Bannon Shelley, Gonsalvez Craig J, Croft Rodney J, Boyce Philip M
Brain and Behaviour Research Institute, School of Psychology, University of Wollongong, New South Wales, and Department of Psychological Medicine, Westmead Hospital, Sydney, Australia.
Aust N Z J Psychiatry. 2006 Nov-Dec;40(11-12):1031-8. doi: 10.1080/j.1440-1614.2006.01928.x.
Despite the neuropsychology literature providing reliable evidence of impaired executive functions in obsessive-compulsive disorder (OCD), to date it has not been determined whether these deficits are trait-related (independent of symptomatology) or state-dependent (dependent on symptomatology). The current research examines the executive functions in OCD in a comprehensive manner and, for the first time, assesses the stability of these deficits over the developmental course of the disorder.
Using a cross-sectional design, Study 1 examined the executive functions (set shifting, inhibition, planning, verbal fluency and working memory) in 60 subjects (20 actively Symptomatic OCD, 20 Remitted OCD and 20 Panic Disorder). Using a longitudinal design, Study 2 reassessed a subsample of OCD subjects (participants in Study 1) once they reached remitted status.
Study 1 found that the OCD groups exhibited deficits in set shifting and inhibition relative to Panic Disorder controls; however, no deficits were observed in planning, verbal fluency or working memory. There were no differences found between the Symptomatic and Remitted OCD groups on any of the executive function measures. Study 2 found that the identified executive function deficits in individuals were stable over time and remained unchanged despite symptom remittance.
Current results confirm the presence of specific executive function deficits in OCD, and indicate that these deficits are trait-like in nature.
尽管神经心理学文献提供了可靠证据，表明强迫症（OCD）患者存在执行功能受损，但迄今为止，尚未确定这些缺陷是与特质相关（独立于症状学）还是与状态相关（取决于症状学）。当前的研究全面考察了强迫症患者的执行功能，并首次评估了这些缺陷在疾病发展过程中的稳定性。
研究1采用横断面设计，对60名受试者（20名有症状的强迫症患者、20名缓解期强迫症患者和20名惊恐障碍患者）的执行功能（定势转换、抑制、计划、言语流畅性和工作记忆）进行了考察。研究2采用纵向设计，在强迫症受试者（研究1中的参与者）达到缓解状态后，对其进行了重新评估。
研究1发现，相对于惊恐障碍对照组，强迫症组在定势转换和抑制方面存在缺陷；然而，在计划、言语流畅性或工作记忆方面未观察到缺陷。有症状的强迫症组和缓解期强迫症组在任何执行功能测量上均未发现差异。研究2发现，个体中确定的执行功能缺陷随时间稳定，且尽管症状缓解仍保持不变。
当前结果证实了强迫症患者存在特定的执行功能缺陷，并表明这些缺陷本质上类似特质。
