综合医院精神卫生问题打印稿 梅其一.pptVIP

* * * 有关研究结果显示，在不同的焦虑障碍和抑郁症之间存在相当比例的共病： 37％社交焦虑症患者存在抑郁症； 27％强迫症患者存在抑郁症；50～60％惊恐障碍患者存在抑郁症；同样，在抑郁症患者中，也存在相当比例的焦虑症。因此，选择治疗抑郁症或焦虑症药物时，必须首选同时对抑郁和焦虑有出色疗效的药物。 据估计，在患有抑郁症的患者中，有大约58％～95％的人将具有相关的焦虑症状。 * * * * Key Point In recent years, depression has been increasingly recognized as a systemic illness, with a wide variety of emotional and physical signs and symptoms Background In addition to depressed mood and anhedonia, emotional symptoms associated with MDD include feelings of hopelessness, low self-esteem, impaired memory, difficulty concentrating, and anxiety Patients with MDD also frequently present with a wide variety of physical complaints, including headache, sleep disturbances, painful physical symptoms, etc As these symptoms are general in nature, it is important to obtain a complete medical history and to rule out other physical illnesses to ensure an accurate diagnosis of depression References DSM-IV-TR?. Washington, DC: American Psychiatric Association; 2000. Kroenke K, et al. Arch Fam Med. 1994;3:774-779. * * Key Point Physical symptoms are common in depressed patients and have been associated with greater disability1 and poor depression outcome following treatment2 Background Approximately ?65% of patients with depression suffer from physical symptoms2,3 Data from the World Health Organization (WHO) international study of psychological disorders in general health care indicated that more than two thirds (69%) of depressed patients (N=1,146) reported only physical symptoms as the reason for their visit4 The degree of physical symptoms has been associated with greater disability1 and poor treatment outcome for depression2 References 1. Kroenke K, et al. Arch Fam Med. 1994;3:774-779. 2. Bair MJ, et al. Psychosom Med. 2004;66:17-22. 3. Bair MJ, et al. Arch Intern Med. 2003;163:2433-2445. 4. Simon GE, et al. N Engl J Med. 1999;341:1329-1335. * * 39 在不同治疗时期，治疗目标有所不同： 急性期以减轻症状为主； 中期以恢复社会功能为主； 长期以减少复燃/复发次数为主。 * * 此图叠加了两张图。说明巩固治疗。 * * * * AHCPR=卫生保健政策与研究署 抗抑郁药