Braam W H, Spijker J, Hendriks G J, Vrijsen J N
Tijdschr Psychiatr. 2020;62(3):187-193.
Most mental health hospitals in the Netherlands use disorder specific standards of care. In case of comorbidity, we lack evidence in choosing the treatment of preference when both depressive- and anxiety disorder(s) are present in the same patient.
AIM: To investigate the prevalence of depression and anxiety (including obsessive compulsive disorder and post-traumatic stress disorder) in an outpatient mental health hospital population treated for their anxiety disorder, and to investigate the difference in outcome of (anxiety) treatment between patients with and without a comorbid depressive disorder.
METHOD: A retrospective study using outcome data from 2012 to 2017. In this period, we identified 127 patients for whom outcome data and diagnostic criteria were available. Comorbidity in this group was determined by a clinical interview. During treatment symptoms were monitored using self-reporting scales, among others the Inventory of Depressive Symptomatology (IDS) and the Beck Anxiety Inventory (BAI).
RESULTS: In 46,5% of the patients a comorbid depressive disorder was diagnosed. No significant difference in treatment outcome was observed between the group of patients with and the group of patients without a comorbid depressive disorder. However, the amount of reduction of depressive symptoms measured by the ids was a good predictor of the reduction of anxiety: a faster reduction of depressive symptoms predicts a better outcome of the treatment of anxiety.
CONCLUSION: Comorbid depressive disorders were observed in almost half of the patients treated in specialized (outpatient) clinics for anxiety disorders. A slower reduction of depressive symptoms predicts worse outcome of the treatment of anxiety.
荷兰的大多数精神卫生医院采用针对特定疾病的护理标准。在存在共病的情况下,当同一名患者同时患有抑郁症和焦虑症时,我们缺乏选择优先治疗方法的依据。
调查在一家门诊精神卫生医院接受焦虑症治疗的人群中抑郁症和焦虑症(包括强迫症和创伤后应激障碍)的患病率,并调查合并抑郁症的患者与未合并抑郁症的患者在(焦虑症)治疗结果上的差异。
一项回顾性研究,使用2012年至2017年的治疗结果数据。在此期间,我们确定了127名有治疗结果数据和诊断标准的患者。该组中的共病情况通过临床访谈确定。在治疗期间,使用自我报告量表监测症状,其中包括抑郁症状量表(IDS)和贝克焦虑量表(BAI)。
46.5%的患者被诊断出合并抑郁症。合并抑郁症的患者组与未合并抑郁症的患者组在治疗结果上未观察到显著差异。然而,通过IDS测量的抑郁症状减轻量是焦虑减轻的良好预测指标:抑郁症状更快减轻预示着焦虑症治疗效果更好。
在专门的(门诊)诊所接受焦虑症治疗的患者中,近一半观察到合并抑郁症。抑郁症状减轻较慢预示着焦虑症治疗效果较差。