在一家三级医疗情绪与焦虑症服务机构就诊的门诊患者中，不同诊断下的社交焦虑症状。

Social anxiety symptoms across diagnoses among outpatients attending a tertiary care mood and anxiety disorders service.

作者信息

Graystone H J, Garner M J, Baldwin D S

机构信息

Clinical Neuroscience Division, School of Medicine, University of Southampton, University Department of Mental Health, RSH Hospital, Brintons Terrace, Southampton, SO14 0YG UK.

出版信息

J Affect Disord. 2009 Apr;114(1-3):305-9. doi: 10.1016/j.jad.2008.06.003. Epub 2008 Jul 25.

DOI:10.1016/j.jad.2008.06.003

PMID:18656267

Abstract

BACKGROUND

Social phobia is a common, persistent and disabling anxiety disorder in which co-existing depressive symptoms are common. However the prevalence of social anxiety symptoms in patients with other mood and anxiety disorders is uncertain.

METHOD

In consecutive patients attending a tertiary referral mood and anxiety disorders service, depressive symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) and social anxiety symptoms by the Liebowitz Social Anxiety Scale (LSAS). The Clinical Global Impression of Severity (CGI-S) was completed following the appointment.

RESULTS

75 patients (48 women, 27 men; mean age 45.9 years) completed the study. 38 had a single diagnosis and 37 co-morbid diagnoses: 15 patients had bipolar disorder, 35 unipolar depressive disorder, 19 an anxiety disorder, and 6 other disorders. Independent samples t-tests and one-way between-subjects ANOVA revealed that the severity of social anxiety symptoms but not depressive symptoms was significantly greater in patients with co-morbid diagnoses (LSAS 73.7 vs 54.2, t(72)=2.44, p<.05; MADRS 21.9 vs 18.0, t(73)=1.76, p=.08; CGI-S 3.7 vs 3.2, t(73)=2.64, p<.05); and in anxiety disorders than in unipolar depression or bipolar disorder (respectively; LSAS 78.8 vs 59.4 vs 50.0, F(2, 65)=3.13, p=.05; MADRS 22.2 vs 19.8 vs 17.5, F(2, 66)<1, ns; CGI-S 3.9 vs 3.3 vs 3.1, F(2, 66)=5.43, p<.01). In the overall sample, correlation coefficients were MADRS and LSAS, R(2)=0.2628, p<.001; MADRS and CGI-S, R(2)=0.5863, p<.001; and LSAS and CGI-S, R(2)=0.327, p<.001. Correlations between MADRS and LSAS scores were higher in bipolar disorder (R(2)=0.4900, p<.01) than in unipolar depression (R(2)=0.376, p<.01) or anxiety disorders (R(2)=0.0041, ns).

LIMITATIONS

Small size of convenience sample undergoing varying treatments within a single specialist tertiary referral centre.

CONCLUSIONS

There was only a moderate correlation between depressive and social anxiety symptoms across a range of diagnoses. Depressive and social anxiety symptoms were most severe but least well correlated among tertiary care outpatients with anxiety disorders, emphasising the need for comprehensive evaluation and treatment.

摘要

背景

社交恐惧症是一种常见、持续且致残的焦虑症，常伴有抑郁症状。然而，其他情绪和焦虑症患者中社交焦虑症状的患病率尚不确定。

方法

在连续就诊于三级转诊情绪和焦虑症服务机构的患者中，通过蒙哥马利-阿斯伯格抑郁评定量表（MADRS）评估抑郁症状，通过利博维茨社交焦虑量表（LSAS）评估社交焦虑症状。就诊后完成临床总体严重程度印象（CGI-S）评定。

结果

75名患者（48名女性，27名男性；平均年龄45.9岁）完成了研究。38名患者为单一诊断，37名患者为共病诊断：15名患者患有双相情感障碍，35名患者患有单相抑郁症，19名患者患有焦虑症，6名患者患有其他疾病。独立样本t检验和单因素组间方差分析显示，共病诊断患者的社交焦虑症状严重程度显著高于抑郁症状（LSAS分别为73.7和54.2，t(72)=2.44，p<.05；MADRS分别为21.9和18.0，t(73)=1.76，p=.08；CGI-S分别为3.7和3.2，t(73)=2.64，p<.05）；焦虑症患者的社交焦虑症状严重程度高于单相抑郁症或双相情感障碍患者（分别为；LSAS分别为78.8、59.4和50.0，F(2, 65)=3.13，p=.05；MADRS分别为22.2、19.8和17.5，F(2, 66)<1，无显著性差异；CGI-S分别为3.9、3.3和3.来自淘豆网www.taodocs.com 转载请标明出处,1，F(2, 66)=5.43，p<.01）。在总体样本中，相关系数为MADRS与LSAS，R(2)=0.2628，p<.001；MADRS与CGI-S，R(2)=0.5863，p<.001；LSAS与CGI-S，R(2)=0.327，p<.001。双相情感障碍患者中MADRS与LSAS评分的相关性高于单相抑郁症患者（R(2)=0.4900，p<.01）或焦虑症患者（R(2)=0.004,1，无显著性差异）。