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强迫症患者生活质量与抑郁的综述

A review on quality of life and depression in obsessive-compulsive disorder.

作者信息

Moritz Steffen

机构信息

Neurocognitive Unit, Psychiatric Hospital, University Medical Centre Hamburg-Eppendorf, Germany.

出版信息

CNS Spectr. 2008 Sep;13(9 Suppl 14):16-22. doi: 10.1017/s1092852900026894.

Abstract

Quality of life (QoL) is increasingly recognized as a pivotal outcome parameter in research on obsessive-compulsive disorder (OCD). While the concept remains somewhat ill-defined, there is now little dispute that the patients' personal goals deserve foremost consideration during the course of treatment as the primary aim of treatment should be relief from individual despair, which is related but by no means synonymous to symptom reduction. Studies using generic (ie, illness-unspecific) instruments have confirmed poor QoL in OCD patients across a wide range of domains, especially with respect to social, work role functioning, and mental health aspects. Scores are sometimes as low as those obtained by patients with schizophrenia. Depression and obsessions are the symptom clusters that most strongly contribute to low QoL. Findings from a novel survey of 105 OCD participants point to multiple daily life problems, poor work status, and tense social networks in these patients. In order to achieve therapeutic success and improve QoL, functional problems at work and comorbid disorders such as secondary depression and physical impairments should be targeted. While successful treatment sometimes positively impacts well-being, in some studies symptom decline did not translate into improved QoL.

摘要

生活质量(QoL)在强迫症(OCD)研究中日益被视为关键的结果参数。尽管这一概念仍有些定义不清,但现在几乎没有争议的是,在治疗过程中患者的个人目标应得到首要考虑,因为治疗的主要目标应该是缓解个体的绝望情绪,这与症状减轻相关但绝不是同义词。使用通用(即疾病非特异性)工具的研究证实,强迫症患者在广泛领域的生活质量较差,尤其是在社交、工作角色功能和心理健康方面。得分有时低至精神分裂症患者的得分。抑郁和强迫观念是导致生活质量低下的最主要症状群。一项对105名强迫症参与者的新调查结果表明,这些患者存在多种日常生活问题、工作状态不佳以及社交网络紧张。为了取得治疗成功并提高生活质量,应针对工作中的功能问题以及继发性抑郁和身体损伤等共病进行治疗。虽然成功的治疗有时会对幸福感产生积极影响,但在一些研究中,症状减轻并未转化为生活质量的改善。

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