Maneeton Narong, Suttajit Sirijit, Maneeton Benchalak, Likhitsathian Surinporn, Eurviyanukul Kanokkwan, Udomratn Pichet, Chan Edwin Shih-Yen, Si Tian-Mei, Sulaiman Ahmad Hatim, Chen Chia-Hui, Bautista Dianne, Srisurapanont Manit
a Department of Psychiatry, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand.
b Department of Psychiatry, Faculty of Medicine , Prince of Songkla University , Songkhla , Thailand.
Nord J Psychiatry. 2017 Oct;71(7):503-508. doi: 10.1080/08039488.2017.1335344. Epub 2017 Jun 20.
Anxious distress in major depressive disorder (MDD) is common and associated with poor outcomes and management difficulties.
This post hoc analysis aimed to examine the socio-demographic and clinical correlates of anxiety distress in Asian outpatients with MDD.
Instead of two out of five specifiers defined by the Diagnostic and Statistical Manual Version-5, anxious distress defined in this study was operationalized as the presence of at least two out of four proxy items drawn from the 90-item Symptom Checklist, Revised (SCL-90-R). Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale, the Sheehan Disability Scale and the Multidimensional Scale of Perceived Social Support.
The data of 496 patients with MDD were included. Anxious distress was found in 371 participants (74.8%). The binary logistic regression analysis found that anxious distress was independently and significantly correlated with working status, higher MADRS scores, severe insomnia and functional impairment.
Three-fourths of Asian patients with MDD in tertiary care settings may have DSM-5 anxious distress of at least moderate distress. Its prevalence may vary among working groups. The specifier was associated with greater depressive symptom severity, severe insomnia and functional impairment.
重度抑郁症(MDD)中的焦虑性痛苦很常见,且与不良预后和管理困难相关。
这项事后分析旨在研究亚洲门诊MDD患者焦虑性痛苦的社会人口学和临床相关因素。
本研究中定义的焦虑性痛苦并非采用《精神疾病诊断与统计手册》第5版定义的五个说明符中的两个,而是从90项症状自评量表修订版(SCL - 90 - R)中抽取的四个替代项目中至少有两个存在时定义为焦虑性痛苦。其他测量指标包括蒙哥马利 - 阿斯伯格抑郁评定量表(MADRS)、疲劳严重程度量表、希恩残疾量表和多维感知社会支持量表。
纳入了496例MDD患者的数据。371名参与者(74.8%)存在焦虑性痛苦。二元逻辑回归分析发现,焦虑性痛苦与工作状态、较高的MADRS评分、严重失眠和功能损害独立且显著相关。
在三级医疗机构中,四分之三的亚洲MDD患者可能存在至少中度痛苦的DSM - 5焦虑性痛苦。其患病率在不同工作群体中可能有所不同。该说明符与更严重的抑郁症状、严重失眠和功能损害相关。