du Toit P L, van Kradenburg J, Niehaus D, Stein D J
Medical Research Council Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
Compr Psychiatry. 2001 Jul-Aug;42(4):291-300. doi: 10.1053/comp.2001.24586.
Increasing attention has been paid to the possibility that a range of disorders, the putative obsessive-compulsive spectrum disorders (OCSDs), may share overlapping phenomenological and neurobiological features with obsessive-compulsive disorder (OCD). The development of a structured clinician-administered interview for the putative OCSDs (SCID-OCSD) is described. This instrument was used to investigate differences between OCD patients with a comorbid putative OCSD and OCD patients without a comorbid putative OCSD. A sample of 85 adult patients (38 men and 47 women) presenting for treatment of OCD was interviewed with the SCID-OCSD. OCD patients without comorbid putative OCSDs (n = 36) were compared to patients with comorbid OCSDs (n = 49) in terms of demographic features, clinical characteristics, and associated comorbidity with other non-OCSD DSM-IV axis I disorders. Of the OCD patients, 57.6% currently met criteria for at least one putative OCSD and 67.1% had a lifetime history of at least one comorbid OCSD. The OCSDs with the highest prevalence rates were compulsive self-injury (22.4%), compulsive buying (10.6%), and intermittent explosive disorder (10.6%). There was a significantly larger proportion of women in the group with comorbid OCSDs. Although the two groups did not differ in terms of severity of OCD symptoms, the group with comorbid OCSDs had significantly more obsessions and compulsions. The two groups did not differ significantly in terms of associated psychopathology other than OCSDs. We conclude that the SCID-OCSD provides clinicians and researchers with an instrument for the diagnosis of putative OCSDs. Our findings suggest that putative OCSDs have a relatively high prevalence rate in OCD patients. In addition, OCD patients with comorbid OCSDs differ with regard to certain demographic and clinical features. Further research, particularly genetic and neuroimmunological work, may ultimately be useful in validating the obsessive-compulsive spectrum.
一系列疾病，即假定的强迫谱系障碍（OCSDs），可能与强迫症（OCD）具有重叠的现象学和神经生物学特征，这一可能性已受到越来越多的关注。本文描述了一种针对假定的OCSDs的结构化临床访谈工具（SCID-OCSD）。该工具用于调查合并假定OCSD的OCD患者与未合并假定OCSD的OCD患者之间的差异。对85名前来治疗OCD的成年患者（38名男性和47名女性）进行了SCID-OCSD访谈。将未合并假定OCSD的OCD患者（n = 36）与合并OCSD的患者（n = 49）在人口统计学特征、临床特征以及与其他非OCSD DSM-IV轴I障碍的合并症方面进行比较。在OCD患者中，57.6%目前符合至少一种假定OCSD的标准，67.1%有至少一种合并OCSD的终生病史。患病率最高的OCSD是强迫性自我伤害（22.4%）、强迫性购物（10.6%）和间歇性爆发障碍（10.6%）。合并OCSD的组中女性比例明显更高。尽管两组在OCD症状严重程度方面没有差异，但合并OCSD的组有明显更多的强迫观念和强迫行为。除OCSD外，两组在相关精神病理学方面没有显著差异。我们得出结论，SCID-OCSD为临床医生和研究人员提供了一种诊断假定OCSD的工具。我们的研究结果表明，假定的OCSD在OCD患者中患病率相对较高。此外，合并OCSD的OCD患者在某些人口统计学和临床特征方面存在差异。进一步的研究，特别是基因和神经免疫学方面的研究，最终可能有助于验证强迫谱系。
