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广泛性焦虑症的临床特征:老年人与年轻人对比

Clinical characteristics of generalized anxiety disorder: older vs. young adults.

作者信息

Altunoz Umut, Kokurcan Ahmet, Kirici Sevinc, Bastug Gulbahar, Ozel-Kizil Erguvan Tugba

机构信息

a Department of Transcultural Psychiatry & Psychotherapy , Wahrendorff Clinic , Hannover , Germany.

b Psychiatry Clinic , Corum Sungurlu State Hospital , Corum , Turkey.

出版信息

Nord J Psychiatry. 2018 Feb;72(2):97-102. doi: 10.1080/08039488.2017.1390607. Epub 2017 Oct 24.

Abstract

BACKGROUND

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders in older people. Although GAD in older adults seems to differ in many aspects like clinical presentation, severity and treatment response, there is a paucity of comparative research.

AIMS

The aim of the study is to compare the clinical presentation of GAD between older and young adults.

METHODS

One hundred and two non-demented older patients (age ≥65) and 64 young patients (age <45) who were diagnosed with GAD according to the DSM-IV-TR criteria were included to the study. Socio-demographic Data Form, the Structured Clinical Interview for DSM Disorders-1 (SCID-1), the Questionnaire for the Suggested Behavioral Criteria of GAD for DSM-5, the Hamilton Depression Scale (HAM-D), the Generalized Anxiety Disorder Severity Scale (GADSS) and the Sheehan Disability Scale (SDS) were applied to both groups.

RESULTS AND CONCLUSIONS

Older GAD patients had more disturbances of sleep, less reassurance seeking behaviors, higher rates of depression and higher depression severity when compared to the young patients. Although older people seemed to have a lower severity of GAD, they had higher disability due to worries. Older patients worried more about their own health and family well-being, whereas young patients worried more about future and other's health.

摘要

背景

广泛性焦虑障碍(GAD)是老年人中最常见的焦虑障碍之一。尽管老年人的广泛性焦虑障碍在临床表现、严重程度和治疗反应等许多方面似乎有所不同,但比较研究却很匮乏。

目的

本研究旨在比较老年人和年轻人中广泛性焦虑障碍的临床表现。

方法

根据《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)标准被诊断为广泛性焦虑障碍的102名非痴呆老年患者(年龄≥65岁)和64名年轻患者(年龄<45岁)纳入本研究。两组均采用社会人口统计学数据表、《精神疾病诊断与统计手册》障碍结构式临床访谈第一版(SCID-1)、《精神疾病诊断与统计手册》第五版广泛性焦虑障碍建议行为标准问卷、汉密尔顿抑郁量表(HAM-D)、广泛性焦虑障碍严重程度量表(GADSS)和希恩残疾量表(SDS)。

结果与结论

与年轻患者相比,老年广泛性焦虑障碍患者睡眠障碍更多,寻求安慰行为更少,抑郁发生率更高且抑郁严重程度更高。尽管老年人的广泛性焦虑障碍严重程度似乎较低,但他们因担忧而导致的残疾程度更高。老年患者更担心自己的健康和家庭幸福,而年轻患者更担心未来和他人的健康。

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