Jaisoorya T S, Reddy Y C Janardhan, Srinath S
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Compr Psychiatry. 2003 Jul-Aug;44(4):317-23. doi: 10.1016/S0010-440X(03)00084-1.
The relationship between obsessive-compulsive disorder (OCD) and putative obsessive-compulsive (OC) spectrum disorders is unclear. This study investigates the prevalence of putative OC spectrum disorders in OCD subjects in a controlled clinical design. The putative OC spectrum disorders studied included somatoform disorders (body dysmorphic disorder [BDD] and hypochondriasis), eating disorders, tic disorders (e.g., Tourette's syndrome [TS]), and impulse control disorders (e.g., trichotillomania). Only those disorders that are commonly noted to be possibly related to OCD are studied. Included in this study were 231 subjects with a diagnosis of OCD according to DSM-IV criteria and 200 controls who were not screened for psychiatric morbidity. The subjects and controls were assessed in detail by extensive clinical and semistructured interviews by expert clinical psychiatrists. The lifetime diagnoses were made by consensus of two psychiatrists. Prevalence of tic disorders, hypochondriasis, BDD, and trichotillomania was significantly greater in OCD subjects compared to controls. However, the prevalence of sexual compulsions, pathological gambling, eating disorders, and depersonalization disorder was not greater in the OCD subjects compared to controls. The findings of this comorbidity study suggest that tic disorders, hypochondriasis, BDD, and trichotillomania are perhaps part of the OC spectrum disorders. There is a need to evaluate evidence from other sources such as epidemiological, neurobiological, and family studies to further our understanding of the concept of OC spectrum disorders.
强迫症（OCD）与假定的强迫性（OC）谱系障碍之间的关系尚不清楚。本研究在对照临床设计中调查了强迫症患者中假定的OC谱系障碍的患病率。所研究的假定OC谱系障碍包括躯体形式障碍（身体变形障碍[BDD]和疑病症）、进食障碍、抽动障碍（如妥瑞氏综合征[TS]）和冲动控制障碍（如拔毛癖）。仅研究那些通常被认为可能与强迫症相关的障碍。本研究纳入了231名根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准诊断为强迫症的患者以及200名未接受精神疾病筛查的对照者。由专业临床精神科医生通过广泛的临床和半结构化访谈对患者和对照者进行详细评估。终身诊断由两名精神科医生共同做出。与对照者相比，强迫症患者中抽动障碍、疑病症、BDD和拔毛癖的患病率显著更高。然而，与对照者相比，强迫症患者中性强迫行为、病理性赌博、进食障碍和人格解体障碍的患病率并未更高。这项共病研究的结果表明，抽动障碍、疑病症、BDD和拔毛癖可能是OC谱系障碍的一部分。有必要评估来自其他来源（如流行病学、神经生物学和家族研究）的证据，以加深我们对OC谱系障碍概念的理解。
