Department of Psychology, University of Florence, Florence, Italy.
Compr Psychiatry. 2012 Nov;53(8):1056-62. doi: 10.1016/j.comppsych.2012.04.002. Epub 2012 May 11.
The main aim of the present research was to evaluate the coherence of generalized anxiety disorder (GAD) psychopathological pattern, the robustness of its diagnostic criteria, and the clinical utility of considering this disorder as a discrete condition rather than assigning it a dimensional value.
The study was designed in a purely naturalistic setting and carried out using a community sample; data from the Sesto Fiorentino Study were reanalyzed.
Of the 105 subjects who satisfied the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for the diagnosis of GAD, only 18 (17.1%) had no other comorbid DSM-IV disorder. The most frequent comorbid condition was major depressive disorder (70.4 %). Only 2 of the GAD diagnostic symptoms (excessive worry and muscle tension) showed a specific association with the diagnosis itself, whereas the others, such as feeling wound up, tense, or restless, concentration problems, and fatigue, were found to be more prevalent in major depressive disorder than in GAD.
Our study demonstrates that GAD, as defined by DSM-IV criteria, shows a substantial overlap with other DSM-IV diagnoses (especially with mood disorders) in the general population. Furthermore, GAD symptoms are frequent in all other disorders included in the mood/anxiety spectrum. Finally, none of the GAD symptoms, apart from muscle tension, distinguished GAD from patients without GAD.
本研究的主要目的是评估广泛性焦虑障碍（GAD）病理模式的连贯性，其诊断标准的稳健性，以及将该障碍视为离散病症而不是赋予其维度值的临床实用性。
该研究在纯粹的自然主义环境中设计，并使用社区样本进行；重新分析了塞斯托-菲奥伦蒂诺研究的数据。
在满足《精神障碍诊断与统计手册》第四版（DSM-IV）广泛性焦虑障碍诊断标准的 105 名受试者中，只有 18 名（17.1%）没有其他共病 DSM-IV 障碍。最常见的共病情况是重性抑郁障碍（70.4%）。仅有 2 个 GAD 诊断症状（过度担忧和肌肉紧张）与诊断本身有特定关联，而其他症状，如紧张、烦躁不安、注意力问题和疲劳，在重性抑郁障碍中比在 GAD 中更为普遍。
我们的研究表明，DSM-IV 标准定义的 GAD 在普通人群中与其他 DSM-IV 诊断（尤其是心境障碍）有很大的重叠。此外，GAD 症状在心境/焦虑谱中包含的所有其他障碍中都很常见。最后，除了肌肉紧张之外，GAD 的任何症状都不能将 GAD 与没有 GAD 的患者区分开来。
