Vesga-López Oriana, Schneier Franklin R, Wang Samuel, Heimberg Richard G, Liu Shang-Min, Hasin Deborah S, Blanco Carlos
Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, 1051 Riverside Dr., New York, NY 10032, USA.
J Clin Psychiatry. 2008 Oct;69(10):1606-16. Epub 2008 Sep 23.
To assess gender differences in the epidemiology, comorbidity, and treatment-seeking patterns of DSM-IV generalized anxiety disorder (GAD) in the United States.
Data were derived from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population.
The lifetime and 12-month male:female prevalence ratios of DSM-IV GAD were 1:1.9 and 1:2.2, respectively. Men with GAD had significantly higher rates of comorbid alcohol and drug use disorders, nicotine dependence, and antisocial personality disorder. Women with GAD had significantly higher rates of comorbid mood disorders (except bipolar disorder) and anxiety disorders (except social anxiety disorder). Men with GAD reported greater use of alcohol and drugs to help relieve GAD symptoms. GAD in women was associated with higher rates of family history of depression. Disability associated with GAD was greater in women than in men. Rates of treatment seeking for DSM-IV GAD were low for both genders, but particularly low among men.
There are significant gender differences in the prevalence, comorbidity pattern, sociodemographic and clinical correlates, course, and treatment-seeking rates of persons with DSM-IV GAD. Increased recognition and treatment of GAD, particularly among men, could lead to substantial reductions in the societal and personal burden and improve the quality of life of those afflicted with this disorder.
评估美国精神疾病诊断与统计手册第四版(DSM-IV)中广泛性焦虑症(GAD)在流行病学、共病情况及寻求治疗模式方面的性别差异。
数据来源于2001 - 2002年全国酒精及相关疾病流行病学调查,这是一项对美国人口代表性样本(N = 43,093)进行的大型横断面调查。
DSM-IV GAD的终生患病率及12个月患病率的男女比例分别为1:1.9和1:2.2。患有GAD的男性共病酒精和药物使用障碍、尼古丁依赖及反社会人格障碍的发生率显著更高。患有GAD的女性共病情绪障碍(双相情感障碍除外)和焦虑障碍(社交焦虑障碍除外)的发生率显著更高。患有GAD的男性报告更多地使用酒精和药物来帮助缓解GAD症状。女性GAD与抑郁症家族史的较高发生率相关。与GAD相关的残疾在女性中比在男性中更严重。DSM-IV GAD的男女寻求治疗率都较低,但男性尤其低。
在DSM-IV GAD患者的患病率、共病模式、社会人口统计学及临床相关因素、病程及寻求治疗率方面存在显著的性别差异。提高对GAD的认识和治疗,特别是在男性中,可能会大幅减轻社会和个人负担,并改善患有这种疾病者的生活质量。