Chavira Denise A, Garrido Helena, Bagnarello Monica, Azzam Amin, Reus Victor I, Mathews Carol A
Department of Psychiatry, University of California San Diego, San Diego, California 92037, USA.
Depress Anxiety. 2008;25(7):609-19. doi: 10.1002/da.20357.
This study compares the presentation and expression of obsessive-compulsive symptoms between a Latin-American and North American sample. In Costa Rica (CR) and the United States (US), respectively, 26 and 52 affected individuals with early-onset obsessive-compulsive disorder (OCD) were recruited. The Yale Brown Obsessive Compulsive Scale (YBOCS), a semi-structured psychiatric interview, and self-report questionnaires were administered. Age of onset and the distribution of OCD across men and women were similar across groups. Both CR and US participants reported obsessions and compulsions, with similar frequencies of symptoms, and contamination, symmetry, and hoarding as the most common symptom subtypes. The US sample had higher YBOCS total severity scores than the Costa Rican group. Similarly, there were significant ethnicity effects for YBOCS compulsion [F(1, 70)=17.88, P<.001] and obsession severity [F(1, 70)=8.78, P<.001], with Caucasians having higher scores than Costa Ricans on both subscales. Comorbidity rates were higher for US Caucasians than Costa Ricans for all disorders; differences were significant for mood disorders [64.7% versus 34.6%], alcohol use [21.3% versus 3.8%], cannabis use disorders [19.1% versus 0%], and other substance use disorders [39.4% versus 0%]. Regression analyses revealed that ethnicity, trait anxiety, and proband status were the only significant predictors of total YBOCS severity. Findings suggest that the core phenotype of OCD is the same in both CR and the US, and perhaps biologically driven. However some features of OCD, such as impairment, may be culturally influenced, leading to differences in prevalence rates and treatment utilization.
本研究比较了拉丁裔美国人和北美样本中强迫症症状的表现与表达。分别在哥斯达黎加（CR）和美国（US）招募了26名和52名患有早发性强迫症（OCD）的患者。使用了耶鲁布朗强迫症量表（YBOCS）、半结构化精神科访谈和自我报告问卷。各群体之间的发病年龄以及强迫症在男性和女性中的分布相似。CR和美国的参与者均报告了强迫观念和强迫行为，症状出现频率相似，污染、对称和囤积是最常见的症状亚型。美国样本的YBOCS总严重程度得分高于哥斯达黎加组。同样，YBOCS强迫行为[F(1, 70)=17.88, P<.001]和强迫观念严重程度[F(1, 70)=8.78, P<.001]存在显著的种族效应，两个分量表上白种人的得分均高于哥斯达黎加人。所有疾病中，美国白种人的合并症发生率均高于哥斯达黎加人；情绪障碍[64.7%对34.6%]、酒精使用[21.3%对3.8%]、大麻使用障碍[19.1%对0%]和其他物质使用障碍[39.4%对0%]的差异具有统计学意义。回归分析显示，种族、特质焦虑和先证者状态是YBOCS总严重程度的仅有的显著预测因素。研究结果表明，CR和美国的OCD核心表型相同，可能由生物学因素驱动。然而，OCD的一些特征，如损害，可能受文化影响，导致患病率和治疗利用率存在差异。
