DD）的精神科门诊患者中，慢性疾病（广泛性焦虑症和心境恶劣障碍）与急性疾病（惊恐障碍和重度抑郁症）之间的关系。对慢性疾病的单纯型、混合型以及早发型/晚发型形式进行了相互比较，然后在临床指标和精神病史方面与惊恐障碍和重度抑郁症进行了比较。在单纯广泛性焦虑症与混合性广泛性焦虑症之间，以及单纯心境恶劣障碍与混合性心境恶劣障碍之间，发现差异极小。慢性疾病，即心境恶劣障碍和广泛性焦虑症，相互比较时具有不同的临床症状特征，并且与其母系疾病的关系似乎比它们彼此之间的关系更为密切。然而，尽管存在这些相似之处，但心境恶劣障碍与重度抑郁症之间存在显著差异，与之形成对比的是广泛性焦虑症与惊恐障碍之间差异极小，这使得广泛性焦虑症作为一个与惊恐障碍不同的有效诊断类别得到的支持较少。早发型/晚发型心境恶劣障碍和广泛性焦虑症的比较显示，晚发型心境恶劣障碍的症状更为严重，而早发型广泛性焦虑症的症状更为严重。这些症状严重程度的不同模式可能值得进一步研究以进行更精确的综合征描述。
