标准与讨论
ENGLISH ABSTRACT
《中国焦虑障碍防治指南》第二版解读
施慎逊
张宁
司天梅
陆峥
潘集阳
许秀峰
吴文源
作者及单位信息
·
DOI: 10.3760/cma.j.cn113661-20240221-00065
Interpretation of Chinese guideline for the prevention and treatment of anxiety disorders (the second edition)
Shi Shenxun
Zhang Ning
Si Tianmei
Lu Zheng
Pan Jiyang
Xu Xiufeng
Wu Wenyuan
Authors Info & Affiliations
Shi Shenxun
Huashan Hospital of Fudan University, Shanghai 200040,China
Zhang Ning
Brain Hospital of Nanjing Medical University, Nanjing 210024,China
Si Tianmei
The Sixth Hospital of Peking University, Beijing 100191,China
Lu Zheng
Tongji Hospital of Tongji University,Shanghai 200065,China
Pan Jiyang
The First Hospital of Jinan University,Guangzhou 510630,China
Xu Xiufeng
The First Hospital of Kunming Medical University,Kunming 650031,China
Wu Wenyuan
Tongji Hospital of Tongji University,Shanghai 200065,China
·
DOI: 10.3760/cma.j.cn113661-20240221-00065
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摘要

《中国焦虑障碍防治指南》第二版在相隔第一版13年后于2023年8月正式出版。第二版的修订原则是:保持第一版框架,在原有框架基础上结合研究进展,进行必要的修订,补充国内外最新成果的内容。参照DSM-5和ICD-11精神障碍分类和国内临床实际情况,第二版的焦虑障碍包括惊恐障碍、广泛性焦虑障碍、社交焦虑障碍、分离焦虑障碍、躯体疾病所致焦虑障碍。增加了国内近期的焦虑障碍流行病学资料。参照国际指南,增加了第一版未纳入的药物。根据中国特点和治疗方法的发展,补充了中成药治疗、物理治疗和基于网络的心理治疗。在查阅文献的基础上,补充了孕产妇使用抗抑郁药风险的最新资料。焦虑障碍的治疗原则贯彻全病程治疗理念,分为急性期、巩固期、维持期治疗。治疗药物均采用一线、二线等推荐方法。

焦虑症;惊恐障碍;广泛性焦虑障碍;社交焦虑障碍;分离焦虑障碍;躯体疾病所致焦虑障碍
ABSTRACT

The second edition of the Chinese guideline for the prevention and treatment of anxiety disorders was published in August 2023, 13 years after the first edition. The revision principles for the second edition were maintaining the first edition's framework, and based on that framework, making necessary revisions by incorporating research progress and supplementing the latest research findings from the domestic studies and the overseas literature. Referring to the DSM-5 and ICD-11 classifications of mental disorders and the actual clinical situation in China, the anxiety disorders in the second edition were panic disorder, generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, and anxiety disorder due to another medical condition. The latest epidemiological data on anxiety disorders in China were added. Following the international guidelines, medications not included in the first edition have been added. Chinese traditional medicines, physical therapy, and internet web-based psychotherapy were also supplemented to fit Chinese clinical settings. Based on a literature review, the latest information on the risks of using antidepressants during pregnancy has been added.A whole course of treatment across the acute phase, consolidation phase, and maintenance phase was further addressed as the treatment principle. First-line and second-line recommendations are provided for medication selections.

Anxiety disorders;Panic disorder;Generalized anxiety disorder;Social anxiety disorder;Separation anxiety disorder;Anxiety disorder due to another medical condition
Wu Wenyuan, Email: nc.defudabe.ijgnotywuw
引用本文

施慎逊,张宁,司天梅,等. 《中国焦虑障碍防治指南》第二版解读[J]. 中华精神科杂志,2024,57(06):327-336.

DOI:10.3760/cma.j.cn113661-20240221-00065

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《中国焦虑障碍防治指南》第二版(以下简称第二版《指南》)于2023年8月正式出版。《焦虑障碍防治指南》第一版(以下简称第一版《指南》)于2010年出版 1,对提高焦虑障碍的诊治率起到了极大的促进作用,受到临床医生的好评。随着DSM-5精神障碍诊断分类和国外焦虑障碍诊治指南的陆续发表,以及ICD-11的修订及焦虑障碍诊治研究的进展,2017年由中华医学会精神医学分会焦虑障碍协作组发起并负责对第一版《指南》进行修订。编写人员在之前的17位编者的基础上,更换4人,新增9人,共22位编者。第二版《指南》的修订原则是:在第一版《指南》框架的基础上,结合国内外最新研究进展进行补充和修订。参照DSM-5和ICD-11精神障碍分类和国内临床实际情况,第二版《指南》的焦虑障碍包括:惊恐障碍、广泛性焦虑障碍、社交焦虑障碍、分离焦虑障碍、躯体疾病所致焦虑障碍。
第二版《指南》编写过程中参考文献的循证证据检索来源于以下国内外数据库:中国知网、中国生物医学文献数据库、万方数据库、PubMed、Cochrane Library、EMBASE、WHO网站。循证证据的等级认定:以Meta分析、前瞻性双盲安慰剂对照研究、国外最新临床指南认可的药物为优先推荐。在初稿基础上,对书稿进行了2次集体互审,然后各副主编负责各章节审阅,最后双主编通篇审阅修订19次定稿。
由于ICD-11出版等问题,第二版《指南》经过5年修订终于出版。为了让广大读者和医生更全面和透彻地了解第二版《指南》各章节及重点内容的制订背景,更好地指导临床实践,编写组主要成员对总论和各论(惊恐障碍、广泛性焦虑障碍、社交焦虑障碍、分离焦虑障碍、躯体疾病所致焦虑障碍)的各部分进行解读。
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备注信息
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吴文源,Email: nc.defudabe.ijgnotywuw
B
施慎逊, 张宁, 司天梅, 等.《中国焦虑障碍防治指南》第二版解读[J]. 中华精神科杂志, 2024, 57(6): 327-336. DOI: 10.3760/cma.j.cn113661-20240221-00065.
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上海市重点扶持学科 (2023ZDFC0502)
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