Department of Psychiatry, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Milano, Italy.
World J Biol Psychiatry. 2010 Feb;11(1):59-65. doi: 10.3109/15622970903418544.
The Duration of Untreated Illness (DUI), defined as the time elapsing between the onset of a disorder and the beginning of the first pharmacological treatment, has been increasingly investigated as a predictor of outcome and course across different psychiatric disorders. Purpose of this naturalistic study was to evaluate the influence of DUI on treatment response and remission in a sample of patients with obsessive-compulsive disorder (OCD).
Sixty-six outpatients with a DSM-IV diagnosis of OCD were included in the study. Patients received, according to their clinical conditions, an open pharmacological treatment of 12 weeks and were evaluated by the administration of the Yale Brown Obsessive Compulsive Scale (Y-BOCS) at baseline and endpoint. Treatment response was defined as a decrease .25% on Y-BOCS score compared to baseline, while remission was defined as an endpoint Y-BOCS total score #10. A logistic regression was performed considering DUI as the independent continuous variable and treatment response and remission as the dependent variables. Moreover, the sample was divided into two groups according to a categorical cut-off for the DUI of 24 months and odds ratios (OR) were calculated on the basis of the same variables.
DUI, considered as a continuous variable, was not predictive of treatment response (OR51.00, P50.15) nor remission (OR51.00, P50.59). When considered as a categorical variable, however, a DUI # 24 months was predictive of treatment response (OR50.27, P50.03).
Results from the present naturalistic study suggest a complicated relationship between DUI and treatment outcome in OCD encouraging further investigation with larger samples in order to better define long versus short DUI in this condition.
未治疗疾病持续时间（DUI）定义为疾病发作和首次药物治疗开始之间的时间流逝，已越来越多地被研究作为不同精神障碍的结果和病程的预测指标。本自然研究的目的是评估 DUI 对强迫症（OCD）患者样本治疗反应和缓解的影响。
研究纳入了 66 名符合 DSM-IV 强迫症诊断的门诊患者。根据他们的临床情况，患者接受了为期 12 周的开放药物治疗，并在基线和终点时通过耶鲁-布朗强迫量表（Y-BOCS）进行评估。治疗反应定义为 Y-BOCS 评分较基线下降 25%，而缓解定义为终点 Y-BOCS 总分 #10。进行逻辑回归，将 DUI 作为独立的连续变量，将治疗反应和缓解作为因变量。此外，根据 DUI 的 24 个月分类截止值将样本分为两组，并根据相同变量计算比值比（OR）。
DUI 被视为连续变量时，与治疗反应（OR51.00，P50.15）或缓解（OR51.00，P50.59）无关。然而，当被视为分类变量时，DUI # 24 个月与治疗反应（OR50.27，P5.03）有关。
本自然研究的结果表明，DUI 与 OCD 治疗结果之间存在复杂关系，鼓励进一步研究，以更大的样本量更好地定义该条件下的长 DUI 与短 DUI。
