Ardizzone Ignazio, Soletti Laura, Panunzi Sara, Carratelli Teresa I
Dipartimento di Scienze Neurologiche Psichiatriche e Riabilitative dell'Età Evolutiva, Sapienza Università di Roma.
Riv Psichiatr. 2010 Mar-Apr;45(2):94-101.
This study examines the obsessive-compulsive disorder (OCD) with normal and poor insight of illness and it detects the presence of autistic traits. The aim is to establish the relationship between OCD and Autistic Spectrum Disorder (ASD): comorbidity or subtype of OCD?
The sample consists of 48 adolescents (aged 12-18) with a clinical diagnosis of OCD (according DSM-IV-TR). After administering the Children's Yale Brown Obsessive-Compulsive Scale (CYBOCS) and the Brown Assessement Beliefs Scale (BABS), the sample is divided into two groups according to insight of illness. Autism Diagnostic Observation Schedule (ADOS) and Social Communication Questionnaire (SCQ) were used to assist in the ASD diagnosis; Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) was administered to assess personality disorders.
47% of subjects presents poor insight and 27% are included within the diagnostic criteria for autistic spectrum disorder. Poor insight in obsessive-compulsive symptoms is significantly associated with the presence of autistic traits. There is also a significant association between cluster hoarding and poor insight.
This study suggests the existence of an obsessive autistic atypical subtype, where the compulsive dimension of repetitive behaviours vanishes in an autistic dimension with stereotyped manifestations. Further research should be conducted to better understand this obsessive autistic atypical subtype and to put it in the obsessive-compulsive spectrum in adolescence.
本研究对患有强迫症（OCD）且自知力正常和自知力差的患者进行检查，并检测自闭症特征的存在情况。目的是确定强迫症与自闭症谱系障碍（ASD）之间的关系：是共病还是强迫症的亚型？
样本包括48名临床诊断为强迫症（根据《精神疾病诊断与统计手册》第四版修订版[DSM-IV-TR]）的青少年（年龄在12 - 18岁）。在施测儿童耶鲁布朗强迫症量表（CYBOCS）和布朗信念评估量表（BABS）后，根据疾病自知力将样本分为两组。使用自闭症诊断观察量表（ADOS）和社会沟通问卷（SCQ）辅助进行自闭症谱系障碍的诊断；采用《精神疾病诊断与统计手册》第四版轴II人格障碍结构化临床访谈（SCID-II）评估人格障碍。
47%的受试者自知力差，27%符合自闭症谱系障碍的诊断标准。强迫症状自知力差与自闭症特征的存在显著相关。囤积症状群与自知力差之间也存在显著关联。
本研究表明存在一种强迫性自闭症非典型亚型，其中重复行为的强迫维度在具有刻板表现的自闭症维度中消失。应进一步开展研究，以更好地理解这种强迫性自闭症非典型亚型，并将其纳入青少年强迫症谱系中。
