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目的 观察抑郁症共病焦虑障碍患者1年(12个月)随访结果及复发相关因素.方法 本研究为前瞻性、多中心、队列随访研究；采用17项汉密尔顿抑郁量表(HAMD17)和汉密尔顿焦虑量表(HAMA)对594例抑郁症患者进行3、6、12个月随访评估,比较抑郁症共病焦虑障碍(共病组,344例)与非共病焦虑障碍(非共病组,250例)的临床痊愈率、复发率、自杀念头、服药依从性、联合治疗的差异；采用logistic逐步回归分析复发相关因素.结果 3、6、12个月3个时点随访到的患者分别为482、441、301例.3个月时,共病组临床痊愈率(53.7％,153/285)低于非共病组(68.0％,134/197),差异有统计学意义(P＜0.01).3个月和6个月时,共病组HAMD总分[(8.80±6.49)、(6.86±7.07)分]和HAMA总分[(6.35±4.64)、(4.88±4.63)分]均高于非共病组[HAMD:(7.20 ±5.97)、(5.33±5.86)分,HAMA:(4.77±4.26)、(3.38 ±3.69)分],12个月时共病组HAMA总分[(3.98±4.01)分]高于非共病组[(2.97±3.95)分],差异均有统计学意义(P＜0.05或P＜0.01).3、6、12个月3个时点共病组与非共病组的复燃率分别为6.7％(19/285) vs 5.6％(11/197),13.3％ (36/270)vs 8.2％ (14/171),14.9％ (30/202) vs 9.1％ (9/99),2组比较差异无统计学意义(P均＞0.05)；但生存分析显示,2组1年复发率差异有统计学意义(X2=4.487,P＜0.05).2组自杀念头、转躁率、服药依从性和社会功能差异均无统计学意义(P均＞0.05).共病组和非共病组分别有50.5％和43.4％的患者在1年随访时仍合用苯二氮(卓)类药.Logistic多元回归分析显示,6个月时自杀念头[OR=32.258,95％可信区间(CI) 7.092 ～ 142.857,P＜0.01]和服药依从性(OR=0.564,95％ CI0.363～0.877,P＜0.05)与复发有关.结论 共病焦虑障碍的抑郁症患者较非共病者近期疗效差,年复发率高；共病与非共病焦虑障碍抑郁症患者的1年总体疗效和临床痊愈率相近；合用苯二氮(卓)类药较普遍；自杀念头是复发的危险因素,服药依从性是复发的保护因素.“,”Objective To observe one year outcome of patients with depression comorbidity with anxiety disorders and predictor factors to recurrence.Method Totally 594 patients from 17 hospitals,met with the diagnosis criteria of DSM-Ⅳ for depression,were prospectively evaluated using the 17-item Hamilton Rating Scale for Depression (HAMD17) and Hamilton Rating Scale for Anxiety (HAMA) at the end of 3,6and 12 months since they were enrolled the study.The conditions of remission,relapse,suicide idea,compliance with medicine and combined therapy were compared between depression comorbidity with (344cases) or without(250 cases) anxiety disorder.Logistic regression analysis was performed to investigate the recurrent predictors of depression.Results There were 482,441 and 301 patients at the three following points separately.The rate of remission in 3 month was significantly lower in comorbidity group (CG) than that in without comorbidity group (WCG) (53.7％ vs.68.0％,P =0.002).The scores of HAMD[(8.80 ±6.49),(6.86 ± 7.07)] and HAMA [(6.35 ± 4.64),(4.88 ± 4.63)] both were significantly higher in CG than those [HAMD:(7.20 ± 5.97),(5.33 ± 5.86),HAMA:(4.77 ± 4.26),(3.38 ± 3.69)] in WCG.And only HAMA score (3.98 ± 4.01) in CG was marked higher than that (2.97 ± 3.95) in WCG (P ＜ 0.05 or P ＜ 0.01).In three different following points,the rates of relapse / recurrence were 6.7％ vs.5.6％,13.3％vs.8.2％,and 14.9％ vs.9.1％ separately,no significant differences between two groups (P ＞ 0.05).But the Kaplan-Meier survival analysis showed the higher recurrent rate in CG (x2 =4.487,P ＜ 0.05).The rate of suicide idea converting mania,compliance with medicine and social function were no significant differences within two groups (P ＞0.05).About half of patients (50.5％ in CG and 43.4％ in WCG) were still using benzodiazepines after one year.Logistic regressive analysis showed that suicide idea and compliance with medicine in 6 month point were associated with one year recurrence in this study.Conclusions The results indicate that short outcome in CG is less than WCG,higher recurrent rate also in CG,and supporting the views outside.The one year outcome may be similar in two groups,nearly 4/5 patients obtained remission after they are treated with antidepressants.It should be concerned that about half of patients still take benzodiazepine for long time.The suicide idea is the predictor factor and the compliance with medicine is the protector factor to the recurrence of depression.