Weidle Bernhard, Jozefiak Thomas, Ivarsson Tord, Thomsen Per Hove
Health Qual Life Outcomes. 2014 Oct 29;12:152. doi: 10.1186/s12955-014-0152-x.
Quality of life (QoL) is a well-established outcome measure. However, in contrast to adult obsessive-compulsive disorder (OCD), little is known about QoL in children with OCD. This study aimed to assess QoL, social competence and school functioning of paediatric patients with OCD by comparing them with the general population and assessing the relations between comorbidity, duration and severity of symptoms, family accommodation and QoL.
Children and adolescents (n = 135), aged 7-17 (mean 13 [SD 2.7] years; 48.1% female) were assessed at baseline for treatment. QoL was assessed by self-report and caregiver's proxy report on the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R) and compared with an age- and sex-matched sample from the general population. Social competence and school functioning were assessed with the Child Behavior Checklist, comorbidity with the Kiddie Schedule for Affective Disorders and Schizophrenia (Present and Lifetime Version), severity of OCD with the Children's Yale-Brown Obsessive Compulsive Scale and the families' involvement with the child's OCD symptoms with the Family Accommodation Scale.
QoL and social competence were reduced (p < .001) in patients with OCD compared with controls (KINDL-R mean score 62.40 [SD 13.00] versus 69.72 [12.38] in self-reports and 61.63 [SD 13.27] versus 74.68 [9.97] in parent reports). Patients with comorbidity had lower QoL (p = .001) in proxy ratings than those with OCD only (mean score 56.26 [SD 12.47] versus 64.30 [SD 12.75]). In parent proxy reports, severity of OCD (r = -.28) and family accommodation (r = -.40) correlated moderately negatively with QoL.
To our knowledge, this is the largest QoL study of paediatric OCD. QoL was markedly reduced in children with OCD, especially in those with comorbid psychiatric disorders. Based on our findings, we suggest employing QoL assessment in order to have a more comprehensive understanding of childhood OCD.
This study was registered in Current Controlled Trials; Nordic Long-term Obsessive Compulsive disorder (OCD) Treatment Study (ISRCTN66385119).
生活质量（QoL）是一项已确立的结果指标。然而，与成人强迫症（OCD）不同，关于儿童强迫症患者的生活质量知之甚少。本研究旨在通过将儿科强迫症患者与普通人群进行比较，并评估共病、症状持续时间和严重程度、家庭迁就与生活质量之间的关系，来评估儿科强迫症患者的生活质量、社交能力和学校功能。
对135名7至17岁（平均13岁[标准差2.7]；48.1%为女性）的儿童和青少年在基线时进行治疗评估。使用儿童和青少年健康相关生活质量测量问卷（KINDL-R）通过自我报告和照顾者代理报告来评估生活质量，并与来自普通人群的年龄和性别匹配样本进行比较。使用儿童行为检查表评估社交能力和学校功能，使用儿童情感障碍和精神分裂症量表（目前和终生版本）评估共病情况，使用儿童耶鲁-布朗强迫症量表评估强迫症的严重程度，使用家庭迁就量表评估家庭对儿童强迫症症状的参与情况。
与对照组相比，强迫症患者的生活质量和社交能力降低（p < 0.001）（自我报告中KINDL-R平均得分62.40[标准差13.00]对69.72[12.38]，家长报告中为61.63[标准差13.27]对74.68[9.97]）。共病患者的代理评分中的生活质量低于仅患有强迫症的患者（p = 0.001）（平均得分56.26[标准差12.47]对64.30[标准差12.75]）。在家长代理报告中，强迫症的严重程度（r = -0.28）和家庭迁就（r = -0.40）与生活质量呈中度负相关。
据我们所知，这是最大规模的儿科强迫症生活质量研究。强迫症患儿的生活质量明显降低，尤其是那些患有共病精神障碍的患儿。基于我们的研究结果，我们建议采用生活质量评估，以便更全面地了解儿童强迫症。
本研究已在当前对照试验中注册；北欧长期强迫症（OCD）治疗研究（ISRCTN66385119）。
