Rhebergen D, van der Steenstraten I M, Sunderland M, de Graaf R, Ten Have M, Lamers F, Penninx B W J H, Andrews G
Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands.
Clinical Research Unit for Anxiety and Depression (CRUfAD), University of New South Wales, Sydney, NSW, Australia.
Psychol Med. 2014 Jun;44(8):1701-12. doi: 10.1017/S0033291713002225. Epub 2013 Sep 11.
The nosological status of generalized anxiety disorder (GAD) versus dysthymic disorder (DD) has been questioned. The aim of this study was to examine qualitative differences within (co-morbid) GAD and DD symptomatology.
Latent class analysis was applied to anxious and depressive symptomatology of respondents from three population-based studies (2007 Australian National Survey of Mental Health and Wellbeing; National Comorbidity Survey Replication; and Netherlands Mental Health Survey and Incidence Study-2; together known as the Triple study) and respondents from a multi-site naturalistic cohort [Netherlands Study of Depression and Anxiety (NESDA)]. Sociodemographics and clinical characteristics of each class were examined.
A three-class (Triple study) and two-class (NESDA) model best fitted the data, reflecting mainly different levels of severity of symptoms. In the Triple study, no division into a predominantly GAD or DD co-morbidity subtype emerged. Likewise, in spite of the presence of pure GAD and DD cases in the NESDA sample, latent class analysis did not identify specific anxiety or depressive profiles in the NESDA study. Next, sociodemographics and clinical characteristics of each class were examined. Classes only differed in levels of severity.
The absence of qualitative differences in anxious or depressive symptomatology in empirically derived classes questions the differentiation between GAD and DD.
广泛性焦虑障碍（GAD）与恶劣心境障碍（DD）的疾病分类地位一直受到质疑。本研究的目的是检验（共病的）GAD和DD症状学中的质性差异。
对来自三项基于人群的研究（2007年澳大利亚全国心理健康与幸福调查、全国共病调查复制版以及荷兰心理健康调查与发病率研究-2，统称为“三项研究”）的受访者以及来自一个多地点自然主义队列[荷兰抑郁与焦虑研究（NESDA）]的受访者的焦虑和抑郁症状进行潜在类别分析。对每个类别的社会人口统计学和临床特征进行了检查。
一个三类（三项研究）和两类（NESDA）模型最符合数据，主要反映了症状严重程度的不同水平。在三项研究中，未出现主要分为GAD或DD共病亚型的情况。同样，尽管NESDA样本中存在单纯的GAD和DD病例，但潜在类别分析在NESDA研究中未识别出特定的焦虑或抑郁特征。接下来，对每个类别的社会人口统计学和临床特征进行了检查。类别仅在严重程度水平上有所不同。
在通过实证得出的类别中，焦虑或抑郁症状学不存在质性差异，这对GAD和DD之间的区分提出了质疑。
