A Basic And Clinical Study In Comorbid Anxiety And Depression

Objective s This study attempted to explore clinical phenomenological, psychosocial, biochemical and electrophysiological characteristics of patients with comorbid anxiety and depression(CAD), and to clari1~r the relationship between CAD and sure?major depression or 損ure?anxiety disorder, and to find the risk factors of CAD. Methods: 25 patients who both met major depression and generalized anxiety disorder(or panic disorder) in DSM-IV( CAD group), 30 patients who only met major depression in DSM-1V( depression group), 14 patients who only met generalized anxiety disorder and 6 patients who only met panic disorder in DSM-IV(anxicty group) were investigated. All patients were interviewed in semi-stmctured manner with common data and case history questionnaire, HAYi4EX HAMA LES~ SSRSI FES-CV~ TABP~ EPQ~ DSQ, and measured plasma monoamine neurotransmitters and examined brain electricity area mapping(BEAM). While some indexes were compared with norms or normal controls. Results: 1. Clinical phenomenology showed: (1) CAD group had older and later onset than depression group and anxiety group. (2) CAD group had more acute onset than the other two groups. (3) CAD group had more severe clinical somptoms than depression group and anxiety group. (4) CAD group had more impairment of social functioning than depression group and anxiety group. (5) CAD and depression group had higher rates of suicide intent or attempted suicide. (6) The family histroy of CAD group was similar to that of depression group. (7) The main symptoms of CAD group were similar to those of depression group, but CAD bad some features of somatization similar to anxiety group. (8) There were no significantly differences in the couse and recent prognosis among three groups, but the time of prominence progress in CAD group bad longer than that of anxiety group. 2. Psychosocial facters showed: (1) CAD group had no significantly differences in negative life event among three groups. (2) The social support scores of CAD group had higher than in 3 those of depression group, but no significantly differences with anxiety group. (3) CAD group had family function deficits, but less severe than depression group and anxiety group. (4) The incidence of type A behavior in CAD group was similar to depression group, but significantly higher than anxiety group. The TH factor scores of CAD group and anxiety group were significantly higher than those of normal controls. (5) The N factor scores (EPQ) of three groups were significantly higher than those of form. Compared with CAD patients, anxiety group significantly lower scores for humor, significantly higher scores for reaction formation; depression group significantly higher scores for fantasy. 3. Biochemical and electrophysiological tests showed: (1) CAD group bad no significantly differences with depression group and anxiety group in plasma monoamine neurotransmitter levels. (2) There were no significantly differences among three groups in alpha power and right/left asymmetries, but they had different features compared with normal controls. 4. The risk factors of CAD bad older, later onset, acute onset, less subjective support, humor and reaction formation, and so on. On the other band, if the patients had reluctance referral, obvious biological symptoms, higher HAMD ad HAMA scores, and longer time of prominence progress, CAD should also be taked into account.