Brawman-Mintzer O, Lydiard R B, Emmanuel N, Payeur R, Johnson M, Roberts J, Jarrell M P, Ballenger J C
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425.
Am J Psychiatry. 1993 Aug;150(8):1216-8. doi: 10.1176/ajp.150.8.1216.
The goal of this study was to test the validity of generalized anxiety disorder as an independent diagnostic entity and to evaluate the prevalence and type of other psychiatric disorders coexisting with generalized anxiety disorder. Although a few published studies have addressed the subject, this study presents data from a larger group of subjects and excludes concurrent major depression as a potential confound.
The authors studied patients with a primary diagnosis of generalized anxiety disorder assigned after evaluation with the Structured Clinical Interview for DSM-III-R. Patients with a concurrent major depressive episode were excluded. All diagnoses for which the patient met criteria were determined, including lifetime occurrence of major depressive episode and substance use.
One hundred nine patients with generalized anxiety disorder were included in the analysis. Twenty-eight (26%) of these patients were not given any other lifetime psychiatric diagnosis. The most prevalent comorbid diagnoses were social phobia (25 [23%] of the patients) and simple phobia (23 [21%] of the patients). Forty-six (42%) of the patients with generalized anxiety disorder had experienced at least one major depressive episode during their lifetime.
These results support previous findings of high rates of psychiatric comorbidity in generalized anxiety disorder and validate the usefulness of generalized anxiety disorder as a separate diagnostic entity.
本研究的目的是检验广泛性焦虑症作为一个独立诊断实体的有效性，并评估与广泛性焦虑症共存的其他精神障碍的患病率和类型。尽管已有一些发表的研究涉及该主题，但本研究提供了来自更大样本量受试者的数据，并排除了同时存在的重度抑郁症这一潜在混杂因素。
作者对经《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）结构化临床访谈评估后被初步诊断为广泛性焦虑症的患者进行了研究。排除了同时存在重度抑郁发作的患者。确定患者符合标准的所有诊断，包括重度抑郁发作的终生患病率和物质使用情况。
109例广泛性焦虑症患者纳入分析。其中28例（26%）患者未获得任何其他终生精神疾病诊断。最常见的共病诊断是社交恐惧症（25例[23%]患者）和单纯恐惧症（23例[21%]患者）。46例（42%）广泛性焦虑症患者终生至少经历过一次重度抑郁发作。
这些结果支持了先前关于广泛性焦虑症中精神疾病共病率高的研究发现，并验证了广泛性焦虑症作为一个单独诊断实体的实用性。
