Norberg Melissa M, Calamari John E, Cohen Robyn J, Riemann Bradley C
Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA.
Depress Anxiety. 2008;25(3):248-59. doi: 10.1002/da.20298.
Despite the substantial impairments in life functioning associated with obsessive-compulsive disorder (OCD), treatment outcome evaluations have focused almost exclusively on symptom reduction, a focus that may be too narrow to determine whether clinically significant change has occurred. Quality of life (QOL) impairment was evaluated in a clinical OCD sample (N=188) using a multidimensional life satisfaction measure. Relationships between treatment response and QOL change also were evaluated with a subsample of participants (n=120). Congruent with previous studies of OCD, substantial pretreatment QOL impairment was found across all life domains. Distinct treatment change subgroups were identified: a group reporting strong symptom reduction and very good QOL gains, a second group with significant symptom reduction but less robust QOL improvements, and a third group with limited symptom gains and QOL decreases. Implications for understanding OCD-related impairment and the clinical significance of treatment outcomes are discussed.
尽管强迫症（OCD）会给生活功能带来严重损害，但治疗结果评估几乎完全集中在症状减轻上，这种关注点可能过于狭窄，无法确定是否发生了具有临床意义的变化。使用多维生活满意度测量方法，对一个临床强迫症样本（N = 188）的生活质量（QOL）损害进行了评估。还对一部分参与者（n = 120）的子样本评估了治疗反应与生活质量变化之间的关系。与先前对强迫症的研究一致，在所有生活领域都发现了严重的治疗前生活质量损害。确定了不同的治疗变化亚组：一组报告症状明显减轻且生活质量有很大提高，第二组症状有显著减轻但生活质量改善不那么明显，第三组症状改善有限且生活质量下降。讨论了对理解强迫症相关损害和治疗结果临床意义的启示。
