Slattery Marcia J, Dubbert Billinda K, Allen Albert J, Leonard Henrietta L, Swedo Susan E, Gourley Mark F
National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
J Clin Psychiatry. 2004 Mar;65(3):301-6. doi: 10.4088/jcp.v65n0303.
The goal of this pilot study was to investigate the prevalence of obsessive-compulsive disorder (OCD) in a group of patients with systemic lupus erythematosus (SLE).
Fifty adult patients enrolled in out-patient SLE studies at the National Institute of Arthritis and Musculoskeletal and Skin Diseases (February 1995-October 1996) completed a self-report questionnaire adapted from the Yale-Brown Obsessive Compulsive Scale and an in-person psychiatric clinical interview with a psychiatrist or psychiatric clinical nurse specialist. DSM-IV lifetime diagnosis of OCD was determined by clinical interview.
Sixteen subjects (32%) met DSM-IV lifetime diagnostic criteria for OCD and an additional 5 (10%) met criteria for subclinical OCD. Mean +/- SD number of symptoms reported on the self-report questionnaire was significantly higher among subjects diagnosed with OCD on clinical interview (40.7 +/- 23.2) compared with those without OCD (8.9 +/- 11.7; t = 5.8, df = 27, p <.001).
Obsessive-compulsive disorder was 10 to 15 times more common in this cohort of patients with SLE compared with those in community-based studies of OCD. The use of an OCD self-report rating scale proved helpful in the identification of OCD symptoms among patients with SLE. Results suggest that further studies of OCD in patients with SLE are needed and may provide new insight into the pathophysiology of both disorders.
本初步研究的目的是调查系统性红斑狼疮(SLE)患者群体中强迫症(OCD)的患病率。
1995年2月至1996年10月在国立关节炎、肌肉骨骼和皮肤病研究所参加门诊SLE研究的50名成年患者完成了一份根据耶鲁-布朗强迫症量表改编的自我报告问卷,并接受了精神科医生或精神科临床护士专家的面对面精神科临床访谈。通过临床访谈确定强迫症的DSM-IV终生诊断。
16名受试者(32%)符合强迫症的DSM-IV终生诊断标准,另有5名(10%)符合亚临床强迫症标准。在临床访谈中被诊断为强迫症的受试者在自我报告问卷上报告的症状平均数量+/-标准差(40.7+/-23.2)显著高于无强迫症的受试者(8.9+/-11.7;t=5.8,自由度=27,p<.001)。
与基于社区的强迫症研究相比,强迫症在这一SLE患者队列中的常见程度高10至15倍。使用强迫症自我报告评定量表被证明有助于识别SLE患者中的强迫症症状。结果表明,需要对SLE患者的强迫症进行进一步研究,这可能为两种疾病的病理生理学提供新的见解。