Karpov B, Joffe G, Aaltonen K, Suvisaari J, Baryshnikov I, Näätänen P, Koivisto M, Melartin T, Oksanen J, Suominen K, Heikkinen M, Paunio T, Isometsä E
Department of Psychiatry, University of Helsinki, Helsinki University Hospital, PO Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland.
Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271 Helsinki, Finland.
Eur Psychiatry. 2016 Sep;37:1-7. doi: 10.1016/j.eurpsy.2016.04.007. Epub 2016 Jul 21.
Comorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear.
The Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n=113), bipolar disorder (BD, n=99), or depressive disorder (DD, n=188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups.
Frequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P=0.010) and less often avoided anxiety-provoking situations (P=0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders.
Comorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis.
许多精神疾病中都存在共病性焦虑症状和障碍，但方法学上的差异使得对其频率和强度进行比较变得困难。此外，情绪障碍和精神分裂症谱系障碍患者中共病性焦虑症状的危险因素是否相似仍不清楚。
在赫尔辛基大学精神病学联盟研究中，使用总体焦虑严重程度和损害量表（OASIS）来测量患有精神分裂症或分裂情感性障碍（SSA，n = 113）、双相情感障碍（BD，n = 99）或抑郁症（DD，n = 188）的精神科护理患者的焦虑症状。采用双变量相关性分析和多元线性回归模型，研究三个诊断组中抑郁症状、神经质、早期心理创伤和痛苦、自我效能感、边缘型人格障碍症状以及依恋风格与焦虑症状之间的关联。
40.2%的SSA患者、51.5%的BD患者和55.6%的DD患者报告有频繁或持续的焦虑；这些患者中分别有43.8%、41.4%和41.2%将其描述为严重或极其严重。与其他患者相比，SSA患者的焦虑程度明显较低（P = 0.010），且较少回避引发焦虑的情境（P = 0.009）。在回归分析中，所有患者的OASIS得分均与高神经质、抑郁症状和边缘型人格障碍症状以及低自我效能感相关，而在情绪障碍患者中，OASIS得分与早期创伤相关。
共病性焦虑症状在患有情绪或精神分裂症谱系障碍的精神科患者中普遍存在，且据报道几乎一半患者的症状严重。无论主要诊断如何，焦虑症状似乎都与同时存在的抑郁症状和人格特征密切相关。
