Institute of Psychiatry, King׳s College London, London, UK.
OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK; MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King׳s College London, London, UK.
Psychiatry Res. 2015 Jul 30;228(1):8-13. doi: 10.1016/j.psychres.2015.03.012. Epub 2015 Mar 18.
Obsessive-compulsive disorder (OCD) and autism spectrum disorders (ASD) are highly co-morbid. It is suggested that youth with ASD will respond less well to cognitive behaviour therapy (CBT), as compared to their typically developing counterparts. To date there is no empirical evidence to support this view. The current study sought to compare CBT for OCD outcomes among youth with and without ASD. 22 young people with ICD-10 diagnoses of OCD and ASD (OCD+ASD) were matched with 22 youth with OCD, but no ASD (OCD+NoASD) according to base line OCD symptom severity, age, and gender. Outcomes were assessed for the two groups following a course of individually tailored, but protocol-driven CBT for OCD. While both groups responded to treatment the OCD+ASD group's outcomes were inferior to the OCD+NoASD group, as indicated by a significantly smaller decrease in symptoms over treatment (38.31% vs. 48.20%) and lower remission rates at post-treatment (9% vs. 46%). Overall, young people experiencing OCD in the context of ASD benefitted from CBT, but to a lesser extent than typically developing children. Recent efforts to modifying standard CBT protocols for OCD in ASD should continue in order to optimise outcomes among youth with this particular dual psychopathology.
强迫症障碍 (OCD) 和自闭症谱系障碍 (ASD) 高度共病。有研究表明,与发育正常的同龄人相比,患有 ASD 的年轻人对认知行为疗法 (CBT) 的反应较差。迄今为止,没有实证证据支持这种观点。本研究旨在比较有和没有 ASD 的强迫症青少年接受认知行为治疗 (CBT) 的 OCD 结果。根据 OCD 症状严重程度、年龄和性别,将 22 名患有 OCD 和 ASD 的年轻人(OCD+ASD)与 22 名患有 OCD 但没有 ASD 的年轻人(OCD+NoASD)进行匹配。两组均接受个体化、基于方案的 OCD 认知行为治疗。虽然两组均对治疗有反应,但 OCD+ASD 组的结果不如 OCD+NoASD 组,表现为治疗过程中症状的显著减少幅度较小(38.31%对 48.20%),治疗后缓解率较低(9%对 46%)。总体而言,在 ASD 背景下经历 OCD 的年轻人从 CBT 中受益,但程度低于发育正常的儿童。为了优化患有这种特定双重精神病理学的年轻人的结果,应继续努力修改针对 ASD 中的 OCD 的标准 CBT 方案。