tic 相关的强迫症的临床特征:一项大型多中心研究的结果。
Clinical features of tic-related obsessive-compulsive disorder: results from a large multicenter study.
机构信息
Department of Psychiatry, University of Sao Paulo Medical School (USP), São Paulo, Brazil.
出版信息
CNS Spectr. 2012 Jun;17(2):87-93. doi: 10.1017/S1092852912000491.
OBJECTIVE
To evaluate the clinical features of obsessive-compulsive disorder (OCD) patients with comorbid tic disorders (TD) in a large, multicenter, clinical sample.
METHOD
A cross-sectional study was conducted that included 813 consecutive OCD outpatients from the Brazilian OCD Research Consortium and used several instruments of assessment, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Yale Global Tic Severity Scale (YGTSS), the USP Sensory Phenomena Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders.
RESULTS
The sample mean current age was 34.9 years old (SE 0.54), and the mean age at obsessive-compulsive symptoms (OCS) onset was 12.8 years old (SE 0.27). Sensory phenomena were reported by 585 individuals (72% of the sample). The general lifetime prevalence of TD was 29.0% (n = 236), with 8.9% (n = 72) presenting Tourette syndrome, 17.3% (n = 141) chronic motor tic disorder, and 2.8% (n = 23) chronic vocal tic disorder. The mean tic severity score, according to the YGTSS, was 27.2 (SE 1.4) in the OCD + TD group. Compared to OCD patients without comorbid TD, those with TD (OCD + TD group, n = 236) were more likely to be males (49.2% vs. 38.5%, p < .005) and to present sensory phenomena and comorbidity with anxiety disorders in general: separation anxiety disorder, social phobia, specific phobia, generalized anxiety disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder, impulse control disorders in general, and skin picking. Also, the "aggressive," "sexual/religious," and "hoarding" symptom dimensions were more severe in the OCD + TD group.
CONCLUSION
Tic-related OCD may constitute a particular subgroup of the disorder with specific phenotypical characteristics, but its neurobiological underpinnings remain to be fully disentangled.
目的
在一个大型的多中心临床样本中评估伴有抽动障碍(TD)的强迫症(OCD)患者的临床特征。
方法
进行了一项横断面研究,纳入了来自巴西 OCD 研究联合会的 813 名连续的 OCD 门诊患者,并使用了几种评估工具,包括耶鲁-布朗强迫症量表、维度耶鲁-布朗强迫症量表、耶鲁全球抽动严重程度量表(YGTSS)、USP 感觉现象量表和 DSM-IV 轴 I 障碍的结构临床访谈。
结果
样本的平均当前年龄为 34.9 岁(SE 0.54),强迫症症状(OCS)发病的平均年龄为 12.8 岁(SE 0.27)。585 人(样本的 72%)报告了感觉现象。TD 的总体终生患病率为 29.0%(n=236),其中 8.9%(n=72)为妥瑞氏综合征,17.3%(n=141)为慢性运动性抽动障碍,2.8%(n=23)为慢性发声性抽动障碍。根据 YGTSS,OCD+TD 组的抽动严重程度评分为 27.2(SE 1.4)。与无共患 TD 的 OCD 患者相比,共患 TD(OCD+TD 组,n=236)更可能为男性(49.2% vs. 38.5%,p<0.005),且更可能出现感觉现象和广泛性焦虑障碍共病:分离焦虑障碍、社交恐惧症、特定恐惧症、广泛性焦虑障碍、创伤后应激障碍、注意力缺陷多动障碍、冲动控制障碍和皮肤搔抓。此外,OCD+TD 组的“攻击”、“性/宗教”和“囤积”症状维度更为严重。
结论
与抽动相关的 OCD 可能构成该疾病的一个特定亚组,具有特定的表型特征,但其神经生物学基础仍有待充分阐明。