强迫症中的分离焦虑障碍。

Separation anxiety disorder in OCD.

机构信息

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1629 Thames Street, Baltimore, MD 21287, USA.

出版信息

Depress Anxiety. 2011 Mar;28(3):256-62. doi: 10.1002/da.20773. Epub 2011 Feb 9.

DOI:10.1002/da.20773

PMID:21308883

Abstract

BACKGROUND

A history of separation anxiety disorder (SAD) is frequently reported by patients with obsessive-compulsive disorder (OCD). The purpose of this study was to determine if there are clinical differences between OCD-affected individuals with, versus without, a history of SAD.

METHODS

Using data collected during the OCD Collaborative Genetic Study, we studied 470 adult OCD participants; 80 had a history of SAD, whereas 390 did not. These two groups were compared as to onset and severity of OCD, lifetime prevalence of Axis I disorders, and number of personality disorder traits.

RESULTS

OCD participants with a history of SAD were significantly younger than the non-SAD group (mean, 34.2 versus 42.2 years; P<.001). They had an earlier age of onset of OCD symptoms (mean, 8.0 versus 10.5 years; P<.003) and more severe OCD, as measured by the Yale-Brown Obsessive Compulsive Scale (mean, 27.5 versus 25.0; P<.005). In addition, those with a history of SAD had a significantly greater lifetime prevalence of agoraphobia (odds ratio (OR) = 2.52, 95% confidence interval (CI) = 1.4-4.6, P<.003), panic disorder (OR = 1.84, CI = 1.03-3.3 P<.04), social phobia (OR = 1.69, CI 1.01-2.8, P<.048), after adjusting for age at interview, age at onset of OCD, and OCD severity in logistic regression models. There was a strong relationship between the number of dependent personality disorder traits and SAD (adjusted OR = 1.42, CI = 1.2-1.6, P<.001).

CONCLUSIONS

A history of SAD is associated with anxiety disorders and dependent personality disorder traits in individuals with OCD.

摘要

背景

强迫症（OCD）患者常自述有分离焦虑障碍（SAD）病史。本研究旨在确定 OCD 患者中是否存在 SAD 病史与无 SAD 病史患者之间的临床差异。

方法

我们使用 OCD 合作遗传研究中收集的数据，研究了 470 名成年 OCD 参与者；其中 80 人有 SAD 病史，而 390 人没有。将这两组患者进行比较，比较的内容包括 OCD 的发病和严重程度、终生 Axis I 障碍患病率以及人格障碍特征的数量。

结果

有 SAD 病史的 OCD 患者明显比无 SAD 病史组年轻（平均年龄，34.2 岁与 42.2 岁；P<.001）。他们的 OCD 症状发病年龄更早（平均年龄，8.0 岁与 10.5 岁；P<.003），耶鲁-布朗强迫症量表（Yale-Brown Obsessive Compulsive Scale）评分更严重（平均得分，27.5 与 25.0；P<.005）。此外，有 SAD 病史的患者终生广泛性焦虑症的患病率显著更高（优势比（OR）=2.52，95%置信区间（CI）=1.4-4.6，P<.003）、惊恐障碍（OR=1.84，CI=1.03-3.3，P<.04）、社交恐惧症（OR=1.69，CI=1.01-2.8，P<.048），这是在 logistic 回归模型中通过调整受访者年龄、OCD 发病年龄和 OCD 严重程度后得出的结果。依赖型人格障碍特征的数量与 SAD 之间存在很强的关系（调整后的 OR=1.42，CI=1.2-1.6，P<.001）。