Institute of Psychiatry, King's College London, UK.
Behav Cogn Psychother. 2010 Mar;38(2):157-71. doi: 10.1017/S1352465809990695.
The value of defining subtypes in obsessive compulsive disorder (OCD) has become an important issue for recent debate. Probably the most robust example of subtyping is the identification of hoarding as being different both in terms of psychopathology and response to treatment.
To identify differences in psychopathology and treatment response in OCD patients with and without additional hoarding symptoms.
Patients who had undertaken CBT for OCD were selected as falling into either a high or a low hoarding group. The high hoarding group (n = 18) was selected on the basis of a high score on the hoarding subscale of a self-report measure of OCD symptoms in addition to reaching clinician judged "threshold" on the hoarding item of the Obsessive Compulsive Personality Disorder (OCPD) SCID-II module. The low hoarding group (n = 20) was selected on the basis of a low score on the hoarding subscale and a clinician judgement that the hoarding item of the OCPD SCID-II module was "absent".
On some measures of pre-treatment psychopathology, patients with OCD with hoarding symptoms were more severely affected than those without hoarding symptoms. It was found that there was no difference in eventual treatment outcome between the two groups, although there was some evidence that the hoarding group showed greater symptom decreases.
The presence of hoarding symptoms does not negatively impact on the treatment of OCD.
在强迫症 (OCD) 中定义亚型的价值已成为近期争论的重要问题。最具代表性的亚型划分是囤积症，无论是在精神病理学还是治疗反应方面都存在差异。
确定伴有和不伴有额外囤积症状的 OCD 患者在精神病理学和治疗反应方面的差异。
选择接受认知行为疗法 (CBT) 治疗 OCD 的患者，将其分为高或低囤积组。高囤积组（n=18）的选择依据是，除了达到强迫症人格障碍 (OCPD) SCID-II 模块中囤积项目的临床医生判断“阈值”外，他们在 OCD 症状的自我报告量表的囤积子量表上的得分较高。低囤积组（n=20）的选择依据是囤积子量表得分较低，且临床医生判断 OCPD SCID-II 模块中的囤积项目“不存在”。
在一些治疗前精神病理学的衡量标准上，伴有囤积症状的 OCD 患者比不伴有囤积症状的患者受影响更为严重。研究发现，两组之间最终的治疗结果没有差异，尽管有一些证据表明囤积组的症状减轻更为明显。
囤积症状的存在并不会对 OCD 的治疗产生负面影响。
