Barlow D H, DiNardo P A, Vermilyea B B, Vermilyea J, Blanchard E B
J Nerv Ment Dis. 1986 Feb;174(2):63-72. doi: 10.1097/00005053-198602000-00001.
One hundred twenty-six patients presenting at an anxiety disorders research clinic were administered a structured interview. Diagnoses were made on the basis of DSM-III criteria but without regard to current exclusionary systems within DSM-III. Rather, clinicians decided whether anxiety and depressive symptoms that met DSM-III criteria for additional diagnoses were associated features of the presenting problem or represented an independent coexisting complication. Diagnoses and accompanying psychometric data delineated groups of patients with somewhat different clinical and psychometric characteristics. But additional anxiety and depressive diagnoses were required in a number of cases. Anxiety states almost always required additional diagnoses whereas for the phobic disorders additional diagnoses occurred less frequently. Simple and social phobia were the most frequent additional diagnoses, but depression was more strongly associated with some anxiety disorders, specifically obsessive-compulsive disorder. In view of the treatment implications of comorbidity, establishing the functional relationships among anxiety symptoms without regard to exclusionary systems would seem important in both clinical and research settings.
在一家焦虑症研究诊所就诊的126名患者接受了结构化访谈。诊断依据《精神疾病诊断与统计手册》第三版（DSM-III）标准做出，但未考虑DSM-III中当前的排除系统。相反，临床医生需判定符合DSM-III标准的额外诊断的焦虑和抑郁症状是当前问题的相关特征，还是代表一种独立并存的并发症。诊断结果及相关心理测量数据划分出了具有不同临床和心理测量特征的患者群体。但在许多病例中需要额外的焦虑和抑郁诊断。焦虑状态几乎总是需要额外诊断，而恐惧症额外诊断的情况较少发生。单纯恐惧症和社交恐惧症是最常见的额外诊断，但抑郁与某些焦虑症的关联更强，特别是强迫症。鉴于共病对治疗的影响，在临床和研究环境中，不考虑排除系统来确定焦虑症状之间的功能关系似乎都很重要。
