Menza M A, Robertson-Hoffman D E, Bonapace A S
Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson University Medical School, New Brunswick 08903.
Biol Psychiatry. 1993 Oct 1;34(7):465-70. doi: 10.1016/0006-3223(93)90237-8.
Parkinson's disease (PD) is frequently accompanied by symptoms of depression and anxiety. However, the relationship between anxiety and depression has not been rigorously defined in these patients. In this study, 42 patients with PD and 21 matched medical controls were evaluated using DSM-III-R criteria and a variety of psychiatric rating scales. Twelve (29%) PD patients but only one medical control had a formal anxiety disorder diagnosis. Of the 12 patients with PD who had an anxiety disorder diagnosis, 11 (92%) had a comorbid depressive disorder diagnosis. Of the 18 patients with a depressive disorder, 12 (67%) also had an anxiety disorder diagnosis. Furthermore, a stepwise regression analysis found that the depression measure explained 44% of the variance in anxiety measures whereas neither the severity of illness variables nor the levodopa dose contributed significantly to the variance. This study suggests that the excess anxiety found in PD patients is unlikely to be primarily a psychologic reaction to the illness or a side effect of levodopa treatment. Rather, we suggest that anxiety and depression are related manifestations of the underlying neurochemical changes of PD itself.
帕金森病（PD）常常伴有抑郁和焦虑症状。然而，在这些患者中，焦虑与抑郁之间的关系尚未得到严格界定。在本研究中，使用《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）标准和多种精神科评定量表对42例帕金森病患者和21例匹配的医学对照者进行了评估。12例（29%）帕金森病患者被诊断为患有正式的焦虑症，而医学对照者中只有1例。在12例被诊断患有焦虑症的帕金森病患者中，11例（92%）同时被诊断患有共病性抑郁症。在18例患有抑郁症的患者中，12例（67%）也被诊断患有焦虑症。此外，逐步回归分析发现，抑郁测量指标解释了焦虑测量指标中44%的变异，而疾病严重程度变量和左旋多巴剂量对变异均无显著贡献。本研究表明，帕金森病患者中出现的过度焦虑不太可能主要是对疾病的心理反应或左旋多巴治疗的副作用。相反，我们认为焦虑和抑郁是帕金森病本身潜在神经化学变化的相关表现。
