Клиническая характеристика взрослых пациентов с тревогой и связанными расстройствами, направленная на персонализированное ведение
Всемирная психиатрия. №3 2021
Клиническая характеристика взрослых пациентов с тревогой и связанными расстройствами, направленная на персонализированное ведение
Dan J. Stein1 , Michelle G. Craske2 , Barbara O. Rothbaum3 , Samuel R. Chamberlain4 , Naomi A. Fineberg5,6, Karmel W. Choi7 , Peter de Jonge8 , David S. Baldwin4 , Mario Maj9
1 South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, Univer- sity of Cape Town, CapeTown, South Africa; 2Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of Cali- fornia, Los Angeles (UCLA), Los Angeles, CA, USA; 3 Department of Psychiatry, Emory University, Atlanta, GA, USA; 4 Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK; 5 School of Life and Medical Sciences, University of Hertfordshire, and Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK; 6 University of Cambridge Clinical Medical School, Cambridge, UK; 7 Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; 8 Develop- mental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands; 9 Department of Psychiatry, University of Cam- pania “L.Vanvitelli”, Naples, Italy
Стр. 336-356
1998 просмотров
Опубликовано: 1 октября 2021
Аннотация / Abstract
a:2:{s:4:"TEXT";s:65532:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:112599:"Тревожные расстройства – самые распространенные психические расстройства, их распространенность в общей популяции достигает 7,3% 1 . Дифференцировка специфичных тревожных расстройств в DSM-III была важным шагом к разработке более персонализированного лечения пациентов с тревогой 2 . Например, раньше считали, что пациенты с тревожными расстройствами реагируют преимущественно на ингибиторы моноаминоксидазы (МАО) 3 . В то же время тревожные расстройства характеризуются значительной коморбидностью и гетерогенны по своей феноменологии и психобиологии. Так, например, социальное тревожное расстройство часто сопровождается генерализованным тревожным расстройством (ГТР) 4 . Хотя существует множество данных об эффективности селективных ингибиторов обратного захвата серотонина и когнитивно-поведенческой терапии в лечении тревожных расстройств, эта гетерогенность может объяснить, почему некоторые пациенты не реагируют на первую линию терапии 5 . Хотя современные диагностические системы, безусловно, полезны для составления первоначального плана лечения, приходится разрабатывать вспомогательные диагностические методы. Они помогают отойти от гайдлайнов, которые делают упор на СИОЗС и КПТ как первую линию терапии, к более детальной диагностике, которая предоставляет клиницистам больше конкретных рекомендаций и способствует более персонализированному подходу к терапии пациента. Эта статья направлена на систематическое описание важных факторов (доменов), релевантных для персонализированного ведения пациентов с тревожными расстройствами и связанными состояниями, такими как обсессивно-компульсивное расстройство (ОКР) и посттравматическое стрессовое расстройство (ПТСР) (Таблица 1). Для каждого фактора (домена) мы собрали результаты актуальных исследований и рассмотрели релевантные диагностические инструменты, уделяя особое внимание возможности использов...
Тревожные расстройства – самые распространенные психические расстройства, их распространенность в общей популяции достигает 7,3% 1 . Дифференцировка специфичных тревожных расстройств в DSM-III была важным шагом к разработке более персонализированного лечения пациентов с тревогой 2 . Например, раньше считали, что пациенты с тревожными расстройствами реагируют преимущественно на ингибиторы моноаминоксидазы (МАО) 3 . В то же время тревожные расстройства характеризуются значительной коморбидностью и гетерогенны по своей феноменологии и психобиологии. Так, например, социальное тревожное расстройство часто сопровождается генерализованным тревожным расстройством (ГТР) 4 . Хотя существует множество данных об эффективности селективных ингибиторов обратного захвата серотонина и когнитив...
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