Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
Psychol Med. 2023 Dec;53(16):7766-7774. doi: 10.1017/S0033291723001745. Epub 2023 Jul 5.
Anxiety and depression are frequently comorbid yet phenotypically distinct. This study identifies differences in the clinically observable phenome across a wide variety of physical and mental disorders comparing patients with diagnoses of depression without anxiety, anxiety without depression, or both depression and anxiety.
Using electronic health records for 14 994 participants with depression and/or anxiety in the Mayo Clinic Biobank, a phenotype-based phenome-wide association study (PheWAS) was performed to test for differences between these groups across a broad range of clinical diagnoses observed in the electronic health record. Additional analyses were performed to determine the temporal sequencing of diagnoses.
Compared to patients diagnosed only with anxiety, those diagnosed only with depression were more likely to have diagnoses of obesity (OR 1.75; = 1 × 10), sleep apnea (OR 1.71; = 1 × 10), and type II diabetes (OR 1.74; = 9 × 10). Compared to those diagnosed only with depression, those diagnosed only with anxiety were more likely to have diagnoses of palpitations (OR 1.91; = 2 × 10), benign skin neoplasms (OR 1.61; = 2 × 10), and cardiac dysrhythmias (OR 1.45; = 2 × 10). Patients with comorbid depression and anxiety were more likely to have diagnoses of other mental health disorders, substance use disorders, sleep problems, and gastroesophageal reflux relative to isolated depression.
While depression and anxiety are closely related, this study suggests that phenotypic distinctions exist between depression and anxiety. Improving phenotypic characterization within the broad categories of depression and anxiety could improve the clinical assessment of depression and anxiety.
焦虑症和抑郁症经常共病，但表型不同。本研究通过比较无焦虑症的抑郁症患者、无抑郁症的焦虑症患者和同时患有抑郁症和焦虑症的患者，在广泛的身心障碍中，识别出临床表型在各种身体和精神障碍中的差异。
使用梅奥诊所生物库中 14994 名患有抑郁症和/或焦虑症患者的电子健康记录，对基于表型的表型全基因组关联研究（PheWAS）进行分析，以测试这些组在电子健康记录中观察到的广泛临床诊断之间的差异。还进行了额外的分析，以确定诊断的时间顺序。
与仅被诊断为焦虑症的患者相比，仅被诊断为抑郁症的患者更有可能被诊断为肥胖症（OR 1.75；P = 1×10）、睡眠呼吸暂停（OR 1.71；P = 1×10）和 2 型糖尿病（OR 1.74；P = 9×10）。与仅被诊断为抑郁症的患者相比，仅被诊断为焦虑症的患者更有可能被诊断为心悸（OR 1.91；P = 2×10）、良性皮肤肿瘤（OR 1.61；P = 2×10）和心律失常（OR 1.45；P = 2×10）。与单纯抑郁症患者相比，同时患有抑郁症和焦虑症的患者更有可能被诊断为其他心理健康障碍、物质使用障碍、睡眠问题和胃食管反流。
虽然抑郁症和焦虑症密切相关，但本研究表明，抑郁症和焦虑症之间存在表型差异。改善抑郁症和焦虑症广泛分类中的表型特征，可能会改善对抑郁症和焦虑症的临床评估。
