Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Institut de recherche de l'Hôpital Montfort (IRHM), C.T. Lamont Primary Health Care Research Centre, Ottawa, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2017 Feb;37(2):54-62. doi: 10.24095/hpcdp.37.2.04.
Although generalized anxiety disorder (GAD) is common and disabling, there are few Canadian studies on this mental illness. We compared the characteristics, health status, health services use and health care needs of Canadians with GAD to those with depression.
Data are from the 2012 Canadian Community Health Survey-Mental Health, which surveyed a nationally representative sample of Canadians aged 15 years and older (n = 23 709; response rate of 68.9%). The respondents we studied had selfreported symptoms compatible with GAD and/or major depressive episode (MDE) in the preceding 12 months (n = 1598). Estimates were weighted to represent the Canadian household population. We performed descriptive and multinomial multivariate logistic regression analyses.
In 2012, an estimated 700 000 (2.5%) Canadians aged 15 years and older reported symptoms compatible with GAD in the previous 12 months. MDE symptoms co-occurred in 50% of these individuals. Those with GAD only reported fair/poor perceived health (29.7%), moderate to severe psychological distress (81.2%) and moderate to severe disability (28.1%) comparable to (or even slightly worse) than those with MDE only (24.7%, 78.8% and 24.8% respectively). Those with comorbid GAD and MDE demonstrated the worst health outcomes; 47.3% of them reported fair/poor perceived health, 94.0% reported moderate to severe psychological distress and 52.4% reported moderate to severe disability. Nearly 50% of those with comorbid GAD and MDE reported that their need for health care was not met or only partially met, compared to about 30% of those with GAD or MDE only.
While GAD is associated with levels of distress and disability comparable to (or slightly worse) than those affected by MDE only, the health status of those with comorbid disease is significantly worse than those with GAD or MDE only. Improved diagnosis, screening for comorbidity and management are essential to minimize the impacts of this mental illness.
尽管广泛性焦虑障碍（GAD）较为常见且会导致残疾，但加拿大针对这种精神疾病的研究较少。我们将患有 GAD 的加拿大人与患有抑郁症的人进行了比较，以了解他们的特征、健康状况、卫生服务利用情况和医疗保健需求。
数据来自 2012 年加拿大社区健康调查-心理健康，该调查对全国范围内年龄在 15 岁及以上的有代表性的加拿大人样本（n=23709；回应率为 68.9%）进行了调查。我们研究的受访者在过去 12 个月内自我报告有与广泛性焦虑障碍和/或重性抑郁发作（MDE）相符的症状（n=1598）。估计数经过加权处理，以代表加拿大的家庭人口。我们进行了描述性和多元多变量逻辑回归分析。
2012 年，估计有 700000（2.5%）名年龄在 15 岁及以上的加拿大成年人在过去 12 个月内报告有与 GAD 相符的症状。这些人中 50%同时出现 MDE 症状。仅患有 GAD 的人报告的健康状况较差（29.7%）、中度至重度心理困扰（81.2%）和中度至重度残疾（28.1%）与仅患有 MDE 的人相似（或稍差）（分别为 24.7%、78.8%和 24.8%）。同时患有 GAD 和 MDE 的人表现出最差的健康结果；他们中有 47.3%的人报告健康状况较差，94.0%的人报告中度至重度心理困扰，52.4%的人报告中度至重度残疾。近 50%的同时患有 GAD 和 MDE 的人报告他们的医疗需求未得到满足或仅部分得到满足，而仅患有 GAD 或 MDE 的人约有 30%报告他们的医疗需求未得到满足或仅部分得到满足。
尽管 GAD 与仅患有 MDE 的人相比，其痛苦和残疾程度相当（或稍差），但同时患有该病的人的健康状况明显差于仅患有 GAD 或 MDE 的人。改善诊断、共病筛查和管理对于尽量减少这种精神疾病的影响至关重要。
