焦虑障碍患者共病人格障碍的6个月随访调查

目的探讨人格障碍对焦虑障碍临床特点及对预后等的影响。方法对127例符合DSM-Ⅳ轴Ⅰ障碍定式临床检查(the structured clinical interviewfor diagnostic and statistical manual of mental disorders.4th ed,SCID-Ⅰ)焦虑障碍的患者,予以DSM-Ⅳ轴Ⅱ障碍定式临床检查(the structured interview diagnostic and statistical manual of mental disorders.4th ed,SCID-Ⅱ),评估其人格障碍,同时评估焦虑和抑郁水平,6个月后对其临床特点及治疗细节等进行再次评估。结果共病人格障碍的焦虑障碍患者较单纯焦虑障碍有更加严重的焦虑、抑郁状况,社会功能更差,治疗依从性差,预后差,对治疗满意度低,得到的社会支持少,更多的使用2种及2种以上抗焦虑抑郁药或合并使用其他抗精神病药,更倾向于选择多家医疗机构及多名医生就诊。结论焦虑障碍与人格障碍的共病率高,人格障碍对焦虑障碍影响明显,在接诊焦虑障碍患者时,应对其人格障碍给予充分的评估和处理。

Six month Follow-up of Anxiety Disorders Co-morbid with Personality Disorders

Objective To get the influence of personality disorders on anxiety disorders.Methods One hundred and twenty seven out-patients with anxiety disorders were diagnosed with the structured clinical interview for diagnostic and statistical manual of mental disorders.4th ed(text revision)AxisⅠ(SCID-Ⅰ)and their personality disorders were assessed with the structured clinical interview for diagnostic and statistical manual of mental disorders.4th ed SCID-Ⅱ AxisⅡ(SCID-Ⅱ).Moreover,all patients were assessed with the self-rating anxiety scale(SAS),self-rating depression scale(SDS),and followed for half year.Results Compared to anxiety disorders only,anxiety disorders with personality disorders had more severe symptoms,severe impaired social function,higher state of anxiety,worse prognosis,lower satisfaction for treatments,lower support from the society,easier to have been prescribed more than one anti-anxiety medication,anti-depression medication or anti-psychiatric medications,and easier to visit more doctors.Conclusion The high co-morbid rate of anxiety disorders with personality disorders influence the anxiety disorders greatly,personality disorders should be given more attention and assessed sufficiently when doctors are confronted with anxiety disorders patients.