憂鬱症與焦慮症之共患現象__臺灣人文及社會科學引文索引資料庫

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題名：	憂鬱症與焦慮症之共患現象
書刊名：	臺灣精神醫學
作者：	曾美智／李宇宙／李明濱
作者(外文)：	Tseng, Mei-chih／Lee, Yue-joe／Lee, Ming-been
出版日期：	1999
卷期：	13:2
頁次：	頁37-47
主題關鍵詞：	憂鬱症；焦慮症；共患現象；共病率；Depressive disorders；Anxiety disorders；Comorbidity
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(8) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:8 共同引用:0 點閱:122

　　　　　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。

以文找文

　　　　　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.

以文找文

期刊論文
1.	Kahn, R. J.、McNair, D. M.、Lipman, R. S.(1986)。Imipramine and chlordiazepoxide in depressive and anxiety disorders, Ⅱ: efficacy in anxious outpatients。Arch Gen Psychiatry，43，79-85。
2.	Gulley, L. R.、Wemeroff, C. B.(1993)。The neurobiological basis of mixed depression-anxiety states。J Clin Psychiatry，54(suppl)，16-19。
3.	Weissman, M. M.(1988)。The epidemiology of anxiety disorders: rates, risks and familial patterns。J Psychiatr Res，22(supppl)，99-114。
4.	Stavrakaki, C.、Vargo, B.(1986)。The relationship of anxiety and depression: a review of the literature。Br J Psychiatry，149，7-16。
5.	Clayton, P. J.(1991)。The comorbidity factor: Establishing the primary diagnosis in patients with mixed symptoms of anxiety and depression。J Clin Psychiatry，51(11, suppl)，35-39。
6.	Breier, A.、Chamey, D. S.、Heninger, G. R.(1984)。Major depression in patients with agoraphobia and panic disorder。Arch Gen Psychiatry，41，1129-1135。
7.	Balow, D. H.、DiNardo, P. A.、Vermilyea, B. B.、Vermilyea, J.、Blanchard, E. B.(1986)。Comorbidity and depression among the anxiety disorders: issues in classification and diagnosis。J Nerv Ment Dis，174，63-72。
8.	Sanderson, W. C.、Beck, A. T.、Beck, J.(1990)。Syndrome comorbidity in patients with major depression or dysthymia: Prevalence and temporal relationships。Am J Psychiatry，147，1025-1028。
9.	Wittchen, H. U.(1996)。Critical issues in the evaluation of comorbidity of psychiatric disorders。Br J Psychiatry，168(S30)，168-30。
10.	李毅達、賴德仁、李麗卿、柯慧貞、蔡景仁(19950600)。癲癇病人的精神疾病盛行率。中華精神醫學，9(2)，139-147。延伸查詢
11.	Weissman, M. M.、Bland, R.、Canino, G.(1996)。Cross-national epidemiology of major depression and bipolar disorder。JAMA，276，293-299。
12.	Aronson, T. A.、Logue, C. M.(1987)。On the longitudinal course of panic disorder: Developmental history and predictors of phobic complications。Compr Psychiatry，28，344-355。
13.	陳尚義、李明濱(19880900)。恐慌症之研究: 臨床表現､病程與結果。中華精神醫學，2(3)，196-205。延伸查詢
14.	Wittchen, H.、Ahmoi, Essau、Krieg, J.(1991)。Anxiety disorders: Similarities and differences of comorbidity in treated and untreated groups。Br J Psychiatry，159(suppl 12)，23-33。
15.	Sanderson, W. C.、DiNardo, Rapee R. M.、Barlow, D. H.(1990)。Syndrome comorbidity in patients diagnosed with a DSM-III-R anxiety disorder。J Abnorm Psychology，99，308-312。
16.	Zinbarg, R. E.、Barlow, D. H.、Liebowitz, M.(1994)。The DSM-IV field trial for mixed anxiety-depression。Am J Psychiatiy，151，1153-1162。
17.	Liebowitz, M. R.、Gorman, J. M.、Fyer, A. J.(1985)。Social phobia: Review of a neglected anxiety disorder。Arch Gen Psychiatry，42，729-736。
18.	Brown, T. A.、Barolw, D. H.(1992)。Comorbidity among anxiety disorders: Implications for treatment and DSM-IV。J Consul Clin Psychology，60，835-844。
19.	Cheng, T. A.(1988)。A community study of minor psychiatric morbidity in Taiwan。Psychol Med，18，953-968。
20.	Hwu, H. G.、Yeh, E. K.、Chang, L. Y.(1989)。Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnositic Interview Schedule。Acta Psychiatr Scand，79，136-147。
21.	Kessler, R. C.、McGonagle, K. A.、Zhao, S.(1994)。Lifetime and 12-month Prevalence of DSM-III-R Psychiatric Disorders in United States: Results from National Comorbidity Survey。Archives of General Psychiatry，51，8-19。

研究報告
1.	張明永(1993)。神經衰弱與慢性疲乏症候群：一比較文化之研究。延伸查詢

圖書
1.	Racagni, G.、Smeraldi, E.(1987)。Anxious depression: Assessment and treatment。New York：Raven Press。
2.	American Psychiatric Association(1980)。Diagnostic and Statistical Manual of Mental Disorders。Washington, DC。
3.	Spitzer, R. L.、Williams, J. B. W.、Gibbon, M.、Fist, M. B.(1990)。Structured clinical interview for DSM-III-R。Washington, DC：American Psychiatric Press。
4.	Caplan, H. I.、Sadock, B. J.(1998)。Synopsis of Psychiatry。Baltimore：Williams & Wilkins。
5.	American Psychiatric Association(1994)。Diagnostic and Statistical Manual of Mental Disorder: DSM-IV。Washington, D.C.：American Psychiatric Association。
6.	American Psychiatric Association(1987)。Diagnostic and Statistical Manual of Mental Disorders。Washington, DC：American Psychiatric Association (APA)。

圖書論文
1.	Merikangas, K. R.(1990)。Co-morbidity for anxiety and depression: review of family and genetic studies。Comorbidity of Mood and Anxiety Disorders。Washington, DC：American Psychiatric Press。
2.	Burke, J. D.、Burke, K. C.(1990)。Comorbidity of affective and anxiety disorder in the NIMH epidemiological catchment area program。Comorbidity of Mood and Anxiety Disorder。Washington DC：American Psychiatric Press。
3.	Maser, J. D.、Cloninger, C. R.(1990)。Comorbity of anxiety and mood disorder: Introduction and overview。Comorbity of Mood and Anxiety Disorders。Washington, DC：American Psychiatric Press。
4.	Horwath, E.、Weissman, M. M.(1995)。Epidemiology of depression and anxiety disorders。Textbook in Psychiatric Epidemiology。New York：John Wiley & Sons, Inc。
5.	Di Nardo, P. A.、Barlow, D. H.(1990)。Syndrome and symptom co-occurrence in the anxiety disorders。Comorbidity of Mood and Anxiety Disorders。Washington, DC：American Psychiatric Press。
6.	Dobson, K. S.、Cheung, E. C.(1990)。Relationship between anxiety and depression: Conceptual and methodological issues。Comorbidity of Mood and Anxiety Disorders。Washington, DC：American Psychiatric Press。
7.	Angst, J.、Vollrath, M.、Merikangas, K. R.、Ernst, C.(1990)。Comorbidity of anxiety and depression in the Zurich study of young adults。Comorbidity of Mood and Anxiety Disorders。Washington, DC：American Psychiatric Press。

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