Simon Naomi M
Massachusetts General Hospital, Center for Anxiety and Traumatic Stress Disorders, Department of Psychiatry, Simches 2200, 185 Cambridge St, Boston, MA 02114, USA.
J Clin Psychiatry. 2009;70 Suppl 2:10-4. doi: 10.4088/jcp.s.7002.02.
Generalized anxiety disorder (GAD) has a high rate of comorbidity with other psychiatric disorders, including major depressive disorder (MDD), bipolar disorder, other anxiety disorders, and substance use disorders. The similarities between GAD and MDD have led some to suggest that GAD should be reclassified as a mood disorder. The concurrence of GAD with another disorder heightens a patient's risk for impairment, disability, and suicidality. Clinical trials for GAD and disorders that are most likely to occur with GAD have generally not taken comorbidity into account, and there is a paucity of data guiding how comorbidity should inform treatment selection. Research into the biology and psychopathology underlying the high rate of comorbidity of GAD and into efficacious interventions for GAD with comorbidity is needed.
广泛性焦虑障碍(GAD)与其他精神障碍共病率很高,包括重度抑郁症(MDD)、双相情感障碍、其他焦虑障碍和物质使用障碍。GAD与MDD之间的相似性致使一些人提出应将GAD重新归类为心境障碍。GAD与另一种障碍同时存在会增加患者出现功能损害、残疾和自杀行为的风险。针对GAD以及最有可能与GAD同时出现的障碍的临床试验通常未考虑共病情况,而且缺乏指导共病如何影响治疗选择的数据。需要对GAD高共病率背后的生物学和精神病理学以及针对共病GAD的有效干预措施进行研究。