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共病的身体健康状况和焦虑障碍:老年人中基于人群的患病率和健康结果的探索。

Comorbid physical health conditions and anxiety disorders: a population-based exploration of prevalence and health outcomes among older adults.

机构信息

Department of Psychology, University of Manitoba, Winnipeg, MB Canada.

出版信息

Gen Hosp Psychiatry. 2011 Nov-Dec;33(6):556-64. doi: 10.1016/j.genhosppsych.2011.07.005. Epub 2011 Sep 9.

DOI:10.1016/j.genhosppsych.2011.07.005
PMID:21908055
Abstract

OBJECTIVE

The primary objectives of this study were to examine the likelihood of anxiety disorders among respondents with common physical health conditions and to explore the associations between this comorbidity and older adults' perceived mental and physical health.

METHOD

The sample consisted of older adults from the Canadian Community Health Survey 1.2 (n=12,792). Trained lay interviewers assessed psychiatric disorders based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Physical health conditions were based on self-reported diagnoses by health professionals. Multiple logistic regressions examined whether suffering from a physical health condition increased the odds of any assessed anxiety disorder (panic, agoraphobia, social phobia and posttraumatic stress disorder). Multiple linear regressions examined associations between self-rated health and comorbid physical health conditions and anxiety.

RESULTS

After adjusting for confounding variables, the presence of chronically painful conditions (i.e., arthritis, back pain and migraine) and of other commonly occurring diseases (i.e., allergies, cataracts and gastrointestinal, lung and heart disease) were positively associated with anxiety. The comorbidity of anxiety with allergies, cataracts, arthritis and lung disease resulted in poorer self-rated physical and/or mental health after adjusting for confounding variables.

CONCLUSION

Health problems in older adults are associated with increased odds of anxiety, and this comorbidity is associated with poorer self-reported health than medical problems or anxiety alone. These findings have important clinical implications for health professionals.

摘要

目的

本研究的主要目的是调查患有常见身体健康问题的受访者出现焦虑障碍的可能性,并探讨这种共病与老年人感知到的身心健康之间的关系。

方法

该样本由加拿大社区健康调查 1.2 中的老年人组成(n=12792)。经过培训的非专业调查员根据《精神障碍诊断与统计手册》第四版的标准评估精神障碍。身体健康状况基于健康专业人员的自我报告诊断。多因素逻辑回归检验了患有身体健康状况是否会增加任何评估的焦虑障碍(恐慌症、广场恐惧症、社交恐惧症和创伤后应激障碍)的几率。多元线性回归检验了自我报告的健康状况与共病的身体健康状况和焦虑之间的关联。

结果

在调整了混杂变量后,慢性疼痛状况(如关节炎、背痛和偏头痛)和其他常见疾病(如过敏、白内障和胃肠道、肺部和心脏病)与焦虑呈正相关。在调整了混杂变量后,焦虑与过敏、白内障、关节炎和肺病共病会导致自我报告的身体和/或心理健康状况更差。

结论

老年人的健康问题与焦虑的几率增加有关,这种共病与自我报告的健康状况比医疗问题或单独的焦虑更差有关。这些发现对卫生专业人员具有重要的临床意义。

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