Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins, Iowa City, IA 52242, USA.
Br J Psychiatry. 2012 Mar;200(3):210-5. doi: 10.1192/bjp.bp.110.081992. Epub 2011 Oct 7.
It is well established that the presence of prominent anxiety within depressive episodes portends poorer outcomes. Important questions remain as to which anxiety features are important to outcome and how sustained their prognostic effects are over time.
To examine the relative prognostic importance of specific anxiety features and to determine whether their effects persist over decades and apply to both unipolar and bipolar conditions.
Participants with unipolar (n = 476) or bipolar (n = 335) depressive disorders were intensively followed for a mean of 16.7 years (s.d. = 8.5).
The number and severity of anxiety symptoms, but not the presence of pre-existing anxiety disorders, showed a robust and continuous relationship to the subsequent time spent in depressive episodes in both unipolar and bipolar depressive disorder. The strength of this relationship changed little over five successive 5-year periods.
The severity of current anxiety symptoms within depressive episodes correlates strongly with the persistence of subsequent depressive symptoms and this relationship is stable over decades.
在抑郁发作期间出现明显焦虑的情况下，预后较差，这一点已得到充分证实。但仍有重要问题需要解决，即哪些焦虑特征对预后很重要，以及它们的预后效应随时间推移能持续多久。
探讨特定焦虑特征的相对预后重要性，并确定其效应是否能持续数十年，适用于单相和双相障碍。
对 476 例单相和 335 例双相抑郁障碍患者进行了平均 16.7 年（标准差=8.5）的强化随访。
在单相和双相抑郁障碍中，焦虑症状的数量和严重程度与随后抑郁发作的时间呈强而连续的关系，但先前存在的焦虑障碍则没有。这种关系在五个连续的 5 年期间变化不大。
抑郁发作时当前焦虑症状的严重程度与随后抑郁症状的持续存在密切相关，这种关系在数十年内是稳定的。
