Sareen Jitender, Jacobi Frank, Cox Brian J, Belik Shay-Lee, Clara Ian, Stein Murray B
Department of Psychiatry and Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Arch Intern Med. 2006 Oct 23;166(19):2109-16. doi: 10.1001/archinte.166.19.2109.
Evidence has been emerging that anxiety disorders are associated with several physical health conditions. We used the first community survey, which assessed physical conditions based on physician assessment and included standardized diagnostic assessment of mental disorders by trained health professionals, to examine the relationship between anxiety disorders and physical conditions.
The German Health Survey (N = 4181; response rate, 87.6%; ages 18-65 years) used the Composite International Diagnostic Interview to assess Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mood, substance use, and anxiety disorders (panic disorder, social phobia, specific phobia, generalized anxiety disorder, agoraphobia, obsessive-compulsive disorder) and a standardized medical interview supplemented by laboratory data to assess a broad range of physical conditions. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used to measure health-related quality of life. Number of days of role impairment was used to measure past 30-day disability.
After adjusting for sociodemographic factors and other common mental disorders, the presence of an anxiety disorder was significantly associated with thyroid disease, respiratory disease, gastrointestinal disease, arthritis, migraine headaches, and allergic conditions (adjusted odds ratios between 1.39 and 2.12; P<.05). Compared with physical disorders alone, the presence of comorbid anxiety disorder with 1 or more physical disorders was associated with poorer physical component scores on the SF-36 (adjusted mean scores for physical condition alone and physical condition with anxiety disorder, 48.50 and 45.86, respectively; P<.001) and past 30-day disability due to physical problems (adjusted odds ratio, 1.69; 95% confidence interval, 1.20-2.37).
Anxiety disorders are independently associated with several physical conditions in the community, and this comorbidity is significantly associated with poor quality of life and disability.
越来越多的证据表明，焦虑症与多种身体健康状况相关。我们利用首次社区调查，该调查基于医生评估来评估身体状况，并由训练有素的健康专业人员对精神障碍进行标准化诊断评估，以研究焦虑症与身体状况之间的关系。
德国健康调查（N = 4181；应答率87.6%；年龄18 - 65岁）采用复合国际诊断访谈来评估《精神疾病诊断与统计手册》第四版中的情绪、物质使用和焦虑症（惊恐障碍、社交恐惧症、特定恐惧症、广泛性焦虑症、广场恐惧症、强迫症），并通过补充实验室数据的标准化医学访谈来评估广泛的身体状况。医学结局研究36项简短健康调查（SF - 36）用于测量与健康相关的生活质量。角色功能受损天数用于衡量过去30天的残疾情况。
在调整社会人口统计学因素和其他常见精神障碍后，焦虑症的存在与甲状腺疾病、呼吸系统疾病、胃肠道疾病、关节炎、偏头痛和过敏状况显著相关（调整后的优势比在1.39至2.12之间；P <.05）。与仅患有身体疾病相比，合并焦虑症与1种或更多种身体疾病的情况与SF - 36上较差的身体成分得分相关（仅身体状况和伴有焦虑症的身体状况的调整后平均得分分别为48.50和45.86；P <.001）以及因身体问题导致的过去30天残疾（调整后的优势比为1.69；95%置信区间为1.20 - 2.37）。
焦虑症在社区中与多种身体状况独立相关，这种共病与生活质量差和残疾显著相关。
