精神医学65巻7号

2023年07月発行

特集 子どものうつ病に気づく

児童青年期における不安症の診断と治療

著者： 鈴木太¹

所属機関： ¹上林記念病院こども発達センターあおむし

ページ範囲：P.1034 - P.1040

抄録
　抑うつ障害と不安症は神経生物学的には異なる表現型であると見なされているが，いずれも内在化障害に分類され，互いに併存しやすく，治療反応性が類似している。抑うつ障害と不安症を併存する児童や青年は，いずれかだけを有した人と比べて，より重度で，治療に反応しにくい。臨床家は不安症の典型的な発症年齢，抑うつ障害と不安症の発達モデルを意識しながらアセスメントし，不安症をより早期に認識して，集中的な精神医学的治療を導入すべきである。Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5（K-SADS-PL-5）などの構造化面接は不安症を包括的にアセスメントするための助けとなる。抗うつ薬と認知行動療法は不安症治療の選択肢となる。

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