Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Brazil.
Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Brazil; Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand; Impact Strategic Research Center, Deakin University, Geelong, Australia; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
Psychiatry Res. 2018 Feb;260:17-23. doi: 10.1016/j.psychres.2017.11.024. Epub 2017 Nov 8.
Patients with major affective disorders (MAFD) with comorbid anxiety show a greater functional impairment than those without anxiety. The aim of this study is to delineate the associations between severity of anxiety in MAFD, namely bipolar disorder (BD) and major depression (MDD), and MAFD characteristics and serum high-density lipoprotein (HDL)-cholesterol levels. Recruited were 82 participants with anxiety disoders and 83 without anxiety disoders, including 101 MAFD patients and 51 healthy controls. We used the Hamilton Anxiety Rating Scale (HAM-A) to measure severity of anxiety and made the diagnoses of posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), panic disorder (PD), generalized anxiety disorder (GAD) and phobias. The HAM-A score is significantly predicted by higher number of depressive episodes, GAD and phobias, childhood trauma, tobacco use disorder, metabolic syndrome and lowered HDL-cholesterol. Increased HAM-A scores are, independently from severity of depression, associated with lowered quality of life, increased disabilities and suicidal ideation. Lithium treatment significantly lowers HAM-A scores. It is concluded that severity of anxiety significantly worsens the phenomenology of MAFD. Therefore, treatments of MAFD should target increased severity of anxiety and its risk factors including low HDL-cholesterol, metabolic syndrome, childhood trauma and tobacco use disorder.
患有伴发焦虑的重性情感障碍（MAFD）的患者比不伴发焦虑的患者表现出更大的功能障碍。本研究的目的是描述 MAFD 中焦虑的严重程度（即双相情感障碍（BD）和重度抑郁症（MDD））与 MAFD 特征和血清高密度脂蛋白（HDL）-胆固醇水平之间的关联。招募了 82 名患有焦虑障碍和 83 名无焦虑障碍的患者，包括 101 名 MAFD 患者和 51 名健康对照者。我们使用汉密尔顿焦虑量表（HAM-A）来衡量焦虑的严重程度，并做出创伤后应激障碍（PTSD）、强迫症（OCD）、惊恐障碍（PD）、广泛性焦虑障碍（GAD）和恐惧症的诊断。HAM-A 评分显著受抑郁发作次数较多、GAD 和恐惧症、儿童期创伤、吸烟障碍、代谢综合征和 HDL-胆固醇降低的影响。与抑郁严重程度无关，增加的 HAM-A 评分与生活质量降低、残疾增加和自杀意念相关。锂治疗显著降低 HAM-A 评分。研究结论为焦虑的严重程度显著加重了 MAFD 的表现。因此，MAFD 的治疗应针对增加的焦虑严重程度及其风险因素，包括低 HDL-胆固醇、代谢综合征、儿童期创伤和吸烟障碍。
