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强迫症治疗前后的生活质量。

Quality of life in obsessive-compulsive disorder before and after treatment.

作者信息

Moritz Steffen, Rufer Michael, Fricke Susanne, Karow Anne, Morfeld Matthias, Jelinek Lena, Jacobsen Dirk

机构信息

Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Germany.

出版信息

Compr Psychiatry. 2005 Nov-Dec;46(6):453-9. doi: 10.1016/j.comppsych.2005.04.002.

Abstract

BACKGROUND

The assessment of Quality of Life (QoL) is an important tool for elucidating target symptoms that are particularly bothersome to patients. The present study was designed to explore predictors of decreased QoL in obsessive-compulsive disorder (OCD) patients and to explore which aspects of QoL are most affected in OCD. Furthermore, the study investigated changes in QoL after treatment and the association between QoL change scores with symptomatic outcome. In line with prior research, it was expected that low QoL in OCD patients would be most pronounced for the emotional and social aspects of the construct.

METHODS

Seventy-nine OCD patients were initially recruited. Patients were assessed with the SF-36 both before and after treatment. Norm values were derived from the general population to characterize status of impairment. OCD patients were contrasted with published SF-36 scores from 2 OCD samples as well as a newly recruited psychiatric and healthy control sample.

RESULTS

Correlations with QoL were most pronounced for depression severity and number of OCD symptoms. Apart from low social and emotional QoL in the majority of patients, a large subgroup also reported lower physical well-being. Decreased scores on this subscale were mainly associated with length of illness, depression, and number of compulsions. Overall, QoL was significantly improved in therapy responders relative to nonresponders.

CONCLUSIONS

The results largely correspond to previous findings showing that OCD patients share severely compromised well-being. Somewhat unexpected from previous research, QoL deficits were not restricted to emotional and social aspects of QoL but extended to somatic domains. The present results suggest that clinicians should thoroughly explore for depression as well as physical impairments in OCD patients, which, when present, may be additionally targeted to achieve comprehensive treatment success.

摘要

背景

生活质量(QoL)评估是阐明对患者特别困扰的目标症状的重要工具。本研究旨在探索强迫症(OCD)患者生活质量下降的预测因素,并探索强迫症中生活质量受影响最严重的方面。此外,该研究调查了治疗后生活质量的变化以及生活质量变化分数与症状结果之间的关联。与先前的研究一致,预计强迫症患者在该结构的情感和社会方面的低生活质量最为明显。

方法

最初招募了79名强迫症患者。在治疗前后使用SF-36对患者进行评估。从一般人群中得出标准值以表征损伤状态。将强迫症患者与来自2个强迫症样本以及新招募的精神科和健康对照样本的已发表SF-36分数进行对比。

结果

抑郁严重程度和强迫症症状数量与生活质量的相关性最为明显。除了大多数患者的社交和情感生活质量较低外,一大亚组患者还报告身体幸福感较低。该子量表得分降低主要与病程、抑郁和强迫行为数量有关。总体而言,治疗有反应者的生活质量相对于无反应者有显著改善。

结论

结果在很大程度上与先前的研究结果一致,表明强迫症患者的幸福感严重受损。与先前的研究有些不同的是,生活质量缺陷不仅限于生活质量的情感和社会方面,还扩展到了躯体领域。目前的结果表明,临床医生应该彻底探究强迫症患者的抑郁以及身体损伤情况,若存在这些情况,可能需要额外针对性地进行治疗以实现全面的治疗成功。

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