Department of Psychiatry, Leiden University Medical Center.
Clinical Psychology Unit, Leiden University, Institute of Psychology, Leiden, the Netherlands.
J Nerv Ment Dis. 2023 Aug 1;211(8):601-612. doi: 10.1097/NMD.0000000000001667. Epub 2023 May 10.
Anxiety-related disorders constitute the leading prevalent mental disorders, with major burden on patients, their relatives, and society. Moreover, there is considerable treatment nonadherence/nonresponse. We used routine outcome monitoring (ROM) data from outpatients covering four anxiety-related disorders ( DSM-IV-R , N = 470) to examine their 6-month treatment course and its predictors: generalized anxiety disorder, panic disorder with agoraphobia, obsessive-compulsive disorder, and posttraumatic stress disorder. Measures included Mini-International Neuropsychiatric Interview Plus, Brief Symptom Inventory (BSI), Montgomery-Åsberg Depression Rating Scale (MADRS), Brief Anxiety Scale (BAS), and Short Form Health Survey 36 (SF-36). On the clinician-rated instruments (MADRS/BAS), all anxiety-related disorder groups showed a significant albeit modest improvement after treatment. On the BSI self-rating, only generalized anxiety disorder and posttraumatic stress disorder showed a significant modest improvement. No anxiety-related disorder groups improved significantly regarding SF-36 physical functioning. For BSI symptom course, significant predictors were comorbid somatoform/total disorders, SF-36 physical functioning/general health, and MADRS score. Clinical implications and future research recommendations are discussed.
焦虑相关障碍是最常见的精神障碍，给患者、患者亲属和社会带来了沉重负担。此外，治疗的不依从/无反应也相当普遍。我们使用了来自四个焦虑相关障碍（DSM-IV-R，N=470）门诊患者的常规结局监测（ROM）数据，以检查他们的 6 个月治疗过程及其预测因素：广泛性焦虑障碍、伴有广场恐怖症的惊恐障碍、强迫症和创伤后应激障碍。评估指标包括：Mini-国际神经精神访谈加诊量表、Brief Symptom Inventory（BSI）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）、Brief Anxiety Scale（BAS）和健康调查简表 36（SF-36）。在临床医生评定量表（MADRS/BAS）上，所有焦虑相关障碍组在治疗后均有显著但适度的改善。在 BSI 自评中，只有广泛性焦虑障碍和创伤后应激障碍有显著适度的改善。在 SF-36 生理功能方面，没有焦虑相关障碍组有显著改善。BSI 症状病程的显著预测因素包括合并躯体形式/总障碍、SF-36 生理功能/总体健康和 MADRS 评分。讨论了临床意义和未来研究建议。
