Zandberg Laurie J, Zang Yinyin, McLean Carmen P, Yeh Rebecca, Simpson Helen Blair, Foa Edna B
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Behav Res Ther. 2015 May;68:76-81. doi: 10.1016/j.brat.2015.03.005. Epub 2015 Mar 13.
The current study examines the temporal relationship between changes in obsessive-compulsive symptoms and changes in depressive symptoms during exposure and response prevention (EX/RP) therapy for obsessive-compulsive disorder (OCD).
Participants were 40 adults (53% female) who received EX/RP in a randomized controlled trial comparing serotonin reuptake inhibitor (SRI) augmentation strategies. Participants completed clinician-administered assessments of OCD (Yale-Brown Obsessive Compulsive Scale) and depressive symptoms (Hamilton Depression Rating Scale) every four weeks from baseline to 32-week follow-up.
Lagged multilevel mediational analyses indicated that change in OCD symptoms accounted for 65% of subsequent change in depressive symptoms. In contrast, change in depressive symptoms only partially mediated subsequent change in OCD symptoms, accounting for 20% of the variance in outcome.
These data indicate that reductions in co-morbid depressive symptoms during EX/RP for OCD are largely driven by reductions in obsessive-compulsive symptoms.
本研究探讨在强迫症（OCD）的暴露与反应阻止疗法（EX/RP）中，强迫症状变化与抑郁症状变化之间的时间关系。
40名成年人（53%为女性）参与了一项随机对照试验，该试验比较了5-羟色胺再摄取抑制剂（SRI）增强策略，参与者接受EX/RP治疗。从基线到32周随访期间，参与者每四周完成一次由临床医生进行的强迫症评估（耶鲁-布朗强迫量表）和抑郁症状评估（汉密尔顿抑郁量表）。
滞后多水平中介分析表明，强迫症状的变化占后续抑郁症状变化的65%。相比之下，抑郁症状的变化仅部分介导了后续强迫症状的变化，占结果变异的20%。
这些数据表明，在强迫症的EX/RP治疗期间，共病抑郁症状的减轻主要是由强迫症状的减轻所驱动的。
