在急性期精神分裂症中区分未分化焦虑与综合征性焦虑。
Discerning undifferentiated anxiety from syndromal anxiety in acute-phase schizophrenia.
作者信息
Naidu Kalai, van Staden Werdie, Fletcher Lizelle
机构信息
1Department of Psychiatry, University of Pretoria, Pretoria, South Africa.
2Centre for Ethics and Philosophy of Health Sciences, Faculty of Health Sciences, University of Pretoria, Arcadia, Private Bag X323, Pretoria, 0007 South Africa.
出版信息
Ann Gen Psychiatry. 2020 Apr 15;19:26. doi: 10.1186/s12991-020-00277-4. eCollection 2020.
BACKGROUND
Literature on anxiety in schizophrenia is confined to well-established diagnostic syndromes and the diagnostic category of unspecified anxiety disorder has not been quantitatively verified in this population. This study examined whether anxiety that is not differentiated into the well-established syndromes is empirically discernible from syndromal anxiety and no anxiety in acute-phase schizophrenia.
METHODS
After sampling 111 acute-phase schizophrenia patients, they were stratified into three groups: syndromal anxiety; undifferentiated anxiety; and without anxiety disorder. The groups were compared statistically in two data sets on measures for anxiety, psychotic severity, depressive features, akathisia and medication use.
RESULTS
On two measures of anxiety and for both data sets, the groups were significantly different without evidence of a confounding influence by akathisia, medication, or psychotic severity. The undifferentiated group was different from the syndromal group on the Staden Schizophrenia Anxiety Rating Scale (S-SARS) for both data sets (mean difference = 7.46, < 0.001; mean difference = 7.69, < 0.002) and on the Hamilton Anxiety Rating Scale for the one data set (mean difference = 14.68, < 0.001) but not for the replicative data set (mean difference = 1.49, = 0.494). The undifferentiated anxiety group was different from the no anxiety group for the respective data sets on both anxiety scales (S-SARS: mean difference = 8.67, < 0.001; mean difference = 8.64, < 0.001)(HAM-A: mean difference = 6.05, < 0.001; mean difference = 8.67, = 0.002). When depressive features had a confounding effect, it was small relative to the group differences.
CONCLUSIONS
The results suggest some patients in acute-phase schizophrenia present with undifferentiated anxiety that is discernible from both syndromal anxiety and those without an anxiety disorder. This finding may serve as empirical grounds for clinicians to recognise undifferentiated anxiety in acute-phase schizophrenia, and for further research into the clinical importance of undifferentiated anxiety in this population.
背景
关于精神分裂症中焦虑的文献仅限于已确立的诊断综合征，而未特定化的焦虑症诊断类别在该人群中尚未得到定量验证。本研究探讨了在急性期精神分裂症中，未分化为已确立综合征的焦虑是否能从综合征性焦虑和无焦虑状态中通过实证辨别出来。
方法
在对111例急性期精神分裂症患者进行抽样后，将他们分为三组：综合征性焦虑组；未分化焦虑组；无焦虑症组。在两个数据集中，对三组患者在焦虑、精神病严重程度、抑郁特征、静坐不能和药物使用等测量指标上进行统计学比较。
结果
在两个焦虑测量指标以及两个数据集中，三组之间存在显著差异，且没有证据表明静坐不能、药物或精神病严重程度存在混杂影响。在两个数据集中，未分化组在施塔登精神分裂症焦虑评定量表（S-SARS）上与综合征性组不同（平均差异=7.46，<0.001；平均差异=7.69，<0.002），在一个数据集中在汉密尔顿焦虑评定量表上也不同（平均差异=14.68，<0.001），但在重复数据集中则无差异（平均差异=1.49，=0.494）。在两个焦虑量表上，未分化焦虑组在各自数据集中与无焦虑组不同（S-SARS：平均差异=8.67，<0.001；平均差异=8.64，<0.001）（HAM-A：平均差异=6.05，<0.001；平均差异=8.67，=0.002）。当抑郁特征产生混杂影响时，相对于组间差异而言较小。
结论
结果表明，一些急性期精神分裂症患者存在未分化焦虑，这种焦虑可与综合征性焦虑和无焦虑症患者区分开来。这一发现可为临床医生识别急性期精神分裂症中的未分化焦虑提供实证依据，并为进一步研究该人群中未分化焦虑的临床重要性提供依据。
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