Goisman R M, Goldenberg I, Vasile R G, Keller M B
Department of Psychiatry, Harvard Medical School, Boston, MA.
Compr Psychiatry. 1995 Jul-Aug;36(4):303-11. doi: 10.1016/s0010-440x(95)90076-4.
From 11 sites in New England and Missouri, 711 patients with > or = one of five index anxiety disorders were recruited onto a longitudinal study in which they were interviewed every 6 months regarding symptoms, course, and treatments received. Of the five disorders studied, panic disorder without agoraphobia was the disorder most often found as a sole diagnosis and generalized anxiety disorder (GAD) was least often found alone, both as lifetime diagnoses or when restricted to cases active at intake. Panic disorder with agoraphobia and agoraphobia without history of panic disorder (AWOPD) had three specific diagnoses with which they were frequently comorbid: social phobia, simple phobia, and GAD. AWOPD, social phobia, and GAD were frequently found in the presence of each other. It is possible that the experience of anxiety due to any syndromal cause may decrease the threshold for an individual to experience other anxiety symptoms or disorders. Clinicians should be aware of these patterns of comorbidity in order to formulate accurate differential diagnoses and prescribe treatments in a rational manner.
从新英格兰和密苏里州的11个地点招募了711名患有五种指数焦虑症中至少一种的患者,进行一项纵向研究,在该研究中,每6个月对他们进行一次关于症状、病程和接受治疗情况的访谈。在所研究的五种疾病中,无广场恐怖症的惊恐障碍是最常被单独诊断出的疾病,广泛性焦虑症(GAD)无论是终生诊断还是仅限于入组时处于活动期的病例,单独出现的情况最少。伴有广场恐怖症的惊恐障碍和无惊恐障碍病史的广场恐怖症(AWOPD)有三种与之经常共病的特定诊断:社交恐惧症、单纯恐惧症和广泛性焦虑症。AWOPD、社交恐惧症和广泛性焦虑症经常同时出现。由于任何综合征原因导致的焦虑经历可能会降低个体体验其他焦虑症状或疾病的阈值。临床医生应该了解这些共病模式,以便做出准确的鉴别诊断并合理地开出处方进行治疗。