Mood and Anxiety Disorders Unit, Department of Neurosciences, University of Turin, 10126 Torino, Italy.
Compr Psychiatry. 2010 Mar-Apr;51(2):193-200. doi: 10.1016/j.comppsych.2009.03.004. Epub 2009 Apr 16.
Obsessive-compulsive disorder (OCD) is a serious mental disorder that has severe impact on a person's quality of life and those living with a person with OCD. This study systematically examined the clinical variables that are predictive of several domains of quality of life in a large, well-characterized sample of patients attending a specialized treatment unit in Italy.
The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was administered to 151 patients with OCD and their scores were compared to published Italian norms. A principal component analysis was performed on the 13 major categories of the Yale-Brown Obsessive-Compulsive Scale (YBOCS) Symptom Checklist to derive symptom dimension scores. The association between various domains of quality of life and a wide range of clinical variables, including symptom dimension scores, was examined using multiple regression models.
Compared to published Italian norms, patients with OCD showed impairment in most domains of quality of life, particularly social functioning. The principal component analysis of the YBOCS Symptom Checklist yielded 5 symptom dimensions that were identical to those previously identified in the international literature. Fewer years of education, higher depression scores (Hamilton Rating Scale for Depression), higher YBOCS obsessions scores, and higher scores on the contamination/washing symptom dimension independently predicted a poorer score on the physical health component of the SF-36. Higher YBOCS compulsions scores, the presence of a current mood disorder, and higher anxiety scores (Hamilton Rating Scale for Anxiety) predicted a poorer score on the mental health component of the SF-36.
Our study confirms that quality of life is severely impaired in patients with OCD. The identification of predictors of quality of life in OCD can help clinicians to adapt their treatment protocols to cater for the individual needs of their patients.
强迫症（OCD）是一种严重的精神障碍，对患者及其身边人的生活质量有着严重影响。本研究系统地研究了意大利一个专门治疗单位的 151 名患者的临床变量，这些变量与多个生活质量领域相关。
本研究使用健康调查简表 36 项（Medical Outcomes Study 36-Item Short-Form Health Survey，SF-36）评估了 OCD 患者的生活质量，同时将他们的得分与意大利的常模进行了比较。使用主成分分析（principal component analysis）对耶鲁-布朗强迫症量表症状清单（Yale-Brown Obsessive-Compulsive Scale Symptom Checklist）的 13 个主要类别进行了分析，以得出症状维度评分。使用多元回归模型研究了各种生活质量领域与广泛的临床变量（包括症状维度评分）之间的关联。
与意大利的常模相比，OCD 患者在生活质量的大多数领域都存在受损，特别是在社会功能方面。YBOCS 症状清单的主成分分析得出了 5 个症状维度，与国际文献中先前确定的维度相同。受教育年限较少、抑郁评分（汉密尔顿抑郁量表）较高、强迫症症状的 YBOCS 评分较高，以及污染/洗涤症状维度的评分较高，这些因素均独立预测了 SF-36 生理健康成分评分较低。强迫症状的 YBOCS 评分较高、当前存在心境障碍以及焦虑评分（汉密尔顿焦虑量表）较高，这些因素均预测了 SF-36 心理健康成分评分较低。
我们的研究证实 OCD 患者的生活质量严重受损。确定 OCD 生活质量的预测因素可以帮助临床医生调整他们的治疗方案，以满足患者的个体需求。
