Petrova N N, Palkin Yu R, Faddeev D V, Zinovieva A G
Saint-Petersburg State University, St. Petersburg, Russia.
Pavlov City Psychiatric Hospital No. 7, St. Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(4):31-37. doi: 10.17116/jnevro202112104131.
The study was the comparative characterization of depressed patients depending on the presence of comorbid anxiety.
Thirty patients of the Clinic of neuroses named after acad. I.P. Pavlov Clinic of Neuroses. Comparison groups included 15 patients with comorbid anxiety and depressive disorders and 15 patients with depressive disorder without comorbid anxiety. The groups were comparable by sex and age. Clinical-catamnestic, clinical-therapeutic, and clinical-scale methods, including the Hamilton Depression and Anxiety Scales, were used during the study.
The structure of clinically diagnosed comorbid anxiety and depressive disorders was shown to be characterized by high representation of somato-vegetative symptoms and higher level of depression in comparison to depressive disorder without comorbid anxiety. According to psychometric assessment results, the level of anxiety did not differ in comparison groups, while clinically, according to ICD-10 criteria, anxiety was not diagnosed, indicating a discrepancy between clinical and scale assessments of anxiety and depressive disorders and greater accuracy of clinical and scale assessment of the condition. The effectiveness of combined treatment, including psychotropic therapy and psychotherapy, was lower in patients with comorbidity of anxiety and depression according to parameters of the degree of reduction of psychopathological symptoms, duration of treatment, and quality of remission. The structure of incomplete remission was similar in patients with comorbid anxiety and depressive disorders and depression.
The obtained data suggest the expediency of continuous systematization of affective disorders and the need to improve the diagnostic criteria of comorbid anxiety and depressive disorders on the basis of combined clinical and scale assessment.
本研究旨在根据共病焦虑的存在情况对抑郁症患者进行比较特征分析。
以苏联科学院院士伊万·彼得罗维奇·巴甫洛夫命名的神经症诊所的30名患者。比较组包括15名患有共病焦虑和抑郁障碍的患者以及15名无共病焦虑的抑郁障碍患者。两组在性别和年龄上具有可比性。研究过程中使用了临床病史、临床治疗和临床量表方法，包括汉密尔顿抑郁量表和焦虑量表。
临床诊断的共病焦虑和抑郁障碍的结构显示，与无共病焦虑的抑郁障碍相比，躯体自主神经症状的表现较高，抑郁程度也较高。根据心理测量评估结果，比较组之间的焦虑水平没有差异，但根据国际疾病分类第10版（ICD - 10）标准，临床上未诊断出焦虑，这表明焦虑和抑郁障碍的临床评估与量表评估之间存在差异，且病情的临床和量表评估的准确性更高。根据心理病理症状减轻程度、治疗持续时间和缓解质量等参数，包括精神药物治疗和心理治疗在内的联合治疗对焦虑和抑郁共病患者的有效性较低。共病焦虑和抑郁障碍患者与抑郁患者不完全缓解的结构相似。
所获得的数据表明情感障碍持续系统化的必要性，以及在联合临床和量表评估的基础上改进共病焦虑和抑郁障碍诊断标准的必要性。
