Lecrubier Yves, Dolberg Ornah T, Andersen Henning F, Weiller Emmauelle
INSERM, Hôpital de la Salpétrière, Paris, France.
Eur Arch Psychiatry Clin Neurosci. 2008 Apr;258(3):171-8. doi: 10.1007/s00406-007-0771-x.
The purpose of this article is to examine the similarities and differences between patients with Major Depressive Disorder (MDD) versus Generalized Anxiety Disorder (GAD) versus MDD with anxiety symptoms. Data were analysed from all randomized double-blind clinical studies with escitalopram that measured symptoms using either Hamilton Anxiety Scale (HAMA) or Montgomery-Asberg Depression Rating Scale (MADRS). The contribution of each item of a scale to the total score was calculated before and after treatment, in remitters. Most single items of the HAMA contribute nearly equally in patients with GAD. In patients with MDD, four symptoms (i.e. anxious mood, tension, insomnia and concentration) contribute to most to the HAMA total score. In patients with GAD, three symptoms (tension, sleep and concentration) contribute two-thirds of the MADRS total score. In contrast, most MADRS items contribute equally to the total score in patients with MDD. After treatment to remission, the profile of residual symptoms MDD or GAD was similar to the symptom profile before treatment. Anxiety symptoms are very common in patients with MDD or GAD, and the symptomatic pattern is similar. In both disorders, the symptomatic pattern of residual symptoms is similar to the pattern of symptoms before treatment.
本文旨在探讨重度抑郁症（MDD）患者、广泛性焦虑症（GAD）患者以及伴有焦虑症状的MDD患者之间的异同。分析了所有使用艾司西酞普兰的随机双盲临床研究的数据，这些研究使用汉密尔顿焦虑量表（HAMA）或蒙哥马利-阿斯伯格抑郁评定量表（MADRS）来测量症状。在治疗前后，对缓解者计算量表各项目对总分的贡献。HAMA的大多数单项在GAD患者中的贡献几乎相同。在MDD患者中，四种症状（即焦虑情绪、紧张、失眠和注意力不集中）对HAMA总分的贡献最大。在GAD患者中，三种症状（紧张、睡眠和注意力不集中）占MADRS总分的三分之二。相比之下，MDD患者中MADRS的大多数项目对总分的贡献相同。治疗至缓解后，MDD或GAD患者残留症状的特征与治疗前的症状特征相似。焦虑症状在MDD或GAD患者中非常常见，且症状模式相似。在这两种疾病中，残留症状的症状模式与治疗前的症状模式相似。
