Culpepper Larry
Boston Medical Center, 1 Boston Medical Center Place, Dowling 5, Boston, MA 02118, USA.
J Clin Psychiatry. 2009;70 Suppl 2:20-4. doi: 10.4088/jcp.s.7002.04.
Patients with generalized anxiety disorder (GAD) often have multiple medical comorbidities. The adrenal system and genetic and environmental factors are intermediaries between anxiety and medical illnesses such as chronic pain conditions and gastrointestinal, cardiovascular, endocrine, and respiratory disorders. Medical disorders associated with anxiety include migraine, rheumatoid arthritis, peptic ulcer disease, irritable bowel syndrome, coronary heart disease, hyperthyroidism, diabetes, asthma, and chronic obstructive pulmonary disorder. Compared to people with pain conditions without GAD, individuals with pain conditions and GAD experience and register pain differently; they also have increased awareness of symptoms. Comorbid medical illnesses may influence treatment choice for GAD. Treatment of anxiety in young patients with GAD needs to be long-term to decrease vulnerability to medical conditions.
广泛性焦虑症（GAD）患者通常有多种合并症。肾上腺系统以及遗传和环境因素是焦虑与慢性疼痛、胃肠道、心血管、内分泌和呼吸系统疾病等内科疾病之间的中介因素。与焦虑相关的内科疾病包括偏头痛、类风湿性关节炎、消化性溃疡病、肠易激综合征、冠心病、甲状腺功能亢进、糖尿病、哮喘和慢性阻塞性肺疾病。与无GAD的疼痛患者相比，患有疼痛疾病和GAD的个体对疼痛的体验和感受不同；他们对症状的意识也更强。合并内科疾病可能会影响GAD的治疗选择。对患有GAD的年轻患者进行焦虑治疗需要长期进行，以降低患内科疾病的易感性。
