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Yıl:2009; Cilt: 10; Sayı: 1>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2009;10(1):11-17
Anksiyöz depresyonun klinik özellikleri
H Aydın, L Tamam, M Ünal
Diyarbakır Devlet Hastanesi, Diyarbakır
Amaç: Araştırmalar anksiyetenin klinik depresyonda en belirgin belirti olduğunu ve depresyonun başarılı tedavi için şiddetli ve dirençli anksiyetenin önemli olduğunu göstermektedir. Anksiyöz depresyon terimi düşünülürken, hastaların anksiyete ve depresyon belirtilerini üç şekilde gösterebileceği göz önünde tutulmalıdır: komorbid anksiyete ve depresyon, depresyon ve eşik altı anksiyete, eşik altı depresyon ve anksiyete. Depresyon ve anksiyete arasındaki ilişki henüz net olmamasına karşın anksiyöz depresyon tanımının eşik altı anksiyete belirtileri gösteren depresyon için kullanılması gerektiği belirtilmektedir. Depresyon hastalarında anksiyete, şiddet, düşük tedavi yanıtı ve intihara daha fazla eğilimin belirtecidir. Yüksek anksiyeteli depresyon hastalarında hastalık daha şiddetli, iyileşme daha uzun sürede, antidepresanlara yanıt daha düşüktür. Bu çalışmada, anksiyete düzeyi yüksek olan depresyon hastalarının klinik özelliklerinin tanımlanması amaçlanmıştır. Yöntem: Çalışmaya, DSM-IV-TR’ye göre depresif bozukluk tanısı konan, yaşları 18-60 yıl arasında (ortalama 43±12.0 yıl) değişen 18 kadın ve 10 erkekten oluşan anksiyöz depresyon olgusu, yaş ortalaması 40.2±10.7 yıl olan 26 kadın ve 9 erkekten oluşan non-anksiyöz depresyon olgusu alındı. Çalışma toplam 63 olgudan oluşmuştur. Hastalara çalışmanın amacı anlatılmış ve onayları alınmıştır. Deneklere sosyodemografik veri toplama formu, Hamilton Depresyon Ölçeği, Klinik Global İzlem, Hamilton Anksiyete Ölçeği, İntihar Düşünceleri Ölçeği, Beck Depresyon Ölçeği, Durumluk Anksiyete Ölçeği uygulanmıştır. Bulgular: Çalışma sonucunda anksiyöz depresyon grubunda depres-yon şiddetinin daha yüksek olduğu, intihara eğilimin daha yüksek, işlevsel bozulmanın daha fazla olduğu ve affektif bozukluklar açısından ailesel yüklülüğün daha yüksek oranda olduğu saptandı. Tartışma: Sonuç olarak depresyon hastalarını değerlendirirken anksiyete belirtilerine dikkat etmek ve tedavi planını buna göre yapmak gerekmektedir.
The clinical features of anxious depression
Objective: Evidence suggests that anxiety is one of the most prevalent symptoms in clinical depression and that assessing and treating severe, persistent anxiety are of great importance in the successful treatment of depression. When considering anxious depression term, it should be recognized that patients can manifest symptoms of depression and symptoms of anxiety in three separate ways; as comorbid depression and anxiety, as depression with subthreshold anxiety, and as subthreshold depression with subthreshold anxiety. The nature of the link between depression and anxiety remains uncertain; however, based on the evidence to date, the term anxious depression should be reserved for patients who meet diagnostic criteria for depression have subthreshold symptoms of an anxiety disorder. In depressed patients anxiety is a marker of severity, poor outcome, response to treatment, and suicide risk. Depressed patients who have higher ratings for anxiety are more severely ill, takelonger to recover, and show a poor response to antidepressants. The aim of this study was to investigate the clinical features of anxious depression. Methods: In anxious depressive group, 18 women and 10 men, within an age range of 18 and 60 (mean age 43.0±12.0 [year]s) and in non-anxious depressive group 26 women and 9 men (mean age 40.2±10.7 [year]s) were included in this study. The study consisted of a total of 63 cases. All patients have been informed of the study and gave informed consent before participating into this study. Sociodemographic data form, Hamilton Depression Scale, Clinic Global Impression, Hamilton Anxiety Scale, Suicide Thoughts Scale, Beck Depression Scale, State and Trait Anxiety Scale were administered to all subjects. Results: We found that anxious patients have higher depression severity, higher tendency for suicide, higher functional impairment rate and higher genetic loading for affective disorders than non-anxious depressive patients. Conclusion: In conclusion, anxious depression may be a different subtype of depression. While evaluating the depression patients, attention must be paid to anxiety symptoms and treatment plan should be made accordingly.

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