Snyder Hannah R, Kaiser Roselinde H, Warren Stacie L, Heller Wendy
Department of Psychology, University of Denver, Frontier Hall, 2155 S. Race St. Denver, CO 80208, USA.
Department of Psychiatry, Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
Clin Psychol Sci. 2015 Mar;3(2):301-330. doi: 10.1177/2167702614534210.
Obsessive-compulsive disorder (OCD) is a serious and often chronically disabling condition. The current dominant model of OCD focuses on abnormalities in prefrontal-striatal circuits that support executive function (EF). While there is growing evidence for EF impairments associated with OCD, results have been inconsistent, making the nature and magnitude of these impairments controversial. The current meta-analysis uses random-effects models to synthesize 110 previous studies that compared participants with OCD to healthy control participants on at least one neuropsychological measure of EF. The results indicate that individuals with OCD are impaired on tasks measuring most aspects of EF, consistent with broad impairment in EF. EF deficits were not explained by general motor slowness or depression. Effect sizes were largely stable across variation in demographic and clinical characteristics of samples, although medication use, age, and gender moderated some effects.
强迫症（OCD）是一种严重且常常导致慢性残疾的疾病。目前占主导地位的强迫症模型聚焦于支持执行功能（EF）的前额叶 - 纹状体回路的异常。虽然越来越多的证据表明强迫症与执行功能受损有关，但结果并不一致，使得这些损伤的性质和程度存在争议。当前的荟萃分析使用随机效应模型，综合了之前的110项研究，这些研究在至少一项执行功能的神经心理学测量指标上，将强迫症患者与健康对照参与者进行了比较。结果表明，强迫症患者在测量执行功能大多数方面的任务上存在损伤，这与执行功能的广泛损伤一致。执行功能缺陷不能用一般运动迟缓或抑郁来解释。尽管药物使用、年龄和性别对某些效应有调节作用，但效应大小在样本的人口统计学和临床特征变化中基本稳定。
