RESUMO
Questionnaires and clinician rating scales have been used to assess anxious and depressive symptoms among patients with panic disorder, but these methods do not usually evaluate symptoms in the same terms as the standardized criteria of diagnostic interviews. The present study provides data on the prevalence of symptoms of major depressive disorder and generalized anxiety disorder in 64 patients with panic disorder. Symptoms were assessed using DSM-III-R definitional criteria that consider not only the presence and severity of symptoms, but also their duration and pervasiveness. Depressive symptoms that most frequently met definitional criteria for diagnostic significance were fatigue, insomnia, and concentration difficulties. Over 50% of the sample endorsed feelings of tension, irritability, and restlessness. Disturbances in appetite, feelings of worthlessness, and suicidal ideation were found in less than 10% of the nondepressed panic patients. The implications of these findings for conceptualizing the comorbidity among anxiety and depressive disorders are discussed.
Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Transtorno de Pânico/epidemiologia , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Comorbidade , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Transtorno de Pânico/diagnóstico , Prevalência , Escalas de Graduação Psiquiátrica , Índice de Gravidade de DoençaRESUMO
The reliability of DSM-III anxiety disorder diagnoses was determined using a new structured interview, the Anxiety Disorders Interview Schedule (ADIS). Two interviewers examined 60 consecutive outpatients at an anxiety disorders clinic and assigned primary and secondary diagnoses based on the ADIS. The kappa statistic, calculated on the basis of perfect matches on primary diagnoses, indicated good agreement for anxiety, affective, and adjustment disorders, as well as for the specific anxiety disorder categories of agoraphobia, panic, social phobia, and obsessive-compulsive disorder, but not for generalized anxiety disorder. We evaluated the causes for diagnostic disagreement, particularly in relation to the difficult differentiation between generalized anxiety disorder and other anxiety disorders.
