Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China.
Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science &Technology, GongNongBin Road 125#, Wuhan, 430012, China.
Sci Rep. 2017 Jan 18;7:40511. doi: 10.1038/srep40511.
The comorbidity of major depressive disorder (MDD) and generalized anxiety disorder (GAD) is common and often predicts poorer outcomes than either disorder alone. This study aimed to examine the prevalence of comorbid GAD and its association with quality of life (QOL) among MDD patients. A total of 1225 psychiatric outpatients were screened using the Hospital Anxiety and Depression Scale (HADS). Those who scored ≥8 on the HADS were interviewed using DSM-IV criteria by two senior psychiatrists. Patients diagnosed with MDD were further assessed using the 9-item Patient Health Questionnaire, Social Support Rating Scale, Pittsburgh Sleep Quality Index, and World Health Organization QOL Scale, brief version (WHOQOL-BREF). Ultimately, 667 patients were diagnosed with MDD, of 71.7% of whom had GAD. Compared to those with MDD alone, comorbid patients had lower scores on the physical (38.64 ± 10.35 vs.36.54 ± 12.32, P = 0.026) and psychological (35.54 ± 12.98 vs. 30.61 ± 14.66, P < 0.001) domains of the WHOQOL-BREF. The association between comorbid GAD and poor QOL on the two domains remained statistically significant in the multiple linear regression (unstandardized coefficients: -1.97 and -4.65, P < 0.001). In conclusion, the prevalence of comorbid GAD in MDD patients is high, and co-occurring GAD may exacerbate impaired physical and psychological QOL in Chinese MDD patients.
共病性重性抑郁障碍（MDD）和广泛性焦虑障碍（GAD）很常见，且往往比单独存在的障碍预测预后更差。本研究旨在研究共病性 GAD 的患病率及其与 MDD 患者生活质量（QOL）的关系。对 1225 名精神科门诊患者使用医院焦虑抑郁量表（HADS）进行筛查。HADS 评分≥8 的患者由两名资深精神科医生根据 DSM-IV 标准进行访谈。诊断为 MDD 的患者进一步使用 9 项患者健康问卷、社会支持评定量表、匹兹堡睡眠质量指数和世界卫生组织生活质量量表（WHOQOL-BREF）进行评估。最终，有 667 名患者被诊断为 MDD，其中 71.7%的患者合并 GAD。与单纯 MDD 患者相比，共病患者在 WHOQOL-BREF 的身体（38.64±10.35 与 36.54±12.32，P=0.026）和心理（35.54±12.98 与 30.61±14.66，P<0.001）领域的评分较低。在多线性回归中，共病 GAD 与 QOL 两个领域的较差状况之间的关联仍具有统计学意义（未标准化系数：-1.97 和-4.65，P<0.001）。总之，MDD 患者共病 GAD 的患病率较高，共病 GAD 可能会使中国 MDD 患者的身体和心理 QOL 受损恶化。
