Muhsen Khitam, Lipsitz Joshua, Garty-Sandalon Noga, Gross Raz, Green Manfred S
Israel Center for Disease Control, Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel.
Soc Psychiatry Psychiatr Epidemiol. 2008 Nov;43(11):898-904. doi: 10.1007/s00127-008-0379-0. Epub 2008 Jul 19.
Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder with chronic symptoms and is commonly comorbid with depression.
To identify correlates of GAD among adults and to describe treatment patterns and functional limitations among individuals with this disorder.
Data for 2,082 subjects aged >or=21 years from the first Israeli national health interview survey (INHIS-1) (2003-2004) were analyzed. Information on GAD was collected using the short form of the Composite International Diagnostic Interview. Data were also obtained on socio-demographic, physical health characteristics, history of life threatening events, treatment seeking behaviors, use of medication and functional impairment.
The prevalence of GAD was highest among people aged 40-59 years, in those with asthma, hypertension and in those with osteoporosis. Regular exercise was associated with reduced prevalence for GAD (adjusted OR 0.46, 95% CI 0.22-0.95). The exclusion of individuals with major depression from analysis strengthened the association with age (adjusted OR 5.7, 95% CI 1.7, 19.7), weakened the association between GAD and osteoporosis (adjusted OR 3.4, 95% CI 1.2, 9.8), asthma (adjusted OR 3.4, 95% CI 1.2, 9.5) and regular exercise (adjusted OR 0.47 95% CI 0.2, 1.14). In this sub-sample, hypertension was no longer associated with GAD, and a significant association was found between GAD and past experience of life threatening events (adjusted OR 2.3, 95% CI 1.1-4.9). Psychiatric and psychological consultations were low among people with GAD (11.5% and 26.4% for those without and with comorbid depression, respectively), concurrent with a high degree of functional limitation.
Middle age, history of traumatic life events, and certain chronic medical diseases (e.g., asthma and osteoporosis) are important risk factors for GAD. They could be used to help identify and treat people with GAD.
广泛性焦虑障碍（GAD）是一种常见的精神障碍，症状具有慢性特点，且常与抑郁症共病。
确定成年人中GAD的相关因素，并描述该障碍患者的治疗模式和功能受限情况。
对来自以色列首次全国健康访谈调查（INHIS - 1）（2003 - 2004年）的2082名年龄≥21岁的受试者的数据进行分析。使用复合国际诊断访谈简表收集有关GAD的信息。还获取了社会人口统计学、身体健康特征、危及生命事件史、寻求治疗行为、药物使用和功能损害等方面的数据。
GAD患病率在40 - 59岁人群、哮喘患者、高血压患者和骨质疏松症患者中最高。经常锻炼与GAD患病率降低相关（校正OR 0.46，95% CI 0.22 - 0.95）。分析中排除重度抑郁症患者后，加强了与年龄的关联（校正OR 5.7，95% CI 1.7，19.7），削弱了GAD与骨质疏松症（校正OR 3.4，95% CI 1.2，9.8）、哮喘（校正OR 3.4，95% CI 1.2，9.5）和经常锻炼（校正OR 0.47，95% CI 0.2，1.14）之间的关联。在这个子样本中，高血压不再与GAD相关，且发现GAD与过去危及生命事件的经历之间存在显著关联（校正OR 2.3，95% CI 1.1 - 4.9）。GAD患者中接受精神科和心理咨询的比例较低（无共病抑郁症者和有共病抑郁症者分别为11.5%和26.4%），同时功能受限程度较高。
中年、创伤性生活事件史以及某些慢性疾病（如哮喘和骨质疏松症）是GAD的重要危险因素。它们可用于帮助识别和治疗GAD患者。
