Lawrence Amy E, Brown Timothy A
Center for Anxiety and Related Disorders, Boston University, Boston, MA 02215, USA.
J Nerv Ment Dis. 2009 Dec;197(12):879-86. doi: 10.1097/NMD.0b013e3181c29992.
The diagnostic criteria for generalized anxiety disorder (GAD) have elicited numerous criticisms and suggestions for revision. Several researchers have noted that many patients fail to meet full criteria for the disorder, but nevertheless experience clinically significant symptoms. These "subsyndromal" cases are labeled anxiety disorder not otherwise specified (AnxNOS) under the current diagnostic system. The purpose of the this study was to determine the diagnostic criteria most often "missed" in cases that resemble GAD, but do not meet full criteria for the diagnosis. Individuals diagnosed with AnxNOS (n = 146) were compared with those diagnosed with GAD (n = 146) and other anxiety disorders (n = 146) on self-report measures, clinician ratings, and rates of comorbidity. Although individuals with AnxNOS reported clinically significant symptoms, they reported less worry, negative affect, depression, and comorbidity than individuals diagnosed with GAD. Findings are discussed with regard to their implications for revisions to the diagnostic criteria for GAD.
广泛性焦虑症(GAD)的诊断标准引发了众多批评和修订建议。几位研究人员指出,许多患者未完全符合该疾病的标准,但仍经历临床上显著的症状。在当前诊断系统下,这些“亚综合征”病例被标记为未另行规定的焦虑症(AnxNOS)。本研究的目的是确定在类似GAD但未达到完整诊断标准的病例中最常“遗漏”的诊断标准。将被诊断为AnxNOS的个体(n = 146)与被诊断为GAD的个体(n = 146)以及其他焦虑症患者(n = 146)在自我报告测量、临床医生评分和共病率方面进行比较。尽管患有AnxNOS的个体报告了临床上显著的症状,但与被诊断为GAD的个体相比,他们报告的担忧、消极情绪、抑郁和共病情况较少。讨论了这些发现对GAD诊断标准修订的影响。