Ivarsson Tord, Valderhaug Robert
Department of Child and Adolescent Psychiatry, Göteborg University, Kungsgatan 12, SE-411 19 Göteborg, Sweden.
Behav Res Ther. 2006 Aug;44(8):1105-16. doi: 10.1016/j.brat.2005.08.008. Epub 2005 Oct 3.
Obsessive-compulsive disorder (OCD) defined at the diagnostic level encompasses divergent symptoms. The present study examines symptom patterns in OCD in children and adolescents in order to search for the presence of diagnostic heterogeneity.
Two hundred and thirteen outpatients with primary OCD participated. The patients' and primary caretakers' responses on the Children's Yale-Brown Obsessive-Compulsive Scale were used to generate severity ratings for 61 OCD symptoms, and cluster analysed them.
A five cluster solution was judged to be the most clinically and theoretically relevant model. The clusters were named: (1) "Mental Rituals, Touching & Ordering", (2) "Contamination & Cleaning", (3) "Superstitions", (4) "Obsessions/Checking & Confessing" and (5) "Somatic Concerns". The symptom patterns of the groups differed, and three groups were particularly homogeneous. In addition, there were differences in severity, number of symptoms and age.
OCD in children and adolescents is a heterogeneous disorder and discrepancies vis-à-vis adult studies indicate that childhood OCD may have developmentally specific traits. The sub-groups obtained are likely to have implications for the assessment of OCD symptoms in children, their prognosis and outcome in treatment research.
诊断层面定义的强迫症（OCD）包含多种不同症状。本研究调查儿童和青少年强迫症的症状模式，以探寻诊断异质性的存在情况。
213例原发性强迫症门诊患者参与研究。采用患者及其主要照料者对儿童耶鲁-布朗强迫症量表的回答，对61种强迫症症状进行严重程度评分，并进行聚类分析。
五聚类解决方案被判定为最具临床和理论相关性的模型。这些聚类分别命名为：（1）“心理仪式、触摸与排序”，（2）“污染与清洁”，（3）“迷信”，（4）“强迫观念/检查与忏悔”，以及（5）“躯体担忧”。各群组的症状模式不同，其中三个群组尤为同质。此外，在严重程度、症状数量和年龄方面存在差异。
儿童和青少年强迫症是一种异质性疾病，与成人研究的差异表明儿童强迫症可能具有发育上的特定特征。所获得的亚组可能对儿童强迫症症状的评估、其预后及治疗研究结果具有影响。
