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首页> 美国卫生研究院文献>Schizophrenia Bulletin >Comorbid Depressive and Anxiety Disorders in 509 Individuals With an At-Risk Mental State: Impact on Psychopathology and Transition to Psychosis
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Comorbid Depressive and Anxiety Disorders in 509 Individuals With an At-Risk Mental State: Impact on Psychopathology and Transition to Psychosis

机译：509名具有危险心理状态的患者共患抑郁症和焦虑症：对心理病理学和精神病的转变

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Background: The current diagnostic system for subjects at enhanced clinical risk of psychosis allows concurrent comorbid diagnoses of anxiety and depressive disorders. Their impact on the presenting high-risk psychopathology, functioning, and transition outcomes has not been widely researched. Methods: In a large sample of subjects with an At-Risk Mental State (ARMS, n = 509), we estimated the prevalence of DSM/SCID anxiety or depressive disorders and their impact on psychopathology, functioning, and psychosis transition. A meta-analytical review of the literature complemented the analysis. Results: About 73% of ARMS subjects had a comorbid axis I diagnosis in addition to the “at-risk” signs and symptoms. About 40% of ARMS subjects had a comorbid diagnosis of depressive disorder while anxiety disorders were less frequent (8%). The meta-analysis conducted in 1683 high-risk subjects confirmed that baseline prevalence of comorbid depressive and anxiety disorders is respectively 41% and 15%. At a psychopathological level, comorbid diagnoses of anxiety or depression were associated with higher suicidality or self-harm behaviors, disorganized/odd/stigmatizing behavior, and avolition/apathy. Comorbid anxiety and depressive diagnoses were also associated with impaired global functioning but had no effect on risk of transition to frank psychosis. Meta-regression analyses confirmed no effect of baseline anxiety and/or depressive comorbid diagnoses on transition to psychosis. Conclusions: The ARMS patients are characterized by high prevalence of anxiety and depressive disorders in addition to their attenuated psychotic symptoms. These symptoms may reflect core emotional dysregulation processes and delusional mood in prodromal psychosis. Anxiety and depressive symptoms are likely to impact the ongoing psychopathology, the global functioning, and the overall longitudinal outcome of these patients.
机译：背景：目前用于精神病临床风险增加的受试者的诊断系统可以同时诊断焦虑症和抑郁症。它们对目前高危心理病理，功能和过渡结果的影响尚未得到广泛研究。方法：在具有风险心理状态（ARMS，n = 509）的大量受试者中，我们估计了DSM / SCID焦虑症或抑郁症的患病率及其对心理病理学，功能和精神病过渡的影响。文献的荟萃分析补充了该分析。结果：大约73％的ARMS受试者除了“危险”的体征和症状外，还患有I轴合并症。大约40％的ARMS受试者患有抑郁症的合并症，而焦虑症的发病率则较低（8％）。在1683名高危受试者中进行的荟萃分析证实，合并抑郁症和焦虑症的基线患病率分别为41％和15％。在心理病理学水平上，焦虑症或抑郁症的合并诊断与较高的自杀或自残行为，无序/奇怪/污名化的行为以及过分/虔诚相关。合并症焦虑症和抑郁症的诊断也与整体功能受损有关，但对过渡为坦率精神病的风险没有影响。荟萃回归分析证实基线焦虑和/或抑郁合并症对精神病发作没有影响。结论：ARMS患者除了精神病症状减轻以外，还具有较高的焦虑症和抑郁症患病特征。这些症状可能反映了前驱性精神病的核心情绪失调过程和妄想情绪。焦虑和抑郁症状可能会影响这些患者的正在进行的精神病理学，整体功能以及总体纵向预后。

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