Revicki Dennis A, Brandenburg Nancy, Matza Louis, Hornbrook Mark C, Feeny David
Center for Health Outcomes Research, United Biosource Corporation, 7101 Wisconsin Ave, Suite 600, Bethesda, MD 20814, USA.
Qual Life Res. 2008 Dec;17(10):1285-94. doi: 10.1007/s11136-008-9406-6. Epub 2008 Oct 23.
Generalized anxiety disorder (GAD) is prevalent and significantly impacts patient health-related quality of life (HRQL) and disability.
This study evaluated the effect of GAD and anxiety symptom severity on the HRQL of primary-care patients with GAD.
Patients 18 years or older with GAD were recruited from an integrated health care delivery system. Clinical assessments included the Hamilton Anxiety Rating Scale (HAM-A), GAD Questionnaire-IV (GAD-Q-IV), and the Patient Health Questionnaire depression module (PHQ). HRQL was assessed by the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), Sheehan Disability Scale (SDS), SF-12 Health Survey (SF-6D), and the Health Utilities Index (HUI2, HUI3).
The sample included 297 patients, 72% women with mean +/- standard deviation (SD) age of 47.6 +/- 13.7 years. At baseline, the mean HAM-A score was 16.8 +/- 7.6 (suggesting the presence of moderate anxiety symptoms). Anxiety and depression symptoms were significantly correlated with mental component summary (MCS), Q-LES-Q-SF, SDS, SF-6D, HUI2, and HUI3 scores (all P < 0.001). The mean HRQL and all of the preference-based measures varied significantly by anxiety severity groups (all P < 0.001). Anxiety and depression symptoms significantly predicted HRQL and preference-based scores (R(2) values ranged from 0.22 to 0.57).
Anxiety symptoms reported by GAD patients resulted in significant impairment to HRQL and functional outcomes.
广泛性焦虑障碍（GAD）很常见，会显著影响患者的健康相关生活质量（HRQL）和残疾状况。
本研究评估了GAD及焦虑症状严重程度对患有GAD的初级保健患者HRQL的影响。
从一个综合医疗保健服务系统中招募18岁及以上患有GAD的患者。临床评估包括汉密尔顿焦虑量表（HAM - A）、GAD问卷 - IV（GAD - Q - IV）以及患者健康问卷抑郁模块（PHQ）。HRQL通过生活质量享受与满意度问卷简表（Q - LES - Q - SF）、希恩残疾量表（SDS）、SF - 12健康调查（SF - 6D）以及健康效用指数（HUI2、HUI3）进行评估。
样本包括297名患者，72%为女性，平均年龄±标准差（SD）为47.6±13.7岁。基线时，HAM - A平均得分为16.8±7.6（表明存在中度焦虑症状）。焦虑和抑郁症状与心理成分总结（MCS）、Q - LES - Q - SF、SDS、SF - 6D、HUI2和HUI3得分显著相关（所有P < 0.001）。平均HRQL以及所有基于偏好的测量指标在焦虑严重程度组之间存在显著差异（所有P < 0.001）。焦虑和抑郁症状显著预测了HRQL和基于偏好的得分（R²值范围为0.22至0.57）。
GAD患者报告的焦虑症状对HRQL和功能结局造成了显著损害。
