Angst J, Vollrath M
Research Department, Psychiatric University Hospital, Zurich, Switzerland.
Acta Psychiatr Scand. 1991 Nov;84(5):446-52. doi: 10.1111/j.1600-0447.1991.tb03176.x.
The article reviews research and presents our results on the natural history of 2 forms of anxiety disorder, panic disorder and generalized anxiety disorder. Data from our epidemiological cohort study give evidence of premorbid anxiousness and overadaptation already in childhood. Distressing conditions in the family are more prevalent among subjects with anxiety disorders or major depression than among controls. Anxiety disorders frequently begin between age 20-30 and can be triggered by life events. The course is often characterized by a certain chronicity that manifests itself in residual symptoms and mild impairment in social roles even after many years and is frequently complicated with depression. The best predictors are severity and duration of symptoms, as well as comorbidity with depression. Future studies of the natural history should take into account these factors in multivariate approaches.
本文回顾了相关研究，并展示了我们关于两种焦虑症——惊恐障碍和广泛性焦虑症自然病程的研究结果。我们的流行病学队列研究数据表明，病前焦虑和过度适应在童年时期就已存在。家庭中的困扰状况在焦虑症或重度抑郁症患者中比在对照组中更为普遍。焦虑症通常在20至30岁之间发病，可能由生活事件引发。病程往往具有一定的慢性特征，即使多年后仍表现为残留症状和社会角色的轻度受损，并且常伴有抑郁症。最佳预测因素是症状的严重程度和持续时间，以及与抑郁症的共病情况。未来关于自然病程的研究应在多变量方法中考虑这些因素。
