Study of clinical phenomenology, psychosocial factor and biology of comorbid anxiety and depression

doi:10.3321/j.issn:1673-8225.2005.04.005

Abstract：BACKGROUND:Anxiety and depression are two independent disease units in current diagnostic classification criteria;however,both clinical and epidemiological researches find that there is a very high comorbidity of these two disorders.Comorbid anxiety and depression(CAD) has the features of serious symptoms, chronic course of the disease,severe social functional lesion,high suicide rate and poor prognosis,etc.in the comparison with simple anxiety or depression. To understand the clinical phenomenological,psychosocial and biological characters of CAD has significance in the theoretical instruction for clinical intervention and rehabilitation. OBJECTIVE:To explore the clinical phenomenological, psychosocial and biochemical characters of CAD,and to clarify the relationship between CAD and simple depression or anxiety disorder. DESIGN:A case controlled trial based on diagnosis. SETTING:Department of psychiatry of two hospitals affiliated to university. PARTICIPANTS:Twenty five patients with CAD(CAD group),30 patients of major depression disorder(depression group),14 patients of generalized anxiety disorder and 6 patients with panic disorder(anxiety group) were selected from the patients admitted by the Brain Hospital affiliated to Nanjing Medical University from November 1999 to November 2000 according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders(DSM IV). INTERVENTIONS:All the patients were interviewed with common data and case history questionnaire,Hamilton rating scale for depression(HAMD),Hamilton rating scale for anxiety(HAMA),life event scale(LES),social support rating scale(SSRS) and Eysenck personality questionnaire(EPQ).Plasma monoamine neurotransmitters[5 hydroxytryptamine(5 HT),noradrenaline(NA)] were detected as well. The above indicators were compared among the three groups or compared with the Chinese norm. MAIN OUTCOME MEASURES:General condition, case history, evaluation results of HAMD,HAMA,LES,SSRS and EPQ,plasma levels of 5 HT and NA in the patients of each group. CONCLUSION:CAD has some different characteristics from simple major depression or simple anxiety disorder;however,current evidences are not enough to prove that CAD is a new independent disease unit.