Grant Jon E, Mancebo Maria C, Pinto Anthony, Williams Kyle A, Eisen Jane L, Rasmussen Steven A
Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
Psychiatry Res. 2007 Jul 30;152(1):21-7. doi: 10.1016/j.psychres.2006.09.015. Epub 2007 Mar 23.
There has been little research examining clinical correlates of late-onset OCD in a large sample of individuals with a primary diagnosis of OCD. Using a sample of 293 consecutive subjects with lifetime DSM-IV OCD, we compared subjects with late-onset (after age 30 years) OCD to those with earlier onset on a variety of clinical measures. Symptom severity was examined using the Yale-Brown Obsessive Compulsive Scale. Thirty-three (11.3%) of the 293 subjects with OCD reported onset of OCD on or after age 30 years (mean age of OCD onset of 38.8+/-9.7 years). Subjects with late-onset had significantly shorter durations of illness prior to receiving treatment, less severe obsessinality, and a trend demonstrating a greater likelihood of responding to cognitive behavioral therapy (CBT). Late-onset OCD subjects were also significantly less likely to report contamination, religious, or somatic obsessions. Comorbidity, insight, depressive symptoms, quality of life, and social functioning did not differ between groups. These preliminary results suggest that although onset on or after age 30 years is fairly uncommon among people with OCD, individuals developing OCD later in life have similar clinical characteristics as those with earlier onset and may respond better to CBT.
在以强迫症为主诊断的大量个体样本中，很少有研究探讨迟发性强迫症的临床相关因素。我们使用了293名终生患有DSM-IV强迫症的连续受试者样本，在多种临床指标上，将迟发性（30岁及以后）强迫症患者与早发性患者进行了比较。使用耶鲁-布朗强迫症量表检查症状严重程度。在293名强迫症受试者中，有33名（11.3%）报告强迫症发病于30岁及以后（强迫症发病的平均年龄为38.8±9.7岁）。迟发性患者在接受治疗前的病程明显更短，强迫观念程度较轻，并且有迹象表明对认知行为疗法（CBT）有更好反应的可能性更大。迟发性强迫症患者报告污染、宗教或躯体强迫观念的可能性也显著更低。两组之间的共病、自知力、抑郁症状、生活质量和社会功能没有差异。这些初步结果表明，虽然30岁及以后发病在强迫症患者中相当少见，但在生命后期患上强迫症的个体与早发性患者具有相似的临床特征，并且可能对CBT反应更好。
