Department of Psychiatry and Institute for Research in Extramural Medicine, VU-University Medical Center and Academic Outpatient Clinic for Anxiety Disorders, GGZ InGeest, Amsterdam, The Netherlands.
J Affect Disord. 2011 Dec;135(1-3):201-7. doi: 10.1016/j.jad.2011.07.018. Epub 2011 Sep 1.
Many OCD patients present with comorbid conditions, and major depression is one of the most frequent comorbidities observed. OCD patients with comorbid depression exhibit functional disability and poor quality of life. However, it is unclear whether depressive symptoms are predictive of treatment response, and debate remains whether they should be targeted in the treatment of comorbid patients. The current study aimed at assessing the predictive value of depression and OCD symptoms in the long term outcome of OCD treatment.
In the current study, relations between OCD and depressive symptoms were systematically investigated in a group of 121 OCD patients who received 16 sessions of behavior or cognitive therapy either alone or with fluvoxamine.
Depression (either as a continuous or categorical variable) was not predictive of treatment response in any of the treatment modalities for up to 5 years of follow-up. Changes in OCD symptoms largely predicted changes in depressive symptoms but not vice versa.
Subsequent to participation in the RCT, almost two-thirds of the participants received some form of additional treatment (either pharmacological or psychological), and as a result, it is impossible to determine interaction effects with additional treatment received after the trial.
Treatment of OCD with comorbid depression should focus on amelioration of OCD symptoms. When OCD treatment is successful, depressive symptoms are likely to ameliorate as well.
许多强迫症患者伴有共病情况，而重度抑郁症是最常见的共病之一。伴有抑郁共病的强迫症患者表现出功能障碍和生活质量差。然而，目前尚不清楚抑郁症状是否可预测治疗反应，并且对于是否应该在共病患者的治疗中针对这些症状仍存在争议。本研究旨在评估抑郁和强迫症症状在强迫症治疗长期结局中的预测价值。
在本研究中，对 121 名强迫症患者进行了系统研究，这些患者接受了 16 次行为或认知治疗，单独或与氟伏沙明联合治疗。
在长达 5 年的随访中，抑郁（无论是作为连续变量还是分类变量）都不能预测任何治疗方式的治疗反应。强迫症症状的变化在很大程度上预测了抑郁症状的变化，但反之则不然。
在参加 RCT 后，近三分之二的参与者接受了某种形式的额外治疗（药物或心理治疗），因此，无法确定在试验后接受额外治疗的相互作用效果。
伴有抑郁共病的强迫症的治疗应侧重于改善强迫症症状。当强迫症治疗成功时，抑郁症状也可能得到改善。
