Leckman James F, Rauch Scott L, Mataix-Cols David
Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.
CNS Spectr. 2007 May;12(5):376-87, 400. doi: 10.1017/s1092852900021179.
In the absence of definitive etiological markers of vulnerability or a unitary profile of pathophysiology for obsessive-compulsive disorder (OCD), obsessive-compulsive (OC) symptom dimensions seem to offer a fruitful point of orientation. The complex clinical presentation of OCD can be summarized using a few consistent and temporally stable symptom dimensions. These can be understood as a spectrum of potentially overlapping features that are likely to be continuous with "normal" worries and extend beyond the traditional nosological boundaries of OCD. Although the understanding of the dimensional structure of obsessive-compulsive symptoms (OCS) is still imperfect, this quantitative approach to phenotypic traits has the potential to advance our understanding of OCD and may aid in the identification of more robust endophenotypes. Preliminary data suggest that these dimensional phenotypes may be useful in studies of the natural history, genetics, neurobiology, and treatment outcome of OCD. A dimensional approach is not mutually exclusive of other methods to parse the larger spectrum of disorders related to OCD. Thus far, age-of-onset of OCS and the individual's "tic-related" status seem to be particularly useful categorical distinctions. Finally, existing assessment methods are inadequate and new dimensional scales are needed to take full advantage of a dimensional approach in clinical and population-based studies.
由于缺乏强迫症（OCD）易感性的确切病因标志物或单一的病理生理学特征，强迫观念及强迫行为（OC）症状维度似乎提供了一个富有成效的导向点。OCD复杂的临床表现可以用一些一致且随时间稳定的症状维度来概括。这些可以被理解为一系列潜在重叠的特征，它们可能与“正常”担忧连续，并超出了OCD传统的疾病分类界限。尽管对强迫观念及强迫行为症状（OCS）维度结构的理解仍不完美，但这种对表型特征的定量方法有潜力推进我们对OCD的理解，并可能有助于识别更可靠的内表型。初步数据表明，这些维度表型在OCD的自然史、遗传学、神经生物学和治疗结果研究中可能有用。维度方法与解析与OCD相关的更广泛疾病谱的其他方法并非相互排斥。到目前为止，OCS的发病年龄和个体的“抽动相关”状态似乎是特别有用的分类区分。最后，现有的评估方法并不充分，需要新的维度量表来在临床和基于人群的研究中充分利用维度方法。
