Hecht H, von Zerssen D, Wittchen H U
Max Planck Institute of Psychiatry, München, F.R.G.
J Affect Disord. 1990 Feb;18(2):137-44. doi: 10.1016/0165-0327(90)90070-o.
The main aim of the present study was to examine whether the well-established association between depression and social dysfunction still remains when effects of a coexistent anxiety disorder are eliminated from the data. As these effects strongly depend on the proportion of depressed subjects suffering simultaneously from an anxiety disorder, we first examined the frequency of mixed and pure depressive disorders and that of pure anxiety disorders (control subjects) in a community sample (n = 483). Using DIS/DSM-III criteria (reference period 6 months), pure anxiety disorders were most frequent (6%), followed by pure depressive disorders (3%) and the coexistence of anxiety and depression (2%). Cases suffering from both disorders were most severely afflicted in terms of psychopathology (persistence of symptoms, comorbidity regarding other mental disorders). At the diagnostic level, the association between depression and social dysfunction was only slightly influenced by effects resulting from comorbidity; at the level of actual symptoms, however, we found that cases suffering simultaneously from severe depression and severe anxiety were significantly more handicapped in their social lives than depressive subjects with only mild anxiety symptoms.
本研究的主要目的是检验，当数据中排除共病焦虑症的影响后，抑郁症与社会功能障碍之间已被充分证实的关联是否依然存在。由于这些影响在很大程度上取决于同时患有焦虑症的抑郁症患者的比例，我们首先在一个社区样本（n = 483）中考察了混合性和单纯性抑郁症以及单纯性焦虑症（对照对象）的发生频率。采用DIS/DSM-III标准（参考期6个月），单纯性焦虑症最为常见（6%），其次是单纯性抑郁症（3%）以及焦虑症与抑郁症并存的情况（2%）。同时患有这两种疾病的患者在精神病理学方面（症状持续、其他精神障碍的共病情况）受影响最为严重。在诊断层面，抑郁症与社会功能障碍之间的关联仅略微受到共病影响；然而，在实际症状层面，我们发现同时患有重度抑郁症和重度焦虑症的患者在社会生活中的障碍明显大于仅伴有轻度焦虑症状的抑郁症患者。
