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基层医疗中的退伍军人强迫症:患病率和损伤。

Obsessive compulsive disorder in veterans in primary care: prevalence and impairment.

机构信息

Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29401, USA.

出版信息

Gen Hosp Psychiatry. 2013 Jan-Feb;35(1):71-3. doi: 10.1016/j.genhosppsych.2012.09.004. Epub 2012 Oct 6.

DOI:10.1016/j.genhosppsych.2012.09.004
PMID:23044243
Abstract

OBJECTIVE

Obsessive compulsive disorder (OCD) is a severely impairing psychiatric disorder with an estimated 12-month prevalence of 0.39% to 1.20% in community settings. However, there has been little research on the prevalence of OCD in primary care settings and veteran samples. Thus, the present study investigated prevalence, comorbidity, and physical and mental health impairment of veterans with OCD.

METHOD

A total of 854 veterans participated in a cross-sectional investigation in primary care clinics in four Veteran Affairs Medical Centers. Participants completed the Mini International Neuropsychiatric Interview, Clinician-Administered PTSD Scale and Short-Form Health Survey.

RESULTS

A total of 1.9% of participants met the diagnostic criteria for OCD based on the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. Participants with OCD were significantly younger and demonstrated greater psychiatric comorbidity than participants without OCD. Participants with OCD also reported significantly more severe physical health impairment (role limitation, pain, general health), mental health impairment (emotional well-being, role limitations, energy/fatigue) and impairment in social functioning than participants without OCD.

CONCLUSIONS

These findings demonstrate moderately high prevalence and severe impairment associated with OCD in veterans, thus highlighting the need for improved recognition, assessment and specialized treatments for OCD in primary care settings and with veteran patients.

摘要

目的

强迫症(OCD)是一种严重致残的精神障碍,在社区环境中的 12 个月患病率估计为 0.39%至 1.20%。然而,关于强迫症在初级保健环境和退伍军人样本中的患病率的研究甚少。因此,本研究调查了强迫症退伍军人的患病率、共病情况以及身心健康损害。

方法

共有 854 名退伍军人参加了在四个退伍军人事务医疗中心的初级保健诊所进行的横断面调查。参与者完成了迷你国际神经精神访谈、临床医生管理的创伤后应激障碍量表和简短健康调查。

结果

根据《精神障碍诊断与统计手册(第四版)》,共有 1.9%的参与者符合 OCD 的诊断标准。与没有 OCD 的参与者相比,患有 OCD 的参与者明显更年轻,且表现出更严重的精神共病。与没有 OCD 的参与者相比,患有 OCD 的参与者还报告了更严重的身体健康损害(角色限制、疼痛、一般健康)、心理健康损害(情绪健康、角色限制、精力/疲劳)和社会功能损害。

结论

这些发现表明,退伍军人中 OCD 的患病率较高且损害严重,因此需要在初级保健环境中以及在退伍军人患者中提高对 OCD 的识别、评估和专门治疗的认识。

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