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題 名 | 憂鬱症與焦慮症之共患現象=The Comorbidity of Depressive Disorders and Anxiety Disorders |
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作 者 | 曾美智; 李宇宙; 李明濱; | 書刊名 | 臺灣精神醫學 |
卷 期 | 13:2 1999.06[民88.06] |
頁 次 | 頁37-47 |
分類號 | 415.9982 |
關鍵詞 | 憂鬱症; 焦慮症; 共患現象; 共病率; Depressive disorders; Anxiety disorders; Comorbidity; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:了解綜合醫院精神科的憂鬱症與焦慮症的診斷分布和共病率。方法:本研 究的對象為綜合醫院精神科的門診及住院病人,研究當時合乎憂鬱症、焦慮症或同時有憂鬱 症與焦慮症診斷,排除過去和現在合併有精神病症狀者,一共有 150 位。 本研究對象依序 納入研究後,由精神科醫師利用 SCID 結構性面談,建立精神科診斷。結果:所有病人中, 憂鬱症佔 78% ( N=117 ), 焦慮症佔 54% ( N=81 ),其他的共病診斷佔 11% ( N=17 )。憂鬱症中重鬱症最多( N=97.65% ),焦慮症則以單純畏懼症( N=31,20.7% )和懼曠 症最常見( N=27.18% )。 終生共病的盛行率如下:單純憂鬱症者有 58 位( 38.7% ), 單純焦慮症者有 32 位( 21.3% ),憂鬱和焦慮症共病者有 43 位( 28.7% ),憂鬱或焦 慮症與其它第一軸精神科共病者有 17 位( 11.3% )。 憂鬱症和焦慮症的終生共病率很高 :合併一種以上其他診斷的情形,憂鬱症為 53% 到 84%,焦慮症為 81% 到 100%。 焦慮症 中合併憂鬱症的比例( 50% 到 88% )高於憂鬱症中合併焦慮症的比例( 32% 到 53% )。 疾病發生的先後次序, 只有 10% 是重鬱症比焦慮症先發生, 44% 是焦慮症先開始, 另外 46% 是重鬱症與焦慮症在同一病程中一起開始。結論:本研究和其他研究的結果一致地發現 ,憂鬱症和焦慮症的共患現象很普遍;然各診斷的分布和診斷間的共病型態,和其他的研究 有差異,可能的原因是方法學和研究樣本的問題。作者試著就疾病的發生和就醫年齡,憂鬱 症和焦慮症的共病率,提出一個假說法解釋兩者的關係,但需要進行重複或進一步的研究來 印證。 |
英文摘要 | Objective: To investigate the comorbidity of depressive disorders and anxiety disorders in the psychiatry service of a general hospital. Methods: The study subjects consisted of 150 consecutively enrolled psychiatric patients who fulfilled the DSM- Ⅲ -R criteria for depressive disorders, anxiety disorders or concurrent depressive and anxiety disorders. All subjects underwent the Structured Clinical Interview for DSM- Ⅲ -R (SCID-OP). Results: The results showed that a lifetime prevalence rate of 78% for depressive disorders, 54% for anxiety disorders, and 11% for psychiatric diagnoses other than depressive disorders and anxiety disorders in our study population. Compared to the community studies and other clinical studies which were conducted in anxiety disorder clinic, patients with depressive disorders were predominant in this study. Among depressive disorders, major depression (N=97, 65%) was the most common diagnosis. Among anxiety disorders, simple phobia (N=31, 21%) and agoraphobia (N=27, 18%) were the two leading diagnoses. In contrast to other studies, panic disorder and social phobia were less prevalent, but agoraphobia, simple phobia and obsessive-compulsive disorder were more commonly seen in our study. The lifetime comorbidity rates were high among patients with depressive disorders and anxiety disorders: the rate of depressive disorders combined with additional diagnoses ranged from 53%-84%, whereas the rate of anxiety disorders combined with additional diagnoses ranged from 81%-100%. However the rate of anxiety disorder patients met the DSM- Ⅲ -R criteria for depressive disorders (range 50%-80%) was higher than the rate of depressed patients who met the DSM- Ⅲ -R criteria for anxiety disorders (range 32%-53%). Conclusion: Depressive disorders were commonly found to be cormorbid with antiety disorders. However, the rank order of anxiety disorders and the comorbidity rate and patterns among depressive and anxiety disorders were different from other studies. The possible explanations included the methods of assessment and the sample characteristics. We need both replication studies and further studies to explain the differences. |
本系統中英文摘要資訊取自各篇刊載內容。