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目的了解焦虑和抑郁障碍患儿中焦虑与抑郁共病的发生率和行为特点。方法在门诊收集符合中国精神障碍分类与诊断标准第3版中焦虑障碍和抑郁障碍诊断标准的5～17岁儿童青少年,其中单纯焦虑障碍41例(焦虑组),单纯抑郁障碍31例(抑郁组),焦虑与抑郁共病31例(共病组)。由父母、儿童、医师分别采用自编一般资料表、Achenbach儿童行为量表(CBCL)、儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表和儿童大体评定量表,评定三组儿童。结果(1)焦虑障碍患儿有16%(8例)合并抑郁;抑郁障碍患儿有42%(23例)合并焦虑。(2)CBCL焦虑组的活动情况及社会能力总分[(15.74±3.65)分]优于共病组[(12.98±4.00)分]和抑郁组[(14.02±3.67)分],均P<0.01和<0.05;共病组行为问题总分[(61.74±28.96)分]高于焦虑组[(43.44±22.54)分]和抑郁组[(47.74±25.99)分;F=4.62,P<0.05]。(3)SCARED共病组的总分高于焦虑组和抑郁组(P<0.05)。(4)儿童抑郁障碍自评量表抑郁组和共病组总分高于焦虑组(P<0.01)。(5)儿童大体评定量表焦虑组[(67.71±9.54)分]优于抑郁组[(58.55±8.08)分]和共病组[(61.16±7.60)分;F=11.10,P<0.001]。结论儿童焦虑、抑郁共病现象常见,共病患儿比单纯焦虑或抑郁患儿的内化性问题、外化性问题更严重,社会功能损害更明显。
Objective To understand the incidence and behavioral characteristics of anxiety and depression co-morbidities in children with anxiety and depression. Methods Adolescents aged 5 to 17 years with diagnostic criteria for anxiety disorder and depression in the third edition of the Chinese Classification and Diagnosis of Mental Disorders were enrolled in this study. Among them, 41 were simple anxiety disorder (anxiety group), 31 were simple depression (depression group ), Anxiety and depression comorbidity in 31 cases (comorbidity group). The self-compiled general information form, Achenbach Children’s Behavior Scale (CBCL), Childhood Anxiety Disorders Checklist (SCARED), Children’s Depression Disability Self-rating Scale and Children’s General Rating Scale were assessed by parents, children and physicians respectively. Three groups of children. Results (1) 16% of children with anxiety disorder had depression (8 cases) and 42% (23 cases) of children with depression had anxiety. (2) The scores of activity and social competence in CBCL anxiety group [(15.74 ± 3.65) points] were superior to comorbidity group (12.98 ± 4.00) and depression group (14.02 ± 3.67) points, P < 0.01 and <0.05 respectively. The total score of behavioral problems in comorbidity group was (61.74 ± 28.96) points higher than those in anxiety group (43.44 ± 22.54) and depression group (47.74 ± 25.99), F = 4.62 ]. (3) The total score of SCARED comorbidity group was higher than anxiety group and depression group (P <0.05). (4) Children with depression self-rating scale depression and comorbidity group was higher than the anxiety group (P <0.01). (5) Children’s general rating scale anxiety group (67.71 ± 9.54) was superior to the depression group (58.55 ± 8.08) and comorbidity group (61.16 ± 7.60); F = 11.10, P <0.001] . Conclusions Children with common anxiety and depression are common symptoms of comorbidity. Compared with those with simple anxiety or depression, comorbidity problems are more serious in externalization and more obvious in social dysfunction.