Shin N Y, Lee T Y, Kim E, Kwon J S
Interdisciplinary Cognitive Science Program, Seoul National University, Seoul, South Korea.
Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.
Psychol Med. 2014 Apr;44(6):1121-30. doi: 10.1017/S0033291713001803. Epub 2013 Jul 19.
Substantial empirical evidence has indicated impairment in the cognitive functioning of patients with obsessive-compulsive disorder (OCD) despite inconsistencies. Although several confounding factors have been investigated to explain the conflicting results, the findings remain mixed. This study aimed to investigate cognitive dysfunction in patients with OCD using a meta-analytic approach.
The PubMed database was searched between 1980 and October 2012, and reference lists of review papers were examined. A total of 221 studies were identified, of which 88 studies met inclusion criteria. Neuropsychological performance and demographic and clinical variables were extracted from each study.
Patients with OCD were significantly impaired in tasks that measured visuospatial memory, executive function, verbal memory and verbal fluency, whereas auditory attention was preserved in these individuals. The largest effect size was found in the ability to recall complex visual stimuli. Overall effect estimates were in the small to medium ranges for executive function, verbal memory and verbal fluency. The effects of potentially confounding factors including educational level, symptom severity, medication status and co-morbid disorders were not significant.
Patients with OCD appear to have wide-ranging cognitive deficits, although their impairment is not so large in general. The different test forms and methods of testing may have influenced the performance of patients with OCD, indicating the need to select carefully the test forms and methods of testing used in future research. The effects of various confounding variables on cognitive functioning need to be investigated further and to be controlled before a definite conclusion can be made.
大量实证证据表明，尽管存在不一致性，但强迫症（OCD）患者的认知功能存在损害。虽然已经研究了几个混杂因素来解释相互矛盾的结果，但研究结果仍然参差不齐。本研究旨在采用荟萃分析方法调查强迫症患者的认知功能障碍。
检索了1980年至2012年10月期间的PubMed数据库，并查阅了综述论文的参考文献列表。共识别出221项研究，其中88项研究符合纳入标准。从每项研究中提取神经心理学表现、人口统计学和临床变量。
强迫症患者在测量视觉空间记忆、执行功能、言语记忆和言语流畅性的任务中存在显著损害，而这些个体的听觉注意力得以保留。在回忆复杂视觉刺激的能力方面发现了最大的效应量。执行功能、言语记忆和言语流畅性的总体效应估计在小到中等范围内。包括教育水平、症状严重程度、用药情况和共病在内的潜在混杂因素的影响不显著。
强迫症患者似乎存在广泛的认知缺陷，尽管总体上他们的损害并不那么严重。不同的测试形式和测试方法可能影响了强迫症患者的表现，这表明在未来研究中需要仔细选择使用的测试形式和测试方法。在得出明确结论之前，需要进一步研究并控制各种混杂变量对认知功能的影响。
