Langner Judith, Laws Manuela, Röper Gisela, Zaudig Michael, Hauke Walter, Piesbergen Christoph
Ludwig-Maximilians-Universität, Munich, Germany.
Behav Cogn Psychother. 2009 Oct;37(5):485-96. doi: 10.1017/S1352465809990294.
Increasing attention has been given to subtyping OCD with respect to different clinical profiles, response to drug treatments, comorbidity and age of onset. There are a number of studies looking at predictors of treatment outcome in OCD, but so far not for OCD subtypes.
Prediction of outcome after cognitive-behavioural therapy was evaluated in 63 inpatients with early obsessive-compulsive disorder (EOCD < or = 12 years of age) and 191 patients with late obsessive-compulsive disorder (LOCD > 15 years of age).
For EOCD patients factors predicting a good outcome included high motivation and high initial Y-BOCS scores. Factors associated with a bad outcome were higher age at assessment, a longer duration of psychiatric inpatient treatment before assessment and a low level of social functioning (BSS). For LOCD patients living in a stable relationship, high motivation and completing treatment predicted a favourable therapy outcome, while a low level of psychological functioning (BSS) and a longer duration of inpatient psychiatric treatment before assessment were associated with an undesirable therapy outcome.
Subtyping OCD patients according to age of onset seems to be a promising avenue towards improving and developing more specified treatment programs.
关于强迫症根据不同临床特征、对药物治疗的反应、共病情况及发病年龄进行亚型划分，已受到越来越多的关注。有多项研究探讨强迫症治疗结果的预测因素，但迄今为止尚未针对强迫症亚型进行研究。
对63例早发性强迫症（EOCD，年龄≤12岁）住院患者和191例晚发性强迫症（LOCD，年龄＞15岁）患者认知行为治疗后的结果预测进行了评估。
对于早发性强迫症患者，预测良好结果的因素包括高动机和初始Y - BOCS评分高。与不良结果相关的因素包括评估时年龄较大、评估前精神科住院治疗时间较长以及社会功能水平低（BSS）。对于晚发性强迫症患者，处于稳定关系、高动机和完成治疗可预测良好的治疗结果，而心理功能水平低（BSS）以及评估前住院精神科治疗时间较长与不良治疗结果相关。
根据发病年龄对强迫症患者进行亚型划分似乎是改善和制定更具针对性治疗方案的一个有前景的途径。
