关键词: 抑郁症；焦虑症状；艾司西酞普兰；文拉法辛；焦虑性抑郁

Abstract:

Objective   To investigate the clinical features and curative effects in the treatment of depression patients with or without anxiety symptoms. Methods   319 depression disorder patients were divided into 2 groups according to the the Hamilton anxiety scale (HAMA)：the patients in the group A suffered from depression without anxiety（HAMA＜14，n=134）and the patients in the group B suffered from  depression with anxiety（HAMA≥14， n=185). All the patients received the open anti-depression treatment for 8 weeks. The Hamilton depressive scale (HAMD17), HAMA and the treatment emergent symptom scale(TESS) were used to evaluate the efficacy and side effects before the treatment and at the end of the 1st, 2nd,4th and 8th week. Results   There was significant difference between group A and group B in the suicide risk（P<0.01）. The baseline mean scores of HAMD had significant difference between the two groups (P<0.01). After 8 weeks of treatment, the HAMD and HAMA scores in both groups decreased significantly compared with those before the treatment (P<0.01). The effective rates were 65.3% and 47.5% in group A and group B respectively (P<0.01). At the end of 2nd week, the onset rates of the two groups were 75.2% and 50.0%(P<0.01) . There were significant differences in the mean scores of HAMD and HAMA between the two groups at every time point during treatments (P<0.01) . There were no significant differences between groups A1(depression without anxiety symptoms and treatment with Escitalopram) and A2 (depression without anxiety symptoms and treatment with Venlafaxine) in the onset rate at 2nd week, the efficient rate and the clinical cure rate at 8th week (P>0.05). There were no significant differences between groups B1(depression with anxiety symptoms and treat with Escitalopram )and B2(depression with anxiety symptoms and treat with Venlafaxine) in the onset rate at 2nd week and the efficient rate at the 8th week (P>0.05), but there was significant difference in the clinical cure rate at 8th week between group B1 and group B2(P<0.05), and the rates were 3.7% and 12.8%.  Conclusion   The patients suffered from depression with anxiety have worse pathogenetic conditions, higher risk of suicide, poorer response to antidepressants, as well as poorer prognosis contrast with those without anxiety. Venlafaxine has better prognosis than Escitalopram in the treatment of the depression patients with anxiety symptoms.

Key words: Major depression; Comorbid anxiety symptoms; Escitalopram; Venlafaxine; Anxious depression