Boston University, Boston, MA 02215, USA.
Behav Ther. 2010 Sep;41(3):296-305. doi: 10.1016/j.beth.2009.09.002. Epub 2010 Feb 1.
This study examined the impact of comorbidity on treatment outcome and the effects of cognitive behavioral therapy (CBT) for anxiety and depressive disorders on comorbid disorders in a naturalistic sample of 150 patients presenting to an anxiety disorders clinic. The following results were observed across principal (i.e., most severe) diagnoses. Patients with comorbid anxiety and depressive disorders presented for treatment with higher severity of their principal disorder than patients without comorbidity. However, the presence of comorbidity did not predict dropout or poor treatment response, and patients demonstrated significant improvement in their principal disorders regardless of comorbidity. The frequency of clinically severe and subclinical (i.e., not severe enough to meet diagnostic criteria) comorbid conditions decreased significantly over the course of treatment. The implication of these findings for the classification and treatment of emotional disorders is discussed.
本研究考察了共病对治疗结果的影响，以及认知行为疗法（CBT）对焦虑和抑郁障碍共病障碍的影响，研究对象为 150 名就诊于焦虑障碍诊所的患者。在主要（即最严重）诊断中观察到以下结果。与无共病的患者相比，患有焦虑和抑郁共病障碍的患者就诊时其主要障碍的严重程度更高。然而，共病的存在并不预示着脱落或治疗反应不佳，并且无论是否存在共病，患者的主要障碍都有显著改善。治疗过程中，临床严重程度和亚临床（即严重程度不足以达到诊断标准）共病情况的频率显著降低。这些发现对情绪障碍的分类和治疗的影响将进行讨论。
