目的:焦虑性抑郁是在被诊断为重度抑郁障碍(MDD)的亚洲精神病患者中观察到的一个普遍特征。这项研究旨在调查诊断为MDD的台湾个体中焦虑抑郁症的患病率和临床表现。
方法:我们招募了18岁以上通过临床访谈诊断为MDD的精神科门诊患者。这次招募是在台湾北部的五家医院进行的。我们收集了参与者的基线临床和人口统计信息。在21项汉密尔顿抑郁量表(HAM-D)上,使用焦虑/躯体化因子得分≥7的阈值来识别焦虑抑郁。
结果:在我们对399名患者(84.21%为女性)的研究中,64.16%符合焦虑抑郁的标准。他们往往年纪大了,已婚,受教育程度较低,有了更多的孩子,发病年龄较大。焦虑抑郁症患者的HAM-D和临床总体印象-严重程度量表评分较高,更多的恐慌症(没有广场恐惧症),表现出躁动等症状,烦躁,集中困难,心理和躯体焦虑,躯体投诉,软骨病,减肥,和增加洞察力。令人惊讶的是,他们的自杀率与非焦虑抑郁症患者没有显著差异.这突出了认识和解决这些独特特征的重要性。
结论:我们的研究结果揭示,与住院患者相比,台湾诊断为MDD的门诊患者中焦虑抑郁的患病率较低,但大大高于欧洲国家和美国报告的患病率。此外,焦虑抑郁症患者表现出更多的躯体症状。
OBJECTIVE: Anxious depression is a prevalent characteristic observed in Asian psychiatric patients diagnosed with major depressive disorder (MDD). This study aims to investigate the prevalence and clinical presentation of anxious depression in Taiwanese individuals diagnosed with MDD.
METHODS: We recruited psychiatric outpatients aged over 18 who had been diagnosed with MDD through clinical interviews. This recruitment took place at five hospitals located in northern Taiwan. We gathered baseline clinical and demographic information from the participants. Anxious depression was identified using a threshold of an anxiety/somatization factor score ≥7 on the 21-item Hamilton Rating Scale for Depression (HAM-D).
RESULTS: In our study of 399 patients (84.21% female), 64.16% met the criteria for anxious depression. They tended to be older, married, less educated, with more children, and an older age of onset. Anxious depression patients had higher HAM-D and Clinical Global Impression-Severity scale score, more panic disorder (without agoraphobia), and exhibited symptoms like agitation, irritability, concentration difficulties, psychological and somatic anxiety, somatic complaints, hypochondriasis, weight loss, and increased insight. Surprisingly, their suicide rates did not significantly differ from non-anxious depression patients. This highlights the importance of recognizing and addressing these unique characteristics.
CONCLUSIONS: Our study findings unveiled that the prevalence of anxious depression among Taiwanese outpatients diagnosed with MDD was lower compared to inpatients but substantially higher than the reported rates in European countries and the United States. Furthermore, patients with anxious depression exhibited a greater occurrence of somatic symptoms.