Grabe Hans Joergen, Ruhrmann Stephan, Spitzer Carsten, Josepeit Jana, Ettelt Susan, Buhtz Friederike, Hochrein Andrea, Schulze-Rauschenbach Svenja, Meyer Klaus, Kraft Susanne, Reck Claudia, Pukrop Ralf, Klosterkötter Joachim, Falkai Peter, Maier Wolfgang, Wagner Michael, John Ulrich, Freyberger Harald J
Department of Psychiatry and Psychotherapy, University of Greifswald, Stralsund, Germany.
Psychopathology. 2008;41(2):129-34. doi: 10.1159/000112029. Epub 2007 Dec 5.
Previous studies suggested an association between exposure to trauma or stressful life events and obsessive-compulsive disorder (OCD). This study investigates the hypothesis that traumatic events and posttraumatic stress disorders (PTSD) precede the onset of OCD.
210 cases with OCD from university treatment facilities were compared with 133 sex- and age-matched controls from the adult general population. The data were derived from a German family study on OCD (GENOS). Direct interviews were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia - Lifetime Version for Anxiety Disorders (DSM-IV).
Severe traumatization occurred in 6.2% of the OCD cases and in 8.3% of the controls. The lifetime prevalence rates of traumatization, PTSD and acute stress disorder were not different between the subjects with OCD and controls (p > 0.05). In 6 cases, acute stress disorder, subclinical or full PTSD preceded the onset of OCD, in 3 cases the trauma-related disorders and OCD occurred within the same year, in 5 other cases, the trauma-related disorders started after the onset of OCD.
There is no significant association of traumatization or PTSD with OCD compared with controls. Given the low rate of trauma-related disorders occurring before (2.9%) or within (1.5%) the same year as the onset of OCD other factors than severe traumatic events determine the onset of OCD in most of the cases.
先前的研究表明，接触创伤或应激性生活事件与强迫症（OCD）之间存在关联。本研究调查了创伤事件和创伤后应激障碍（PTSD）先于强迫症发病的假说。
将来自大学治疗机构的210例强迫症患者与来自成年普通人群的133名年龄和性别匹配的对照进行比较。数据来源于一项关于强迫症的德国家庭研究（GENOS）。使用德语版的情感障碍和精神分裂症问卷 - 焦虑症终身版（DSM-IV）进行直接访谈。
6.2%的强迫症患者和8.3%的对照经历过严重创伤。强迫症患者和对照之间创伤、PTSD和急性应激障碍的终身患病率没有差异（p>0.05）。6例中，急性应激障碍、亚临床或完全PTSD先于强迫症发病，3例中创伤相关障碍和强迫症在同一年内发生，另外5例中，创伤相关障碍在强迫症发病后开始。
与对照相比，创伤或PTSD与强迫症之间无显著关联。鉴于在强迫症发病前（2.9%）或同一年内（1.5%）发生的创伤相关障碍发生率较低，在大多数情况下，除严重创伤事件外的其他因素决定了强迫症的发病。
