Otsubo Tempei
Seishin Shinkeigaku Zasshi. 2016;118(7):509-515.
Generalized, persistent, and free-floating anxiety was first described by Freud in 1894. The diagnostic term generalized anxiety disorder (GAD) was not in classification systems until the publication of the diagnostic and statistical manual for mental disorders, third edition (DSM-III) in 1980. Initially considered a residual category to be used when no other diagnosis could be made. The term GAD is not accepted as a distinct diagnostic category yet. Since 1980, revisions to the diagnostic criteria for GAD in the DSM-III-R, DSM-IV and DSM-5 classifica- tions have slightly redefined this disorder. The classification is fluid. This article reviews the development of diagnostic criteria for defining GAD from Freud to DSM-5. Excessive worry- ing impairs the individual's capacity to do things quickly and efficiently, whether at home or at work. The worrying takes time and energy; associated symptoms of feeling keyed up or edge, tiredness, difficulty concentrating, and depression. Individuals whose presentation meets crite- ria for GAD are likely to have met, or currently meet, criteria for unipolar depressive disor- ders. Comorbid depression are common in GAD and negatively impact treatment outcome.
广泛性、持续性和游离性焦虑最早由弗洛伊德于1894年描述。直到1980年《精神疾病诊断与统计手册》第三版(DSM-III)出版,诊断术语广泛性焦虑障碍(GAD)才出现在分类系统中。最初它被视为一个残余类别,用于在无法做出其他诊断时使用。术语GAD尚未被接受为一个独特的诊断类别。自1980年以来,DSM-III-R、DSM-IV和DSM-5分类中GAD诊断标准的修订对这种障碍进行了略微重新定义。分类是动态变化的。本文回顾了从弗洛伊德到DSM-5定义GAD的诊断标准的发展历程。过度担忧会损害个体在家或工作中快速高效做事的能力。担忧需要时间和精力,还会伴有紧张或烦躁、疲劳、注意力不集中和抑郁等相关症状。表现符合GAD标准的个体很可能已经符合或目前符合单相抑郁障碍的标准。共病性抑郁在GAD中很常见,并且会对治疗结果产生负面影响。