Depress Anxiety：焦虑障碍患者或应筛查复杂性悲伤

　　美国一项研究提示，临界复杂性悲伤（CG）在居丧的原发性焦虑障碍（AD）患者中有临床意义。在AD患者中筛查CG可能是有必要的。该研究论文3月11日在线发表于《抑郁与焦虑》（Depress Anxiety）杂志。

　　该研究共纳入了242例居丧的原发性AD患者（平均年龄为41.5岁，女性占44.2%），包括广泛性焦虑症（GAD，n=57）、惊恐障碍（PD，n=49）、创伤后应激障碍（PTSD，n=29）和广泛性社交焦虑障碍（GSAD，n =107）患者，以及当时未接受DSM-Ⅳ轴Ⅰ诊断的居丧的155名健康对照者（平均年龄= 43.0岁 ，女性占51.0％）。19项复杂性悲伤量表（ICG）被用于评估CG症状，ICG评分≥30分被定义为临界CG。生活质量和功能障碍的评估分别采用幸福和生活质量满意度问卷（Q-LES-Q）和功能受损度量工具（LIFE-RIFT）。

　　结果显示，与居丧的对照者相比，原发性CG患者的临界CG症状发生率显著升高（12.0％ 对 0.65％，Fisher精确检验P＜0.001）。与居丧的对照者相比，各类AD患者的临界CG发生率均显著升高。在校正年龄、性别、受教育程度和重性抑郁障碍共病后，在AD患者中，临界CG与生活质量降低（β= - 0.140，P = 0.023）和功能受损增加（β=0.141，P=0.035）相关。

与焦虑相关的拓展阅读：

• Depress Anxiety：预防抑郁症和自杀应处理焦虑症状
• Br J Psychiatry：戒烟可减少焦虑
• 医学证实生气焦虑会升高血糖
• AHA2012：ICD电击会增加患者焦虑程度和死亡率
• CMAJ：焦虑或抑郁可能会引发中风
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COMPLICATED GRIEF SYMPTOMS IN ANXIETY DISORDERS: PREVALENCE AND ASSOCIATED IMPAIRMENT

Background

Previous research has identified high rates of comorbid anxiety disorders among individuals presenting with primary CG. In the present study, we examined the prevalence of comorbid CG in bereaved primary anxiety disorder (AD) patients compared to bereaved healthy controls. We also examined the impairment associated with comorbid CG in AD.

Methods

Participants were 242 bereaved adults (mean (SD) age = 41.5 (13.1), 44.2% women) with a primary AD diagnosis, including generalized anxiety disorder (GAD; n = 57), panic disorder (PD; n = 49), posttraumatic stress disorder (PTSD; n = 29), and generalized social anxiety disorder (GSAD; n = 107), as well as 155 bereaved healthy controls with no current DSM-IV Axis I diagnosis (mean (SD) age = 43.0 (13.6), 51.0% women). CG symptoms were measured using the 19-item inventory of complicated grief (ICG), with threshold CG defined as an ICG score of ≥30. Quality of life and functional impairment were assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Range of Impaired Functioning Tool (LIFE-RIFT), respectively.

Results

Participants with primary ADs had significantly higher rates of threshold CG symptoms than bereaved controls (12.0% vs. 0.65%; Fisher's Exact P < 0.001). Rates of threshold CG were significantly elevated for each AD when compared to bereaved controls. After adjustment for age, sex, education, and comorbid major depressive disorder, threshold CG was associated with lower quality of life (β = −0.140, P = 0.023) and greater impairment (β = 0.141, P = 0.035) among individuals with AD.

Conclusions

Our findings suggest that threshold CG is of clinical relevance in bereaved individuals with a primary anxiety disorder. Screening for CG in patients with ADs may be warranted.