Huppert Jonathan D, Moser Jason S, Gershuny Beth S, Riggs David S, Spokas Megan, Filip Jennifer, Hajcak Greg, Parker Holly A, Baer Lee, Foa Edna B
Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market St., Suite 600N, Philadelphia, PA 19104, USA.
J Anxiety Disord. 2005;19(1):127-36. doi: 10.1016/j.janxdis.2004.01.001.
Although case reports suggest the existence of a unique relationship between obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD), results from large-scale epidemiological and clinical studies have been more equivocal. Furthermore, symptom overlap may artificially inflate the significance of the relationship between OCD and PTSD. Utilizing the Obsessive-Compulsive Inventory [OCI; Psychol. Assess. 10 (1998) 206] and the Posttraumatic Diagnostic Scale [PDS; Psychol. Assess. 9 (1997) 445], this study examined the relationship between OCD and PTSD symptoms in 128 patients diagnosed with OCD, 109 patients diagnosed with PTSD, 63 patients diagnosed with another anxiety disorder, and 40 college students. Experts in OCD and PTSD independently rated items on the OCI and PDS for the degree of overlap across the disorders. On the basis of these ratings, we created a scale from each measure that included only non-overlapping items. Results revealed that overall symptoms of OCD and PTSD were related in all samples. However, after controlling for depression and overlapping symptoms simultaneously, this relationship was no longer significant in the OCD and PTSD samples, although it remained significant in the anxious and college student comparison groups. These results support the presence of a relationship between symptoms of OCD and PTSD that may be largely accounted for by a combination of symptom overlap and depression.
尽管病例报告表明强迫症（OCD）与创伤后应激障碍（PTSD）之间存在独特关系，但大规模流行病学和临床研究的结果却更为模糊。此外，症状重叠可能会人为地夸大强迫症与创伤后应激障碍之间关系的重要性。本研究使用强迫症量表[OCI；《心理评估》10（1998）206]和创伤后诊断量表[PDS；《心理评估》9（1997）445]，对128名被诊断为强迫症的患者、109名被诊断为创伤后应激障碍的患者、63名被诊断为其他焦虑症的患者以及40名大学生中强迫症与创伤后应激障碍症状之间的关系进行了研究。强迫症和创伤后应激障碍领域的专家对强迫症量表和创伤后诊断量表中的项目就不同障碍间的重叠程度进行了独立评分。基于这些评分，我们从每个量表中创建了一个仅包含非重叠项目的量表。结果显示，在所有样本中，强迫症和创伤后应激障碍的总体症状都存在关联。然而，在同时控制抑郁和重叠症状后，这种关联在强迫症和创伤后应激障碍样本中不再显著，尽管在焦虑症和大学生比较组中仍然显著。这些结果支持了强迫症和创伤后应激障碍症状之间存在关联，这种关联可能在很大程度上是由症状重叠和抑郁共同导致的。
