Torres Albina R, Prince Martin J, Bebbington Paul E, Bhugra Dinesh, Brugha Traolach S, Farrell Michael, Jenkins Rachel, Lewis Glyn, Meltzer Howard, Singleton Nicola
Division of Psychological Medicine, Institute of Psychiatry, King's College London, UK.
Am J Psychiatry. 2006 Nov;163(11):1978-85. doi: 10.1176/ajp.2006.163.11.1978.
There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking.
Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a non-neurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised.
The authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive-compulsive group had obsessions only. Comorbidity occurred in 62% of these individuals, which was significantly greater than the group with other neuroses (10%). Co-occurring neuroses were depressive episode (37%), generalized anxiety disorder (31%), agoraphobia or panic disorder (22%), social phobia (17%), and specific phobia (15%). Alcohol dependence was present in 20% of participants, mainly men, and drug dependence was present in 13%. Obsessive-compulsive disorder, compared with other neurotic disorders, was associated with more marked social and occupational impairment. One-quarter of obsessive-compulsive disorder participants had previously attempted suicide. Individuals with pure and comorbid obsessive-compulsive disorder did not differ according to most indices of impairment, including suicidal behavior, but pure individuals were significantly less likely to have sought help (14% versus 56%).
A rare yet severe mental disorder, obsessive-compulsive disorder is an atypical neurosis, of which the public health significance has been underestimated. Unmet need among individuals with pure obsessive-compulsive disorder is a cause for concern, requiring further investigation of barriers to care and interventions to encourage help-seeking.
在具有代表性的大型社区样本中，关于强迫症的信息较少。作者旨在确定英国私人家庭中成年人强迫症的患病率及其临床类型，并获得关于功能损害和求助情况的可推广估计值。
对2000年英国国家精神病发病率调查中的8580名个体的数据进行了适当测量分析。该研究比较了强迫症患者、其他神经症患者和非神经症对照组。国际疾病分类第十版（ICD - 10）诊断源自修订后的临床访谈表。
作者识别出114名强迫症患者（74名女性，40名男性），加权1个月患病率为1.1%。强迫症组中的大多数个体（55%）仅有强迫观念。这些个体中有62%存在共病，这显著高于其他神经症组（10%）。同时出现的神经症包括抑郁发作（37%）、广泛性焦虑障碍（31%）、广场恐惧症或惊恐障碍（22%）、社交恐惧症（17%）和特定恐惧症（15%）。20%的参与者存在酒精依赖，主要是男性，13%存在药物依赖。与其他神经症相比，强迫症与更明显的社会和职业功能损害相关。四分之一的强迫症参与者曾尝试自杀。单纯型和共病型强迫症患者在包括自杀行为在内的大多数功能损害指标上并无差异，但单纯型患者寻求帮助的可能性显著更低（14%对56%）。
强迫症是一种罕见但严重的精神障碍，是一种非典型神经症，其公共卫生意义一直被低估。单纯型强迫症患者未满足的需求令人担忧，需要进一步调查护理障碍以及鼓励求助的干预措施。
