Piacentini John, Bergman R Lindsey, Keller Melody, McCracken James
Division of Child and Adolescent Psychiatry, University of California, Los Angeles, School of Medicine, Los Angeles, California, USA.
J Child Adolesc Psychopharmacol. 2003;13 Suppl 1:S61-9. doi: 10.1089/104454603322126359.
Although obsessive-compulsive disorder (OCD) is a chronic and oftentimes debilitating disorder, the specific impact of this illness on the psychosocial functioning of affected youngsters has not been systematically described. A total of 151 clinic-referred youngsters (mean age 11.8 years, 57% male, 83% Caucasian) with primary Diagnostic and Statistical Manual of Mental Disorders (fourth edition) OCD and a primary caretaker completed a checklist designed to assess the impact of OCD on school, social, and family functioning. The two most common OCD-related problems were concentrating on schoolwork and doing homework. Consistent with the heterogeneous nature of OCD, subjects exhibited a broad range of specific impairments. However, almost 90% of youngsters reported at least one significant OCD-related dysfunction, and close to half reported significant OCD-related problems at school, home, and socially. Parents were more likely to report significant impairments in home and school functioning than children. However, few systematic gender or age effects were noted. Impairment ratings were significantly correlated with clinician-generated measures of OCD severity. These results provide the most specific description to date of the adverse impact of OCD on child psychosocial functioning. Given the adverse developmental consequences of psychosocial dysfunction, treatment studies need to carefully track and address OCD-specific functional impairments in affected youngsters.
尽管强迫症（OCD）是一种慢性且往往使人衰弱的疾病，但这种疾病对受影响青少年心理社会功能的具体影响尚未得到系统描述。共有151名因临床问题前来就诊的青少年（平均年龄11.8岁，57%为男性，83%为白种人），他们患有《精神疾病诊断与统计手册》（第四版）中的原发性强迫症，并有一名主要照顾者完成了一份旨在评估强迫症对学校、社交和家庭功能影响的清单。与强迫症相关的两个最常见问题是专注于学业和做家庭作业。与强迫症的异质性一致，受试者表现出广泛的特定损害。然而，近90%的青少年报告至少有一项与强迫症相关的重大功能障碍，近一半的青少年报告在学校、家庭和社交方面存在与强迫症相关的重大问题。与儿童相比，父母更有可能报告家庭和学校功能存在重大损害。然而，几乎没有观察到系统性的性别或年龄效应。损害评分与临床医生对强迫症严重程度的测量结果显著相关。这些结果提供了迄今为止对强迫症对儿童心理社会功能的不利影响最具体的描述。鉴于心理社会功能障碍会产生不利的发育后果，治疗研究需要仔细跟踪并解决受影响青少年中与强迫症相关的特定功能损害问题。
