Klenfeldt Isak Fredén, Karlsson Björn, Sigström Robert, Bäckman Kristoffer, Waern Margda, Östling Svante, Gustafson Deborah, Skoog Ingmar
Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden.
Department of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Unite of Neuropsychiatric Epidemiology, Sahlgrenska Academy at the University of Gothenburg, Sweden.
Am J Geriatr Psychiatry. 2014 Mar;22(3):301-8. doi: 10.1016/j.jagp.2012.09.004. Epub 2013 Mar 13.
We examined the 1-month prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) not fulfilling OCD criteria in relation to sex, age, social and mental function, comorbid depression, and cognitive functioning in an elderly nondemented population.
Population-based sample (N = 900), stratified into two age groups: 70-year-olds (335 women and 224 men) and those aged 78 and above (341 women).
Semi-structured interviews. Psychiatric symptoms were assessed with the Comprehensive Psychopathological Rating Scale and Mini-International Neuropsychiatric Interview, mental and social function with the GAF-scale, memory function with the Word Recall Task and general cognition with MMSE. OCD and Depression were diagnosed according to DSM-IV.
The one-month prevalence of OCD was 2.9%; a further 21% had OCS. Among 70-year-olds, the prevalence of OCD was 1.3% in men and 4.5% in women. Depression was more common among those with OCD (34.6%) than among those with (12.7%) and without (8.0%) OCS. GAF-score was lower among those with OCD (74.8) and OCS (82.9) compared with individuals without obsessions and compulsions (88.2). The association between OCD and GAF-score remained after adjustment for age, sex, and depression. The OCD subgroup with checking behavior had more memory and concentration problems and did worse on Word Recall Task than other groups in our sample.
We found that OCD and OCS are common among the elderly. Both conditions are related to depression and poorer mental and social functioning. Physicians who meet elderly patients need to be aware of OCD as it is potentially treatable.
我们研究了老年非痴呆人群中强迫症（OCD）及未达强迫症标准的强迫症状（OCS）的1个月患病率，以及其与性别、年龄、社会和心理功能、共病抑郁及认知功能的关系。
基于人群的样本（N = 900），分为两个年龄组：70岁组（335名女性和224名男性）以及78岁及以上组（341名女性）。
半结构化访谈。使用综合精神病理学评定量表和迷你国际神经精神访谈评估精神症状，用GAF量表评估心理和社会功能，用单词回忆任务评估记忆功能，用简易精神状态检查表评估一般认知。根据《精神疾病诊断与统计手册》第四版（DSM-IV）诊断强迫症和抑郁症。
强迫症的1个月患病率为2.9%；另有21%有强迫症状。在70岁组中，男性强迫症患病率为1.3%，女性为4.5%。强迫症患者中抑郁症更为常见（34.6%），高于有强迫症状（12.7%）和无强迫症状（8.0%）的人群。与无强迫观念和强迫行为的个体（88.2）相比，强迫症患者（74.8）和有强迫症状者（82.9）的GAF评分更低。在对年龄、性别和抑郁进行调整后，强迫症与GAF评分之间的关联依然存在。在我们的样本中，有检查行为的强迫症亚组比其他组有更多的记忆和注意力问题，在单词回忆任务上表现更差。
我们发现强迫症和强迫症状在老年人中很常见。这两种情况都与抑郁以及较差的心理和社会功能有关。接诊老年患者的医生需要意识到强迫症，因为它有可能得到治疗。
