Maes M, Meltzer H Y, Cosyns P, Schotte C
Department of Psychiatry of Case Western Reserve University, Cleveland, Ohio.
Psychopathology. 1994;27(1-2):1-13. doi: 10.1159/000284842.
Several studies have reported on comorbidity between depression and anxiety. The present study investigates the occurrence of anxiety symptoms during an episode of unipolar depression. The authors administered the 15-item Rating Scale for Anxiety States of Hamilton (HAM-A) to 73 depressed inpatients categorized according to DSM-III criteria into minor (300.40, 309.00), major depression without (296.X2) and with (296.X3) melancholia. Principal-component (PC) analysis revealed three interpretable PCs: a somatic anxiety, a depression-anxiety overlap, and an anxious mood-behavior factor. Subjects with major depression showed significantly higher ratings on total HAM-A score, the three above PCs, and on all HAM-A items (except general somatic muscular and genitourinary symptoms) than subjects with minor depression. A cluster analysis generated two stable, qualitatively distinct clusters: i.e. one with severe anxiety and one with no or minimal anxiety; the six most discriminating symptoms were: tension, behavior at interview (general or physiological), respiratory, genitourinary and autonomic symptoms. Up to 95.4% of patients allocated to the severe anxiety cluster were major depressives. The results suggest that major depression may be divided into two qualitatively distinct classes, i.e. major depression with and without anxiety features.
多项研究报告了抑郁症与焦虑症之间的共病情况。本研究调查了单相抑郁症发作期间焦虑症状的发生情况。作者对73名根据《精神疾病诊断与统计手册》第三版标准分类为轻度（300.40、309.00）、无忧郁症的重度抑郁症（296.X2）和有忧郁症的重度抑郁症（296.X3）的住院抑郁症患者进行了汉密尔顿焦虑状态15项评定量表（HAM - A）测试。主成分（PC）分析揭示了三个可解释的主成分：躯体焦虑、抑郁 - 焦虑重叠以及焦虑情绪 - 行为因子。与轻度抑郁症患者相比，重度抑郁症患者在HAM - A总分、上述三个主成分以及所有HAM - A项目（除一般躯体肌肉和泌尿生殖系统症状外）上的评分显著更高。聚类分析产生了两个稳定的、性质上不同的聚类：即一个有严重焦虑，另一个无焦虑或焦虑轻微；六个最具区分性的症状是：紧张、访谈时的行为（一般或生理）、呼吸、泌尿生殖系统和自主神经症状。分配到严重焦虑聚类中的患者高达95.4%是重度抑郁症患者。结果表明，重度抑郁症可能分为两个性质上不同的类别，即有焦虑特征的重度抑郁症和无焦虑特征的重度抑郁症。
