盐酸文拉法辛缓释胶囊治疗广泛性焦虑障碍合并抑郁障碍的临床对照研究

目的评价盐酸文拉法辛缓释胶囊（怡诺思）治疗广泛性焦虑障碍合并抑郁障碍的临床疗效和不良反应。方法68例广泛性焦虑障碍合并抑郁障碍患者随机分为两组,分别予盐酸文拉法辛缓释胶囊（怡诺思）和安慰剂治疗,疗程8周。用汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）、临床总体印象量表（CGI）评价其疗效,药物副反应量表（TESS）评价不良反应。结果盐酸文拉法辛缓释胶囊组显效率82．4％,明显优于安慰剂组,不良反应少而轻。结论盐酸文拉法辛缓释胶囊可作为一种安全有效的抗焦虑抑郁药物。     

盐酸文拉法辛缓释胶囊治疗广泛性焦虑障碍合并抑郁障碍的临床对照研究

目的 评价盐酸文拉法辛缓释胶囊(怡诺思)治疗广泛性焦虑障碍合并抑郁障碍的临床疗效和不良反应.方法 68例广泛性焦虑障碍合并抑郁障碍患者随机分为两组,分别予盐酸文拉法辛缓释胶囊(怡诺思)和安慰剂治疗,疗程8周.用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、临床总体印象量表(CGI)评价其疗效,药物副反应量表(TESS)评价不良反应.结果 盐酸文拉法辛缓释胶囊组显效率82.4%,明显优于安慰剂组,不良反应少而轻.结论 盐酸文拉法辛缓释胶囊可作为一种安全有效的抗焦虑抑郁药物.     

草酸艾司西酞普兰合喹硫平治疗广泛性焦虑障碍的临床效果

目的:分析草酸艾司西酞普兰片联合喹硫平治疗广泛性焦虑障碍的临床效果。方法:选取我院2016年4月～2018年5月收治的广泛性焦虑障碍患者80例,用随机数字表法分为对照组和研究组各40例,对照组接受草酸艾司西酞普兰片治疗,研究组接受草酸艾司西酞普兰片联合喹硫平治疗。观察两组治疗效果。结果:治疗前,两组HAMA评分、BPRS评分比较,差异无统计学意义(P0.05);治疗后,研究组HAMA评分、BPRS评分均低于对照组(P0.05);研究组不良反应发生率明显低于对照组(P0.05)。结论:广泛性焦虑障碍应用草酸艾司西酞普兰片联合喹硫平治疗,有助于缓解患者焦虑状态,改善其精神状况,且安全性较高,值得临床推广。     

文拉法辛与阿普唑仑治疗广泛性焦虑临床对照研究

目的：比较文拉法辛与阿普唑仑治疗广泛性焦虑的抗焦虑效果和副作用。方法：符合CCMD-3广泛性焦虑诊断标准的123例患者，随机分为研究组和对照组；用HAMA评定症状变化，用TESS评定副作用，疗程6周。结果：治疗组显好率、有效率分别为76．9％、92．30％，两组总有效率接近。治疗组剐反应恶心、头痛、口干、嗜睡等较多见。结论：文拉法辛治疗广泛性焦虑效果较好、副反应轻微。     

文拉法辛与阿普唑仑治疗广泛性焦虑临床对照研究

目的：比较文拉法辛与阿普唑仑治疗广泛性焦虑的抗焦虑效果和副作用。方法：符合CCMD-3广泛性焦虑诊断标准的123例患者，随机分为研究组和对照组；用HAMA评定症状变化，用TESS评定副作用。疗程6周。结果：治疗组显好率、有效率分别为76.9％、92.30％，两组总有效率接近。治疗组副反应恶心、头痛、口干、嗜睡等较多见。结论：文拉法辛治疗广泛性焦虑效果较好、副反应轻微。     

艾司西酞普兰联合认知疗法治疗广泛性焦虑障碍对照研究

目的：探讨艾司西酞普兰联合认知疗法治疗广泛性焦虑障碍的临床疗效和安全性。方法将60例广泛性焦虑障碍患者随机分为两组,每组30例,均口服艾司西酞普兰治疗,研究组在此基础上联合认知疗法治疗,观察8周。于治疗前后采用汉密顿焦虑量表、临床疗效总评量表中疗效总评量表评定临床疗效。结果治疗2周末起两组汉密顿焦虑量表、临床疗效总评量表中疗效总评量表评分均较治疗前显著降低（P＜0．01）,研究组显著低于对照组（P＜0．01）。两组不良反应发生率比较差异无显著性（P＞0．05）。结论艾司西酞普兰联合认知疗法治疗广泛性焦虑障碍疗效显著,优于单用艾司西酞普兰治疗。     

艾司西酞普兰治疗广泛性焦虑障碍的疗效分析

广泛性焦虑障碍（GAD）是以缺少确切对象和特定内容的担心和紧张不安为主的神经症,并伴有明显的植物神经症状、肌肉紧张和运动不安等临床表现。5-羟色胺再摄取抑制剂（SSRIs）是当前临床上治疗广泛性焦虑障碍的一线药物,而艾司西酞普兰是剂量依赖性、高选择性的5-羟色胺再摄取抑制剂,能迅速缓解抑郁和焦虑症状,具有明显的抗焦虑作用［1,2］。为观察治疗广泛性焦虑障碍的疗效和副反应,本资料以阿普唑仑作为对照。结果报告如下。     

艾司西酞普兰治疗广泛性焦虑的疗效

目的:探讨艾司西酞普兰治疗广泛性焦虑症患者的疗效及不良反应.方法:将84例广泛性焦虑症患者随机分为艾司西酞普兰组和西酞普兰组,疗程6周,并用汉密顿焦虑量表(HAMA)、临床疗效总评量表、药物不良反应评定量表对患者治疗前后进行评估.结果:在治疗的第2、4、6周末两组的HAMA分值差异有显著性(P＜0.05).在治疗6周末时,艾司西酞普兰组显效率为78.6%,有效率为90.4%,西酞普兰组分别为73.8%、85.7%,两组差异有显著性(P＜0.05).在不良反应方面,艾司西酞普兰低于西酞普兰组,两组差异有显著性(P＜0.05).结论:艾司西酞普兰治疗广泛性焦虑症安全有效.     

文拉法辛治疗焦虑障碍(一)治疗强迫症

在DSM—IV中，焦虑障碍包括以下几个疾病实体：(1)强迫症；(2)广泛性焦虑；(3)惊恐障碍；(4)恐惧症；(5)创伤后应激障碍等。这些疾病实体当中，强迫症的治疗有一定的困难。     

Emotion Dysregulation in Generalized Anxiety Disorder: A Comparison with Social Anxiety Disorder

From an emotion regulation framework, generalized anxiety disorder (GAD) can be conceptualized as a syndrome involving heightened intensity of subjective emotional experience, poor understanding of emotion, negative reactivity to emotional experience, and the use of maladaptive emotion management strategies (including over-reliance on cognitive control strategies such as worry). The current study sought to replicate previous findings of emotion dysregulation among individuals with GAD and delineate which aspects of emotion dysregulation are specific to GAD or common to GAD and another mental disorder (social anxiety disorder). Individuals with GAD reported greater emotion intensity and fear of the experience of depression than persons with social anxiety disorder and nonanxious control participants. Individuals with social anxiety disorder indicated being less expressive of positive emotions, paying less attention to their emotions, and having more difficulty describing their emotions than either persons with GAD or controls. Measures of emotion differentiated GAD, social anxiety disorder, and normal control groups with good accuracy in a discriminant function analysis. Findings are discussed in light of theoretical and treatment implications for both disorders.An earlier version of this paper was presented at the Association for Advancement of Behavior Therapy, Reno, NV, November, 2002     

Development,validation, and feasibility of a generic yoga-based intervention for Generalized Anxiety Disorder

ContextEvidence suggests that yoga effectively manages anxiety, but techniques are derived from different yoga schools. This paper describes the development, validation, and feasibility of a generic yoga-based intervention in patients with Generalized Anxiety Disorder (GAD).MethodsThe first part of the study consisted of designing a generic yoga module from the traditional and contemporary yogic literature and inputs from ten experienced yoga practitioners. The content was validated using a case-vignette method from 28 yoga experts. These yoga experts rated the usefulness of the practices on a scale of 1–5 (5-extremely useful). The second part consisted of testing the feasibility of this validated generic yoga intervention in an open-label clinical trial in patients with GAD. Two weeks of ten supervised yoga sessions (SYS) were offered by a trained yoga therapist to the recruited participants and subsequently advised for home practice. A weekly booster SYS was also provided for three months after 10SYS.ResultsYoga experts (n = 28) opined that the yoga intervention would be helpful in patients with GAD with minimal modifications. All experts opined that the module was easy to teach, learn and practice. The final yoga module retained 97.7% (42 out of 43) items of the initial module. In the feasibility study, (n = 20) patients were recruited, and fifteen followed-up after one month. All patients were able to learn and practice the final yoga module within ten sessions without any significant adverse effects. The severity of anxiety reduced substantially after the ten days of SYS and this improvement was sustained for the next 4 weeks.ConclusionThe designed generic yoga intervention was validated by yoga experts and found safe and feasible in patients with GAD. Patients obtained significant symptom reductions which need to be confirmed in randomized controlled trials.     

Thought Control Strategies in Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by excessive anxiety and worry that is difficult to control; but methods of thought control among persons with GAD have not been previously investigated. Forty-two patients with GAD and 55 non-anxious controls (NACs) completed the Thought Control Questionnaire (TCQ; A. Wells & M. I. Davies, 1994). Patients with GAD reported significantly greater use of worry and punishment strategies, and less use of distraction and social control strategies, than NACs. Further, worry and punishment strategies were positively correlated with depressive symptoms and excessive worry, while distraction and social control strategies were negatively correlated with these measures of psychopathology. Higher life satisfaction was associated with greater use of distraction and social control strategies, and lesser use of worry and punishment strategies.     

Depression,Generalized Anxiety Disorder,and Certainty in Pessimistic Predictions about the Future

This study examined whether symptoms of GAD and depression were differentially associated with predictions individuals made about their future. Sixty-five undergraduates completed the BDI-II and GAD-Q-IV, predicted whether positive and negative events would happen to them in the future, and indicated their level of certainty about these predictions. Both higher GAD and depression symptoms were associated with an increased tendency to anticipate that negative events would happen. However, only depression was associated with the tendency to predict that positive events would not occur, even after adjusting for GAD symptoms. In addition, GAD and depression scores were positively associated with pessimistic certainty about negative events, but only depression was associated with increased certainty about both the occurrence of negative outcomes and a lack of positive outcomes, even after adjusting for GAD symptoms.

曲唑酮治疗广泛性焦虑障碍的随机对照双盲试验

目的评价曲唑酮与阳性对照药阿普唑仑比较,治疗广泛性焦虑障碍的疗效及其安全性.方法采用随机对照试验方法,将60例广泛性焦虑障碍患者分成曲唑酮组(50～150 mg/d,30例)和阿普唑仑组(1.2～4 mg/d,30例),在3 d清洗期后,进入疗程为4周的治疗,采用SPSS 10.0统计包和意向性治疗分析方法分析资料.结果曲唑酮组总有效率77%(23/30),阿普唑仑组总有效率70%(21/30),两组疗效差异无统计学意义(P＞0.05),其药物不良反应两组基本相当.两组均没有失访.结论曲唑酮是一种有效、安全的抗焦虑药物,有改善睡眠的作用,无潜在的依赖性,不良反应轻,主要表现为头晕、食欲下降等.     

Evidence of Broad Deficits in Emotion Regulation Associated with Chronic Worry and Generalized Anxiety Disorder

This study examined the relationship between emotion regulation deficits and GAD-related outcomes in an analogue sample. Consistent with hypotheses, general emotion dysregulation was associated with reports of chronic worry and with analogue GAD status. Also, specific regulation deficits, including deficits in emotional clarity, acceptance of emotions, ability to engage in goal directed behaviors when distressed, impulse control, and access to effective regulation strategies, were associated with worry and analogue GAD above and beyond variance contributed by negative affectivity. These findings provide additional preliminary evidence for an emotion regulation deficit model of GAD and are discussed in terms of clinical implications and directions for future research.     

暗示疗法治疗广泛性焦虑48例疗效分析

目的 :探索广泛性焦虑患者快速有效的治疗方法。方法 :将 48例符合广泛性焦虑诊断标准 (中国精神疾病的诊断标准 )的迁延不愈者停服抗焦虑药 ,采用口服维生素类药合并细胞色素C、辅酶A等静滴 ,葡萄糖酸钙静脉推注 ,注射用水皮内或穴位注射等进行诱导暗示心理治疗。分别于治疗前     

Attentional Bias in Generalized Anxiety Disorder Versus Depressive Disorder

This review evaluates evidence of attentional biases in generalized anxiety disorder (GAD) and depressive disorder from studies using modified Stroop and visual probe tasks. There appears to be fairly consistent evidence for an attentional bias for external negative cues in GAD, and for the involvement of non-conscious processes in this bias. By contrast, in clinical depression, the evidence for an attentional bias is less robust, despite depressive disorder being commonly associated with high levels of co-morbid anxiety. Where an attentional bias has been found in depressed patients, it seems to occur mainly for self-relevant negative information which is presented under conditions that allow or encourage elaborative processing. Possible explanations for this discrepant pattern of results, and their theoretical and clinical implications are discussed.     

Understanding Separation Anxiety Disorder

BACKGROUND. When children are acutely ill and life is threatened, separation anxiety can develop in parents and children. Separation anxiety has been studied through two traditions—as a normative phenomenon and as a disorder.
SOURCE. A comprehensive review of the literature.
OBJECTIVE. To analyze and evaluate the literature to derive clinical and research implications.
CONCLUSIONS. Support was found for the development of interventions beyond the developmental stage of early childhood. The need for a family approach was evident.     

盐酸曲唑酮与阿普唑仑治疗成人广泛性焦虑效果比较的Meta分析

目的系统评价盐酸曲唑酮与阿普唑仑治疗成人广泛性焦虑的有效性及安全性。方法计算机检索PubMed（1980～2012．5）、CBM（1990～2012．5）、VIP（1989～2012．5）、CNKI（1990～2012．5）币口Wanfang Data（1990～2012．5）,收集盐酸曲唑酮与阿普唑仑治疗成人广泛性焦虑的随机对照试验,南两名评价者按照纳入与排除标准选择试验、提取资料和评价质量后,采用RevMan5．0软件进行Meta分析。结果纳入5个RCT,共403例广泛性焦虑症患者。Meta分析结果显示：①治疗4周后,盐酸曲唑酮组与阿普唑仑组的HAMA评分和治愈率的差异无统计学意义[RR=I．04,95％CI（0．95,1．13）,P=0．38;RR=I．05,95％CI（0．75,1．48）,P=0．76]。②盐酸曲唑酮组的嗜睡发生率低于阿普哗仑组[RR=0．42,95％CI（0．25,0．72）,P=0．001],但两组在头晕、乏力、食欲减退发生牢方面,差异无统计学意义[RR=0．52,95％CI（0．27,1．01）,P=0．05;RR=0．10,95％CI（0．01,1．41）,P=0．09;RR=2．82,95％CI（0．28,28．23）,P=0．38]。结论盐酸曲唑酮和阿普唑仑治疗广泛性焦虑的疗效无差异,但盐酸曲唑酮不良反应较少,而阿普唑仑更易引起嗜睡。由于纳入研究数量有限且方法学质量不高,本研究结果尚需更多高质量随机对照试验进一步证实。