Andreescu Carmen, Lenze Eric J, Dew Mary Amanda, Begley Amy E, Mulsant Benoit H, Dombrovski Alexandre Y, Pollock Bruce G, Stack Jacqueline, Miller Mark D, Reynolds Charles F
Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Room E 823, Pittsburgh, PA15213, USA.
Br J Psychiatry. 2007 Apr;190:344-9. doi: 10.1192/bjp.bp.106.027169.
Comorbid anxiety is common in depressive disorders in both middle and late life, and it affects response to antidepressant treatment.
To examine whether anxiety symptoms predict acute and maintenance (2 years) treatment response in late-life depression.
Data were drawn from a randomised double-blind study of pharmacotherapy and interpersonal psychotherapy for patients age 70 years and over with major depression. Anxiety symptoms were measured using the Brief Symptom Inventory. Survival analysis tested the effect of pre-treatment anxiety on response and recurrence.
Patients with greater pretreatment anxiety took longer to respond to treatment and had higher rates of recurrence. Actuarial recurrence rates were 29% (pharmacotherapy, lower anxiety), 58% (pharmacotherapy, higher anxiety), 54% (placebo, lower anxiety) and 81% (placebo, higher anxiety).
Improved identification and management of anxiety in late-life depression are needed to achieve response and stabilise recovery.
共病焦虑在中老年期的抑郁症中很常见，并且会影响对抗抑郁治疗的反应。
研究焦虑症状是否能预测老年期抑郁症的急性治疗反应及维持治疗（2年）反应。
数据来自一项针对70岁及以上重度抑郁症患者的药物治疗和人际心理治疗的随机双盲研究。使用简明症状量表测量焦虑症状。生存分析检验了治疗前焦虑对反应和复发的影响。
治疗前焦虑程度较高的患者对治疗的反应时间更长，复发率更高。精算复发率分别为29%（药物治疗，低焦虑）、58%（药物治疗，高焦虑）、54%（安慰剂，低焦虑）和81%（安慰剂，高焦虑）。
为了实现治疗反应并稳定康复，需要改善对老年期抑郁症中焦虑的识别和管理。
