Lin Huang-Li, Lee Wei-Yang, Liu Chun-Hao, Chiang Wei-Yu, Hsu Ya-Ting, Hsiao Chin-Fu, Tsou Hsiao-Hui, Liu Chia-Yih
Department of Psychiatry, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Psychiatry Investig. 2024 Jun;21(6):561-572. doi: 10.30773/pi.2023.0419. Epub 2024 Jun 24.
Anxious depression is a prevalent characteristic observed in Asian psychiatric patients diagnosed with major depressive disorder (MDD). This study aims to investigate the prevalence and clinical presentation of anxious depression in Taiwanese individuals diagnosed with MDD.
We recruited psychiatric outpatients aged over 18 who had been diagnosed with MDD through clinical interviews. This recruitment took place at five hospitals located in northern Taiwan. We gathered baseline clinical and demographic information from the participants. Anxious depression was identified using a threshold of an anxiety/somatization factor score ≥7 on the 21-item Hamilton Rating Scale for Depression (HAM-D).
In our study of 399 patients (84.21% female), 64.16% met the criteria for anxious depression. They tended to be older, married, less educated, with more children, and an older age of onset. Anxious depression patients had higher HAM-D and Clinical Global Impression-Severity scale score, more panic disorder (without agoraphobia), and exhibited symptoms like agitation, irritability, concentration difficulties, psychological and somatic anxiety, somatic complaints, hypochondriasis, weight loss, and increased insight. Surprisingly, their suicide rates did not significantly differ from non-anxious depression patients. This highlights the importance of recognizing and addressing these unique characteristics.
Our study findings unveiled that the prevalence of anxious depression among Taiwanese outpatients diagnosed with MDD was lower compared to inpatients but substantially higher than the reported rates in European countries and the United States. Furthermore, patients with anxious depression exhibited a greater occurrence of somatic symptoms.
焦虑抑郁是亚洲被诊断为重度抑郁症(MDD)的精神科患者中普遍存在的特征。本研究旨在调查台湾地区被诊断为MDD的个体中焦虑抑郁的患病率及临床表现。
我们招募了年龄超过18岁、通过临床访谈被诊断为MDD的精神科门诊患者。招募工作在台湾北部的五家医院进行。我们收集了参与者的基线临床和人口统计学信息。使用21项汉密尔顿抑郁量表(HAM-D)中焦虑/躯体化因子得分≥7的阈值来确定焦虑抑郁。
在我们对399名患者(84.21%为女性)的研究中,64.16%符合焦虑抑郁的标准。他们往往年龄较大、已婚、受教育程度较低、子女较多且发病年龄较大。焦虑抑郁患者的HAM-D和临床总体印象-严重程度量表得分更高,惊恐障碍(无广场恐怖症)更多,并且表现出如激动、易怒、注意力不集中、心理和躯体焦虑、躯体不适、疑病症、体重减轻以及洞察力增强等症状。令人惊讶的是,他们的自杀率与非焦虑抑郁患者没有显著差异。这凸显了认识和处理这些独特特征的重要性。
我们的研究结果表明,台湾地区被诊断为MDD的门诊患者中焦虑抑郁的患病率低于住院患者,但远高于欧洲国家和美国报告的患病率。此外,焦虑抑郁患者的躯体症状出现得更多。