Fontenelle Leonardo F, Mendlowicz Mauro V, Marques Carla, Versiani Marcio
Anxiety and Depression Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Brazil.
J Psychiatr Res. 2003 Mar-Apr;37(2):127-33. doi: 10.1016/s0022-3956(02)00087-0.
It has been suggested that early- and late-onset forms of obsessive-compulsive disorder (OCD) may stem from different neurobiological substrates manifesting themselves through particular phenotypic profiles. Our study aimed to assess the existence of clinical and therapeutic differences between adult patients with early- and late-onset OCD (EOCD and LOCD, respectively). Sixty-six patients with OCD were consecutively recruited among individuals seeking treatment in a university hospital clinic for anxiety and depressive disorders. Patients with EOCD (n=33) and LOCD (n=33) were compared and contrasted with regard to clinical and therapeutic characteristics using the two tailed t test for continuous variables and the Pearson's goodness of fit Chi-square test for categorical ones; Fisher's exact test was employed when indicated. We found that, compared to their LOCD counterparts, adult patients with EOCD were characterized by (1) male gender predominance, (2) greater number of clinically significant obsessions and compulsions, (3) higher frequency of rituals repetition, (4) increased severity of obsessive-compulsive symptoms at baseline, and (5) greater number of required therapeutic trials during the follow-up. However, no significant differences between groups were noted in the final treatment outcome. Our results are consistent with previous studies suggesting that EOCD may represent a more severe subtype of this disorder.
有人提出，早发型和晚发型强迫症（OCD）可能源于不同的神经生物学底物，并通过特定的表型特征表现出来。我们的研究旨在评估早发型和晚发型强迫症成年患者（分别为早发型强迫症和晚发型强迫症）在临床和治疗方面是否存在差异。在一家大学医院诊所寻求焦虑和抑郁症治疗的个体中，连续招募了66名强迫症患者。使用连续变量的双尾t检验和分类变量的Pearson拟合优度卡方检验，对早发型强迫症患者（n = 33）和晚发型强迫症患者（n = 33）的临床和治疗特征进行比较和对比；必要时采用Fisher精确检验。我们发现，与晚发型强迫症患者相比，早发型强迫症成年患者的特征为：（1）男性占主导，（2）具有临床意义的强迫观念和强迫行为数量更多，（3）仪式重复频率更高，（4）基线时强迫症状严重程度增加，以及（（5）随访期间所需治疗试验次数更多。然而，两组在最终治疗结果上未发现显著差异。我们的结果与先前的研究一致，表明早发型强迫症可能代表该疾病更严重的亚型。
