米氮平治疗广泛性焦虑症的疗效比较

我们选用米氮平治疗广泛性焦虑症,并与多虑平对照,旨在探讨其疗效和安全性,现报道于后。     

米氮平治疗广泛性焦虑症的临床观察

目的探讨米氮平治疗广泛性焦虑症(GAD)的临床疗效及安全性。方法共85例广泛性焦虑症患者入组,米氮平治疗46例,对照观察组39例,共观察8周,使用HAMA判断疗效,并记录不良反应。结果74例完成研究(米氮平41例,对照组33例)。研究终点,米氮平组HAMA减分平均为12.5±5.8,对照组减分平均为7.7±6.5,两组比较差异有统计学意义(t=3.35,P(0.01);米氮平治疗后14天及其后各随访点HAMA减分与观察组比较差异均有统计学意义;米氮平治疗GAD的有效率71%,显著优于观察组(39%)(2χ=7.32,P<0.01);米氮平的主要不良反应为体重增加、食欲增强、嗜睡及头晕。结论米氮平治疗GAD有效,依从性高,不良反应不多见,可作为临床治疗GAD的一种选择。     

米氮平治疗广泛性焦虑症对照研究

目的 比较米氮平与阿普唑仑治疗广泛性焦虑症的疗效及不良反应.方法 对60例符合CCMD-3广泛性焦虑症诊断标准的患者,随机分为米氮平组和阿普唑仑组,观察治疗期6周,于治疗前及治疗后2、4、6周末用汉密尔顿焦虑量表（HAMA）及不良反应症状量表（TESS）评定疗效和不良反应.结果 米氮平疗效略强于阿普唑仑,不良反应较阿普唑仑稍多,但无严重不良反应或成瘾性.结论 米氮平是治疗广泛性焦虑症的有效、安全、依从性好的药物.     

米氮平治疗广泛性焦虑对照研究

目的:比较米氮平与阿普唑仑治疗广泛性焦虑的临床疗效及不良反应。方法:采用随机分组的方法,对66例广泛性焦虑随机平分为米氮平组(33例)和阿普唑仑组(33例)。疗程6周。用焦虑自评量表(SAS)、Hamilton焦虑量表(HAMA)和治疗中出现的症状量表(TESS)评定疗效和不良反应。结果:米氮平与阿普唑仑疗效相当,不良反应米氮平组较阿普唑仑组少而轻。结论:米氮平治疗广泛性焦虑安全、有效,且不良反应轻微。     

焦虑症患者防御方式与生活质量特征的调查分析

目的探讨焦虑症患者防御方式及生活质量特征。方法分别运用防御方式问卷(QSD)和健康调查问卷(SF-36)对20例焦虑症患者和18例正常对照进行防御机制评定和生活质量调查。结果(1)焦虑症患者较多使用幻想、升华、制止、交往倾向等防御机制。(2)对照组SF-36因子分一般健康(GH)、精力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)显著高于焦虑症患者(P<0.01)。(3)焦虑症患者精力(VT)、情感职能(RE)与不成熟防御机制有密切关系。结论焦虑症患者较多使用不成熟的、中间型的防御机制,并影响其生活质量、心理健康。     

米氮平治疗广泛性焦虑临床观察

采用米氮平(商品名：瑞美隆)治疗广泛性焦虑患者，对其疗效及不良反应进行临床分析，报告如下。     

米氮平与丁螺环酮治疗广泛性焦虑对照研究

以米氮平与丁螺环酮治疗广泛性焦虑临床对照研究。1对象和方法为2006年1月至6月我院门诊患者,符合中国精神障碍分类与诊断标准第3版广泛性焦虑的诊断标准;Hamilton焦虑量表(HAMA)评分≥14分;排除躯体疾病,有自杀倾向者。共50例,随机平分为两组。米氮平组男12例,女13例;平均年龄(31.2±7.8)岁,平均病程(3.3±1.3)年。丁螺环酮组男10例,女15例;平均年龄(29.8±8.5)岁,平均病程(3.2±1.3)年。两组以上各项差异均无显著性(P均>0.05)。米氮平初始剂量15mg,治疗剂量15~45mg/d。丁螺环酮初始剂量15mg/d,治疗剂量10~45mg/d。疗程6周。采用HAMA及…     

米氮平与帕罗西汀治疗广泛性焦虑的对照研究

为探讨米氮平治疗广泛性焦虑患者的疗效,我们以帕罗西汀为对照,研究2药对广泛性焦虑的疗效,报告如下. 1 对象和方法 选自2005年7月至2006年7月我院住院和门诊患者,符合中国精神障碍分类与诊断标准第3版广泛性焦虑障碍的诊断标准;既往未用过抗抑郁剂治疗;排除严重的器质性疾病、物质依赖及哺乳期妇女.     

心理剧治疗对广泛性焦虑症患者生活质量的影响

目的 探讨心理剧治疗对广泛性焦虑症患者生活质量的影响.方法 将76例广泛性焦虑症患者随机分为观察组和对照组各38例.两组均予以米氮平系统治疗,观察组在此基础上则联合心理剧治疗,疗程均为12周.采用Hamilton焦虑量表(HAMA)及生活质量综合评定问卷(GQOLI-74)分别于治疗前及治疗12周末进行评定.结果 治疗...     

米氮平与帕罗西汀治疗广泛性焦虑障碍的对照研究

目的评价米氮平治疗广泛性焦虑障碍的临床疗效及安全性。方法将76例符合中国精神障碍分类与诊断标准第三版（CCMD-3）诊断标准的广泛性焦虑障碍患者（GAD）随机分为米氮平组和帕罗西汀组治疗8周,采用汉密顿焦虑量表（HAMA）、临床疗效总评量表（CGI）、副反应量表（TESS）在治疗前和第2、4、6、8周评定临床疗效及不良反应。结果经8周治疗后,显效率分别为81.6%和84.2%,两组比较,差异无显著性（P〉0.05）。结论米氮平和帕罗西汀对广泛性焦虑障碍的治疗效果相当,且副反应轻,均可作为临床治疗GAD的一种选择。     

米氮平治疗广泛性焦虑障碍的开放性研究

目的研究米氮平治疗广泛性焦虑障碍(GAD)的疗效和安全性。方法对符合CCMD-3广泛性焦虑诊断标准的患者26例使用30mg／d米氮平治疗6周，在0、2．4、6周评定汉密尔顿焦虑量表(HAMA，14项)，并评定疗效、记录出现的不良反应。结果米氮平能显著改善GAD患者的精神性焦虑和躯体性焦虑，治疗结束时的显效率达65．4％，有效率达88．5％：最常见的不良反应均为思睡和体重增加。结论米氮平对广泛性焦虑症疗效肯定，不良反应少。     

Examining quality of life in patients with generalized anxiety disorder: clinical relevance and response to duloxetine treatment

BACKGROUND: Duloxetine, a serotonergic noradrenergic reuptake inhibitor, improved functional outcomes in each of three clinical studies for the treatment of adults with generalized anxiety disorder (GAD). Using comparison norms, the current work describes the clinical relevance of these functional improvements in terms of return to normative functioning and symptom remission. METHODS: Data were pooled at the individual patient level from three double-blind, placebo-controlled trials of duloxetine treatment (9-10 weeks acute therapy, dose ranges 60-120mg). Inclusion/exclusion criteria were consistent across studies, and outcome measures included the Sheehan Disability Scale (SDS), Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF), and European Quality of Life 5 Dimensions (EQ-5D). RESULTS: Adult patients (mean age=42.4 years; 65% women) were randomly assigned to duloxetine (N=668) or placebo (N=495). At baseline, the majority of patients were impaired on the SDS global functioning (89%), Q-LES-Q-SF maximum percent (95%), and EQ-5D (76%) scores. On each measure, a greater percentage of duloxetine-treated patients converted from an impaired baseline to a normative endpoint score than did placebo-treated patients (p0.001, all comparisons). Remission defined as a HAMA total score at endpoint of 10, compared with 7, captured a greater proportion of patients who were functionally in remission. CONCLUSIONS: GAD is associated with substantial impairment in functioning and subjective well-being, and patients treated with duloxetine 60-120mg/day, compared with placebo, experienced a greater return to normative functioning. Attention to role functioning and quality of life may refine our definition of remission when using standard symptom measures of anxiety.     

Quality of life in geriatric generalized anxiety disorder: a preliminary investigation

OBJECTIVE: To examine the impact of late-life generalized anxiety disorder (GAD) on health-related quality of life. METHOD: We compared quality of life in 75 treatment-seeking older adults with GAD, 39 of whom had psychiatric comorbidity, with 32 older adults without psychiatric illness. We examined predictors of quality of life in these samples. We also compared data from the GAD patients to published norms from a large national sample of older adults with chronic medical conditions or major depression. RESULTS: Older GAD patients reported worse health-related quality of life across most domains than asymptomatic older individuals. There were no differences in quality of life between GAD patients with and without psychiatric comorbidity, and comorbidity did not predict quality of life in multivariate regression analyses. Presence of GAD or symptoms of anxiety or depression were significantly related to impairment in every domain of quality of life. Comparisons with national norms suggest that older GAD patients report overall worse quality of life than individuals with recent acute myocardial infarction or type II diabetes, and are comparable in quality of life to individuals with major depression. CONCLUSION: Results suggest that late-life GAD is associated with substantial impairment in quality of life, and these findings cannot be explained by psychiatric comorbidity.     

Quality of life impairment in generalized anxiety disorder, social phobia, and panic disorder

Interest in the assessment of quality of life in the anxiety disorders is growing. The present study examined quality of life impairments in individuals with generalized anxiety disorder (GAD), social phobia, and panic disorder. Results showed that individuals with these disorders reported less satisfaction with their quality of life than non-anxious adults in the community. However, the degree of quality of life impairment is similar across these three disorders. Additionally, comorbid depression, but not anxiety, was found to negatively impact quality of life in these individuals. Finally, diagnostic symptom severity was not found to influence quality of life, indicating that subjective measures of quality of life offer unique information on the effects of anxiety disorders.     

慢性焦虑症患者的生活事件和防御方式

目的探讨生活事件、防御方式与慢性焦虑症发生的关系。方法利用生活事件量表(LES)和防御方式问卷(DSG)对55例慢性焦虑症患者进行测试,以51名正常人作为对照。结果慢性焦虑症组的生活事件负性刺激量和总刺激量评分较高,防御方式不成熟得分较高,中间型防御方式得分5项较高,2项较低,与对照组差异非常显著。结论慢性焦虑症的发生与负性生活事件,防御方式不成熟及一些中间型防御方式不恰当使用密切相关。     

焦虑症患者的生命质量与焦虑症状的相关性研究

目的 探讨焦虑症患者的生命质量以及与焦虑症状的关系.方法 采用生命质量量表(LQS)及Hamilton焦虑量表(HAMA)对60例焦虑症患者进行了问卷调查,并与60例正常对照者比较.结果 焦虑症患者的生命质量总分及各因子评分均明显低于正常对照者(P＜0.01).焦虑症患者的生命质量总分及各因子评分与HAMA总分及因子分均呈显著性负相关(P＜0.01).结论 焦虑症患者的生命质量较差,且与焦虑症状有关,即焦虑症状越重,其生命质量越差.     

Sertraline in generalized anxiety disorder: efficacy in treating the psychic and somatic anxiety factors

OBJECTIVE: The objective was to study the efficacy of sertraline on symptoms of psychic and somatic anxiety in patients suffering from moderate-to-severe generalized anxiety disorder (GAD). METHOD: Out-patients with DSM-IV GAD were randomized to 12 weeks of double-blind treatment with placebo. The psychic and somatic anxiety factors of the Hamilton Anxiety Rating Scale (HAM-A) and the Quality of Life, Enjoyment, and Satisfaction Questionnaire were analyzed. RESULTS: Treatment with sertraline resulted in significantly greater last observation carried forward (LOCF)-endpoint improvement than placebo on both the HAM-A psychic and somatic anxiety factors. At LOCF-endpoint, all items on the HAM-A psychic factor were more improved on sertraline than placebo, as were three of seven items on the somatic factor. Reduction of secondary depressive symptoms was more correlated with endpoint improvement in quality of life than either psychic- or somatic anxiety. CONCLUSION: Sertraline treatment demonstrated efficacy for both the psychic and somatic anxiety symptoms of GAD.     

焦虑症患者的生活质量及相关因素分析

目的 探索焦虑症患者的生活质量及相关因素。方法 对60例符合CCMD-3诊断标准的焦虑症患者进行一般情况调查、汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）、健康状况调查问卷（SF-36）评定。结果除生理机能一项外,焦虑症患者SF-36各维度的评分均显著低于常模（P〈0．01）。患者HAMD评分和SF-36各维度评分呈显著负相关（P〈0．05或P〈0．01）。伴有抑郁症状的焦虑症患者,其SF-36的躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康6个维度得分显著低于不伴抑郁症状的患者（P〈0．05或P〈0．01）,其HAMA评分显著高于不伴抑郁症状的患者（P〈0．01）。结论 焦虑症患者的生活质量低于一般正常人群,伴有的抑郁症状的焦虑症患者其生活质量受损更加严重。     

The experience of disability and quality of life in social anxiety disorder

Although disability is a concept most often associated with role dysfunction, and quality of life is most often associated with life satisfaction, these terms are frequently used interchangeably in the literature. In contrast, this study proposes that disability and quality of life are independent but related constructs. Additionally, we propose that disability partially mediates the relationship between symptoms and quality of life. That is, greater symptoms are associated with more impairment, which is, in turn, associated with less satisfaction with one's life. Ninety-six individuals with social anxiety disorder were given measures of social anxiety symptoms, disability, and quality of life. The results of the study suggest that disability and quality of life are, in fact, distinct concepts, and the experience of disability partially mediates the relationship between a patient's experience of symptoms and his or her perceived life satisfaction.