Poyurovsky Michael, Kriss Victoria, Weisman Gregory, Faragian Sarit, Schneidman Michael, Fuchs Camil, Weizman Abraham, Weizman Ronit
Research Unit, Tirat Carmel Mental Health Center, Tirat Carmel, Israel.
Am J Med Genet B Neuropsychiatr Genet. 2005 Feb 5;133B(1):31-6. doi: 10.1002/ajmg.b.30148.
A substantial proportion of schizophrenia patients also has obsessive-compulsive disorder (OCD). To further validate the clinical validity of a schizo-obsessive diagnostic entity, we assessed morbid risks for schizophrenia-spectrum disorders and OC-associated disorders in first-degree relatives of schizophrenia probands with and without OCD. Two groups of schizophrenia probands [with OCD (n = 57) and without OCD (n = 60)] and community-based controls (n = 50) were recruited. One hundred eighty two first-degree relatives of probands with OCD-schizophrenia, 210 relatives of non-OCD schizophrenia probands, and 165 relatives of community subjects were interviewed directly [59.3% (108/182), 51.9% (109/210), and 54.5% (90/165), respectively], using the Structured Clinical Interview for Axis-I DSM-IV Disorders and Axis II DSM-III-R Personality Disorders and the remaining relatives were interviewed indirectly, using the Family History Research Diagnostic Criteria. Relatives of OCD-schizophrenia probands had significantly higher morbid risks for OCD-schizophrenia (2.2% vs. 0%; P = 0.033) and OCPD (7.14% vs. 1.90%; P = 0.014), and a trend towards higher morbid risk for OCD (4.41% vs. 1.43%; P = 0.08) compared to relatives of non-OCD schizophrenia probands. When morbid risks for OCD, OCPD, and OCD-schizophrenia were pooled together, the significant between-group difference became robust (13.74% vs. 3.33%; P = 0.0002). In contrast, relatives of the two schizophrenia groups did not differ significantly in morbid risks for schizophrenia-spectrum disorders, mood disorders, or substance abuse disorders. A differential aggregation of OC-associated disorders in relatives of OCD-schizophrenia versus non-OCD schizophrenia probands, provides further support for the validity of a putative OCD-schizophrenia ("schizo-obsessive") diagnostic entity.
相当一部分精神分裂症患者还患有强迫症（OCD）。为了进一步验证精神分裂症-强迫症诊断实体的临床有效性，我们评估了伴有和不伴有强迫症的精神分裂症先证者的一级亲属患精神分裂症谱系障碍和强迫症相关障碍的患病风险。招募了两组精神分裂症先证者[伴有强迫症（n = 57）和不伴有强迫症（n = 60）]以及社区对照（n = 50）。使用《轴I DSM-IV障碍和轴II DSM-III-R人格障碍的结构化临床访谈》，直接访谈了182名伴有强迫症-精神分裂症先证者的一级亲属、210名不伴有强迫症的精神分裂症先证者的亲属以及165名社区受试者的亲属[分别为59.3%（108/182）、51.9%（109/210）和54.5%（90/165）]，其余亲属则使用《家族史研究诊断标准》进行间接访谈。与不伴有强迫症的精神分裂症先证者的亲属相比，伴有强迫症-精神分裂症先证者的亲属患强迫症-精神分裂症（2.2%对0%；P = 0.033）和强迫型人格障碍（OCPD，7.14%对1.90%；P = 0.014）的患病风险显著更高，患强迫症的患病风险也有升高趋势（4.41%对1.43%；P = 0.08）。当将强迫症、强迫型人格障碍和强迫症-精神分裂症的患病风险汇总在一起时，组间差异变得显著（13.74%对3.33%；P = 0.0002）。相比之下，两组精神分裂症患者的亲属在患精神分裂症谱系障碍、情绪障碍或物质滥用障碍的患病风险上没有显著差异。伴有强迫症-精神分裂症先证者的亲属与不伴有强迫症的精神分裂症先证者的亲属中强迫症相关障碍的差异聚集，为假定的强迫症-精神分裂症（“精神分裂症-强迫症”）诊断实体的有效性提供了进一步支持。
