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儿童和青少年创伤事件与强迫症:二者是否存在关联?

Traumatic events and obsessive compulsive disorder in children and adolescents: is there a link?

机构信息

Child and Youth Mental Health Program, British Columbia Children's Hospital, Vancouver, Canada.

出版信息

J Anxiety Disord. 2011 May;25(4):513-9. doi: 10.1016/j.janxdis.2010.12.005. Epub 2010 Dec 27.

Abstract

BACKGROUND

The extant literature supports an association between psychological trauma and development of OCD in adults, and this link is a plausible mediator for environment-gene interactions leading to phenotypic expression of OCD.

OBJECTIVE

To explore the relationship between OCD and traumatic life events in children and adolescents.

METHODS

We examined the prevalence of traumatic life events and PTSD in a large sample of systematically assessed children with OCD. OCD symptoms and severity were assessed using the Children's Yale Brown Obsessive Compulsive Scale (CY-BOCS) in those with and without concurrent PTSD.

RESULTS

Rate of PTSD and trauma exposure was higher in children with OCD than in a comparable control group of non-OCD youth matched for age, gender and SES. Children with concurrent PTSD had more intrusive fears and distress and less control over their rituals than children with OCD but without PTSD. Total CY-BOCS scores were higher in those with concurrent PTSD. Specific type of OCD symptoms was not altered by a PTSD diagnosis.

CONCLUSIONS

A history of psychologically traumatic events may be over-represented in children with OCD. Given the need to search for non-genetic factors that may lead to onset of OCD, better and more systematic methods to obtain and quantify psychologically traumatic life events are needed in clinical populations.

摘要

背景

现有文献支持心理创伤与成人 OCD 发展之间的关联,这种关联是导致 OCD 表型表达的环境-基因相互作用的合理中介。

目的

探讨儿童和青少年 OCD 与创伤性生活事件之间的关系。

方法

我们检查了在一个经过系统评估的 OCD 大样本中创伤性生活事件和 PTSD 的发生率。在伴有或不伴有并发 PTSD 的患者中,使用儿童耶鲁布朗强迫症量表(CY-BOCS)评估 OCD 症状和严重程度。

结果

与年龄、性别和 SES 相匹配的非 OCD 青年对照组相比,患有 OCD 的儿童 PTSD 和创伤暴露的发生率更高。并发 PTSD 的儿童有更多的侵入性恐惧和痛苦,对仪式的控制程度低于没有 PTSD 的 OCD 儿童。伴有并发 PTSD 的儿童的总 CY-BOCS 评分更高。特定类型的 OCD 症状不受 PTSD 诊断的影响。

结论

患有 OCD 的儿童可能有更多的心理创伤史。鉴于需要寻找可能导致 OCD 发作的非遗传因素,临床人群中需要更好和更系统的方法来获取和量化心理创伤性生活事件。

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