Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
J Affect Disord. 2024 Oct 1;362:510-517. doi: 10.1016/j.jad.2024.07.035. Epub 2024 Jul 14.
Anxious depression is a prevalent subtype of depression associated with adverse outcomes such as higher depression severity and higher rates of suicidality. This study leveraged a state-wide research registry of depressed and/or suicidal youth to compare the prevalence, clinical correlates, and symptom patterns of those with versus without anxious depression.
We included baseline data from 797 participants (ages 8-20) with a diagnosis of a depressive disorder. A score on the Generalized Anxiety Disorder Scale (GAD-7) ≥ 10 was used to define individuals with and without anxious depression. A structured battery was used to capture psychiatric diagnostic status, depression/anxiety severity, suicide risk, history of trauma, functioning, and resilience.
The prevalence of anxious depression among youth with depressive disorders was 59.5 % (n = 474). Youth with anxious depression had greater depression severity and anxiety symptoms, higher suicidality, and a higher prevalence of comorbid anxiety disorders than those without. Youth with anxious depression had greater impairment in functioning defined as worse pain interference, pain severity, fatigue, and social relationships compared to those without anxious depression. Youth with anxious depression also reported higher rates of depressive symptoms such as irritable mood, feelings of guilt, and psychomotor agitation compared to those without anxious depression.
Anxious depression is associated with worse depression severity, higher suicidality, and lower functioning. Longitudinal work is needed to examine long-term courses of anxious depression to explore its stability as a diagnostic subcategory.
焦虑型抑郁症是一种常见的抑郁症亚型，与不良后果相关，如抑郁严重程度更高和自杀率更高。本研究利用一个全州范围内的抑郁和/或自杀青年研究登记处，比较了有焦虑型抑郁症和无焦虑型抑郁症患者的患病率、临床相关性和症状模式。
我们纳入了 797 名（8-20 岁）有抑郁障碍诊断的参与者的基线数据。使用一般焦虑障碍量表（GAD-7）得分≥10 来定义有和无焦虑型抑郁症的个体。使用一个结构化的电池来捕捉精神病学诊断状况、抑郁/焦虑严重程度、自杀风险、创伤史、功能和适应力。
在有抑郁障碍的青年中，焦虑型抑郁症的患病率为 59.5%（n=474）。与无焦虑型抑郁症的患者相比，有焦虑型抑郁症的患者抑郁严重程度和焦虑症状更严重，自杀风险更高，共患焦虑障碍的比例更高。与无焦虑型抑郁症的患者相比，有焦虑型抑郁症的患者在功能障碍方面有更大的损害，表现为更严重的疼痛干扰、疼痛严重程度、疲劳和社会关系。有焦虑型抑郁症的患者还报告了更高的抑郁症状发生率，如易怒、内疚感和精神运动性激越。
焦虑型抑郁症与更严重的抑郁严重程度、更高的自杀风险和更低的功能有关。需要进行纵向研究来检查焦虑型抑郁症的长期病程，以探索其作为一个诊断亚类的稳定性。
