焦虑症:一个回顾
Kristin L Szuhany1, Naomi M Simon1
1Department of Psychiatry, New York University Grossman School of Medicine, New York.
JAMA
|December 27, 2022
概括
焦虑症影响34%的美国成年人, 有效的第一线治疗包括认知行为疗法,SSRI如塞特拉林,SNRIs如文拉法辛.
科学领域:
- 精神病学与心理健康
- 主要护理医学
背景情况:
- 在美国,焦虑症的终身患病率约为34%.
- 这些疾病往往是慢性,导致生活质量和日常功能严重受损.
- 常见的焦虑障碍包括一般性焦虑障碍,社会焦虑障碍和恐慌障碍,经常出现在初级保健机构.
研究的目的:
- 提供焦虑障碍的概述,包括它们的流行,症状和诊断方法.
- 突出基于证据的第一线治疗常见焦虑症.
- 告知临床医生在选择焦虑患者治疗时应考虑的因素.
主要方法:
- 对美国焦虑症的流行数据的综述.
- 焦虑症的特征症状和身体表现
- 关于药物治疗 (SSRI,SNRIs) 和心理治疗 (CBT) 疗效的元分析结果的摘要.
主要成果:
- 与安慰剂相比,选择性血清素再吸收抑制剂 (SSRI) 和血清素 - 上腺素再吸收抑制剂 (SNRIs) 在全 generalized焦虑症,社会焦虑症和恐慌症方面表现出小到中等效果.
- 认知行为疗法 (CBT) 对一般焦虑症,社会焦虑症和恐慌症具有大到中等效果,表明其有效性显著.
- 简短的查工具,如通用焦虑障碍-7 (GAD-7) 可以帮助诊断焦虑障碍在初级保健.
结论:
- 焦虑症是普遍存在的, 需要有效的管理策略.
- 认知行为疗法,SSRI (例如,塞特拉林) 和SNRIs (例如,文拉法辛延长释放) 是已确定的第一线治疗方法.
- 治疗选择应该是个性化的,考虑患者的偏好,并发病症以及成本和护理准入等实际因素.
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