Katschnig H, Nutzinger D O, Nouzak A, Schanda H, David H
Psychiatrische Universitätsklinik, Wien.
Psychiatr Prax. 1990 Jul;17(4):136-43.
Psychopathological analysis of the patterns of symptoms in 176 depressive in-patients disclosed in 73.3% of all patients the presence of anxiety symptoms: of these, 38.6% merely had diffuse anxiety, whereas 34.7% showed either additionally or alone specific anxiety symptoms such as phobias and panic attacks. Similar to the results obtained by dividing the patients into an "endogenous" and "neurotic" group, namely, that there was no difference between the subtypes in respect of triggering the depressive episodes by life events, or in respect of the suicide rate 30 months after discharge and in respect of a chronic course developing during the 2 years following the discharge, there was likewise no difference with regard to these criteria if the patients were subdivided into depressive patients without anxiety and those with anxiety symptoms. However, a subdivision of the depressive patients with anxiety symptoms into a group having only free-floating anxiety and a group with specific anxiety symptoms, resulted in a clear association with these criteria: If a phobia or panic attacks were present, triggering by life events was far more frequent than if there was only free-floating was more often chronic in the first group, but there was no difference in suicidality. The results indicate that it will be necessary to provide for a more differentiated classification of anxiety symptoms before deciding in clinical routine what steps to take wherever depression and anxiety symptoms are present side by side. The same applies to treatment studies.
对176名抑郁住院患者的症状模式进行的精神病理学分析显示,73.3%的患者存在焦虑症状:其中,38.6%仅有弥漫性焦虑,而34.7%还存在或仅存在特定焦虑症状,如恐惧症和惊恐发作。与将患者分为“内源性”和“神经症性”组所获得的结果相似,即各亚型在生活事件引发抑郁发作方面、出院30个月后的自杀率以及出院后2年内出现慢性病程方面没有差异,如果将患者细分为无焦虑的抑郁患者和有焦虑症状的抑郁患者,在这些标准方面同样没有差异。然而,将有焦虑症状的抑郁患者细分为仅有自由浮动焦虑的组和有特定焦虑症状的组,结果与这些标准有明显关联:如果存在恐惧症或惊恐发作,生活事件引发的情况远比仅有自由浮动焦虑时更频繁;第一组慢性病程更常见,但自杀倾向没有差异。结果表明,在临床常规中决定对同时存在抑郁和焦虑症状的患者采取何种措施之前,有必要对焦虑症状进行更细致的分类。这同样适用于治疗研究。