美国、德国和其他欧洲国家的研究显示,广泛性焦虑障碍(GAD)经常与其他精神障碍共病。[3]Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994 Jan;51(1):8-19.http://www.ncbi.nlm.nih.gov/pubmed/8279933?tool=bestpractice.com[4]Lieb R, Becker E, Altamura C. The epidemiology of generalized anxiety disorder in Europe. Eur Neuropsychopharmacol. 2005 Aug;15(4):445-52.http://www.ncbi.nlm.nih.gov/pubmed/15951160?tool=bestpractice.com[5]Alonso J, Angermeyer MC, Bemert S, et al. 12-month comorbidity and associated factors in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl. 2004;(420):28-37.http://www.ncbi.nlm.nih.gov/pubmed/15128385?tool=bestpractice.com[6]Nabavi B, Mitchell AJ, Nutt D. A lifetime prevalence of comorbidity between bipolar affective disorder and anxiety disorders: a meta-analysis of 52 interview-based studies of psychiatric population. EBioMedicine. 2015 Sep 8;2(10):1405-19.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634892/http://www.ncbi.nlm.nih.gov/pubmed/26629535?tool=bestpractice.com[7]Goldstein-Piekarski AN, Williams LM, Humphreys K. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders. Transl Psychiatry. 2016 Jun 28;6(6):e847.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931606/http://www.ncbi.nlm.nih.gov/pubmed/27351601?tool=bestpractice.com 欧洲一项研究显示,在病程大于12个月且患有一种以上精神障碍的患者中,76%的人患有GAD,该研究还显示GAD的年患病率为1%(男性为0.5%,女性为1.3%)。[8]Alonso J, Lepine JP. Overview of key data from the European Study of the Epidemiology of Mental Disorders. J Clin Psychiatry. 2007;68(suppl 2):3-9.http://www.ncbi.nlm.nih.gov/pubmed/17288501?tool=bestpractice.com 据估计在欧洲GAD的月患病率在0.2%到1%之间,终身患病率为0.1%到21.7%之间。 4%到7.9%的初级保健就诊患者和22%的出现了焦虑表现的人得到了诊断。[4]Lieb R, Becker E, Altamura C. The epidemiology of generalized anxiety disorder in Europe. Eur Neuropsychopharmacol. 2005 Aug;15(4):445-52.http://www.ncbi.nlm.nih.gov/pubmed/15951160?tool=bestpractice.com 新西兰一项研究估计的年患病率为2%(其中男性为1.4%,女性为2.6%),终生患病率为6%。[9]Oakley-Browne M, Wells E, Scott K, et al. Te rau hinengaro: the New Zealand mental health survey. 2006 [internet publication].http://www.health.govt.nz/publication/te-rau-hinengaro-new-zealand-mental-health-survey
在美国,GAD的终身患病率约为5%,而年患病率为3%,但不同GAD患病率研究的调查方法和研究人群不尽相同。 被诊断的患者中约2/3为女性,在临床中女性相对男性被诊断的比例要更大(55%~60%)。[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Publishing; 2013. 前来就诊的人群中有超过一半的人在儿童或青少年期就有过焦虑发作。该诊断在65岁以上的人群中较少出现。[9]Oakley-Browne M, Wells E, Scott K, et al. Te rau hinengaro: the New Zealand mental health survey. 2006 [internet publication].http://www.health.govt.nz/publication/te-rau-hinengaro-new-zealand-mental-health-survey[10]Pigott T. Gender differences in the epidemiology and treatment of anxiety disorders. J Clin Psychiatry. 1999;60 Suppl 18:4-15.http://www.ncbi.nlm.nih.gov/pubmed/10487250?tool=bestpractice.com 尽管养老院人群的患病率呈现上升。[11]Creighton AS, Davison TE, Kissane DW. The prevalence of anxiety among older adults in nursing homes and other residential aged care facilities: a systematic review. Int J Geriatr Psychiatry. 2016 Jun;31(6):555-66.http://www.ncbi.nlm.nih.gov/pubmed/26552603?tool=bestpractice.com 在女性中,GAD 发病风险在妊娠期间 (根据一项大型研究,妊娠期间总患病率为 4.1%)有所增加,产后亦然(产后头24周的患病率为 5.7%)。[12]Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017 May;210(5):315-23.http://www.ncbi.nlm.nih.gov/pubmed/28302701?tool=bestpractice.com 慢性病患者的患病率似乎也有所增加。[13]Remes O, Brayne C, van der Linde R, et al. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain Behav. 2016 Jun 5;6(7):e00497.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951626/http://www.ncbi.nlm.nih.gov/pubmed/27458547?tool=bestpractice.com 美国一项大型流行病学研究发现,几乎半数GAD患者在确诊后2年内仍诊断如此。[3]Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994 Jan;51(1):8-19.http://www.ncbi.nlm.nih.gov/pubmed/8279933?tool=bestpractice.com 在美国不同诊断工具间信度会有一定差异,这也可能是导致不同国家间患病率存在差异的原因之一。[14]Judd LL, Kessler RC, Paulus MP, et al. Comorbidity as a fundamental feature of generalized anxiety disorders: results from the National Comorbidity Study (NCS). Acta Psychiatr Scand Suppl. 1998;393:6-11.http://www.ncbi.nlm.nih.gov/pubmed/9777041?tool=bestpractice.com[15]Andrews G, Peters L, Guzman AM, et al. A comparison of two structured diagnostic interviews: CIDI and SCAN. Aust N Z J Psychiatry. 1995 Mar;29(1):124-32.http://www.ncbi.nlm.nih.gov/pubmed/7625961?tool=bestpractice.com