多发性硬化症患者共病焦虑障碍及抑郁治疗。
Comorbid anxiety disorders and treatment of depression in people with multiple sclerosis.
机构信息
Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1220, Chicago, IL 60611, USA.
出版信息
Rehabil Psychol. 2010 Aug;55(3):255-62. doi: 10.1037/a0020492.
OBJECTIVE
Anxiety is highly comorbid with depression, but little is known about the impact of anxiety disorders on the effectiveness of empirically supported psychotherapies for depression. We examined such outcomes for people with Multiple Sclerosis (MS) and depression, with versus without comorbid anxiety disorders.
DESIGN
Participants with MS (N = 102) received 16 weeks of telephone-administered psychotherapy for depression and were followed for one year post-treatment.
RESULTS
Participants with comorbid anxiety disorders improved to a similar degree during treatment as those without anxiety disorders. Outcomes during follow-up were mixed, and thus we divided the anxiety diagnoses into distress and fear disorders. The distress disorder (GAD) was associated with elevated anxiety symptoms during and after treatment. In contrast, fear disorders (i.e., panic disorder, agoraphobia, social phobia, specific phobia) were linked to depression, specifically during follow-up, across 3 different measures.
CONCLUSIONS
People with GAD receiving treatment for depression may benefit from additional services targeting anxiety more specifically, while those with comorbid fear disorders may benefit from services targeting maintenance of gains after treatment.
目的
焦虑与抑郁高度共病，但对于焦虑障碍对抑郁的循证心理治疗的效果的影响知之甚少。我们研究了多发性硬化症（MS）患者伴或不伴共病焦虑障碍的抑郁患者的治疗效果。
设计
102 名 MS 患者接受了 16 周的电话管理的抑郁心理治疗，并在治疗后随访一年。
结果
伴有共病焦虑障碍的患者在治疗期间与无焦虑障碍的患者改善程度相似。随访期间的结果喜忧参半，因此我们将焦虑诊断分为困扰和恐惧障碍。困扰障碍（广泛性焦虑障碍）与治疗期间和治疗后的焦虑症状升高有关。相比之下，恐惧障碍（即惊恐障碍、广场恐怖症、社交恐怖症、特定恐惧症）与抑郁有关，在 3 种不同的测量方法中，都与随访期间的抑郁有关。
结论
接受抑郁治疗的广泛性焦虑障碍患者可能需要额外的更有针对性的焦虑治疗服务，而伴有共病恐惧障碍的患者可能需要在治疗后保持疗效的服务。
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