McLean Hospital, Belmont, MA, USA.
Psychopathology. 2013;46(3):176-85. doi: 10.1159/000339556. Epub 2012 Aug 16.
Reported rates of comorbid anxiety disorders in psychotic and mood disorders vary widely among studies.
We used the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, to examine rates of comorbid anxiety disorders in patients with schizoaffective disorder (SZA; n = 153), bipolar I disorder (BP; n = 304) and schizophrenia (SZ; n = 174).
The rates of anxiety disorders in participants with SZA (30.1%), BP (22.4%) and SZ (16.7%) differed significantly [χ²(2) = 8.368, p = 0.015]. Among anxiety disorders, this effect was most pronounced for panic disorder (PD). PD rates were significantly higher in participants with SZA (15.7%) as compared to participants with BP (6.9%) and SZ [6.9%; χ²(2) = 10.879, p = 0.004]. Logistic regression models controlling for demographic and clinical characteristics confirmed that primary diagnosis (SZA, BP or SZ) was a significant predictor of PD comorbidity and approached significance in predicting the comorbidity of any anxiety disorder.
Our findings suggest that patients with SZA have high rates of anxiety disorders. Clinicians treating patients with SZA should evaluate for anxiety disorder comorbidity, especially as anxiety symptoms may not be reported at first presentation.
在精神病学和心境障碍中,焦虑障碍共病的报告率在不同的研究中差异很大。
我们使用精神障碍诊断与统计手册第四版的结构临床访谈,来检查精神分裂情感障碍(SZA;n=153)、双相情感障碍 I 型(BP;n=304)和精神分裂症(SZ;n=174)患者的焦虑障碍共病率。
SZA(30.1%)、BP(22.4%)和 SZ(16.7%)患者中焦虑障碍的发生率差异有统计学意义[χ²(2)=8.368,p=0.015]。在焦虑障碍中,惊恐障碍(PD)的这种影响最为显著。与 BP(6.9%)和 SZ 相比,SZA 患者中 PD 的发生率明显更高(15.7%;χ²(2)=10.879,p=0.004)。控制人口统计学和临床特征的逻辑回归模型证实,主要诊断(SZA、BP 或 SZ)是 PD 共病的显著预测因素,在预测任何焦虑障碍的共病方面也接近显著。
我们的研究结果表明,SZA 患者焦虑障碍的发生率很高。治疗 SZA 患者的临床医生应评估焦虑障碍的共病情况,特别是因为焦虑症状在首次就诊时可能不会被报告。