Department of Rehabilitation Medicine.
Department of Circulation and Medical Imaging.
Rehabil Psychol. 2018 Nov;63(4):532-541. doi: 10.1037/rep0000231. Epub 2018 Oct 8.
This longitudinal study examined the unique relationship between anxiety, symptoms (pain intensity, sleep disturbance, fatigue severity), and function domains (self-reported cognitive function, physical function, satisfaction with social roles) in individuals with chronic physical conditions, independent of depressive symptoms.
Three surveys were mailed on an approximately yearly basis to community-dwelling adults with one of four chronic physical conditions (spinal cord injury, multiple sclerosis, muscular dystrophy, postpoliomyelitis syndrome). The first survey was completed by 1594 individuals (T1). Of these, 1380 completed the second survey (T2), and 1272 completed the third survey (T3).
Mixed growth curve models evidenced significant concurrent and longitudinal associations between anxiety and each symptom and function domain, independent of depression severity. The largest unique association found was between anxiety and self-reported cognitive function; inclusion of the measure of anxiety in the model improved model fit substantially over depression alone, χ²[2] = 104.40, < .001. Both anxiety and depression exhibited similar effect sizes in their unique relationships with each symptom and function domain measure. However, depression was more strongly associated with satisfaction with social roles and physical function than was anxiety.
The findings showed that anxiety assessed at one point in time demonstrated significant and unique associations with concurrent and subsequent symptom and function domains. Given that anxiety has been inadequately studied (and perhaps evaluated and treated) in rehabilitation populations, the current findings suggest that researchers and clinicians should broaden their scope when assessing and treating psychological distress to incorporate anxiety and related disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
本纵向研究考察了焦虑症与慢性躯体疾病患者症状（疼痛强度、睡眠障碍、疲劳严重程度）和功能领域（自我报告的认知功能、身体功能、社会角色满意度）之间的独特关系，且这种关系独立于抑郁症状。
以社区居住的患有四种慢性躯体疾病（脊髓损伤、多发性硬化症、肌肉萎缩症、脊髓灰质炎后综合征）之一的成年人为研究对象，每年进行三次邮寄问卷调查。第一次调查完成时共有 1594 人（T1），其中 1380 人完成了第二次调查（T2），1272 人完成了第三次调查（T3）。
混合增长曲线模型显示，焦虑与每种症状和功能领域均存在显著的同期和纵向关联，且与抑郁严重程度无关。发现的最大独特关联是焦虑与自我报告的认知功能之间的关联；与单独抑郁相比，将焦虑测量纳入模型后，模型拟合度显著提高，χ²[2] = 104.40，<.001。焦虑和抑郁在与每个症状和功能领域测量的独特关系中均表现出相似的效应大小。但是，与焦虑相比，抑郁与社会角色满意度和身体功能的相关性更强。
研究结果表明，在某一时间点评估的焦虑与同时期和随后的症状和功能领域之间存在显著且独特的关联。鉴于焦虑在康复人群中研究不足（可能评估和治疗不足），目前的研究结果表明，研究人员和临床医生在评估和治疗心理困扰时，应该扩大评估范围，纳入焦虑及相关障碍。
