Departments of Psychology and Psychiatry, University of Toronto, 1265 Military Trail, M1C 1A4 Toronto, Ontario, Canada.
Department of Psychiatry, University of Illinois-Chicago, Chicago, IL, USA.
Psychiatry Res. 2019 May;275:310-314. doi: 10.1016/j.psychres.2019.03.050. Epub 2019 Mar 30.
Anxiety symptoms and anxiety disorders are common in both mood and psychotic disorders. However, limited comparative information exists regarding the long-term course of anxiety in schizoaffective disorder, bipolar disorder, and major depressive disorder. Prospective evaluation of the 20-year trajectory of self-reported anxiety and somatic-related anxiety in three major diagnostic groups, 43 schizoaffective patients, 47 bipolar patients, and 109 major depression patients was conducted. The patients were recruited at an index phase of hospitalization, and then reassessed longitudinally at six subsequent follow-ups over 20-years. The sample was well characterized with symptom, recovery and functioning data being available. This study found that in the earlier years of illness, self-reported anxiety was greater in schizoaffective and major depression patients than bipolar patients. The three groups were similar for anxiety symptoms during the 20-year course of their illness. Last, we found in all patients, self-reported anxiety in the early years predicted having a period of recovery and lower global functioning in the future. Our data provides unique information regarding the comparative course of anxiety in related mood and psychotic disorders. Both clinicians and researchers should focus on assessing, diagnosing, and treating anxiety in mood and psychotic disorders, as a means to improve outcomes and quality of life in these individuals.
焦虑症状和焦虑障碍在心境障碍和精神病性障碍中都很常见。然而,关于精神分裂情感障碍、双相情感障碍和重性抑郁障碍中焦虑的长期病程,相关的比较信息有限。本研究前瞻性评估了三大诊断组(43 名精神分裂情感障碍患者、47 名双相情感障碍患者和 109 名重性抑郁障碍患者)中 20 年自我报告焦虑和躯体相关焦虑的轨迹。这些患者在住院的指数阶段被招募,然后在 20 年内的 6 次后续随访中进行纵向评估。该样本具有良好的特征,可获得症状、恢复和功能数据。本研究发现,在疾病的早期,精神分裂情感障碍和重性抑郁障碍患者的自我报告焦虑程度高于双相情感障碍患者。在疾病的 20 年病程中,三组的焦虑症状相似。最后,我们发现所有患者在早期的自我报告焦虑都预示着未来会有一段恢复期和更低的整体功能。我们的数据提供了关于相关心境和精神病性障碍中焦虑比较病程的独特信息。临床医生和研究人员都应该关注评估、诊断和治疗心境和精神病性障碍中的焦虑,以改善这些个体的预后和生活质量。