Batmaz Sedat, Yildiz Mesut, Songur Emrah
a Sedat Batmaz, Gaziosmanpasa University, School of Medicine , Department of Psychiatry , Tokat , Turkey.
b Mesut Yildiz, Gaziosmanpasa University, School of Medicine , Department of Psychiatry , Tokat , Turkey.
Nord J Psychiatry. 2016;70(1):31-7. doi: 10.3109/08039488.2015.1041157. Epub 2015 May 8.
Identification of homogeneous subgroups of obsessive compulsive disorder (OCD) patients may have important implications for improving effective treatment options. It has been proposed that obsessive thoughts can be classified into two subtypes, i.e. autogenous and reactive obsessions. Although it has been shown that patients with autogenous obsessions may display a worse response to treatment, no studies have yet addressed whether there is a different need for the psychopharmacological treatment options in the subtypes of OCD patients.
To investigate the clinical characteristics and treatment differences between autogenous (A-OCD) and reactive (R-OCD) subtypes of OCD patients.
Both OCD subgroups (n = 50 for A-OCD, n = 130 for R-OCD) were compared with each other in terms of their demographic and clinical parameters. Odds ratio values for gender, treatment options, co-morbidity, severity of OCD, and response to treatment were computed. Multivariate hierarchical regression analyses were performed to identify any predictors for treatment options, severity of OCD, and response to treatment.
Our results indicated that the A-OCD and R-OCD groups differed from each other on some demographic and clinical variables in addition to their psychopharmacological treatment needs. Patients in the A-OCD group were found to be prescribed an atypical antipsychotic 2.3 times more likely than the R-OCD group. The odds for a combination treatment, or the improvement of OCD symptoms from baseline levels did not differ between the two subtypes of obsession groups.
Autogenous and reactive subtypes of obsessions may need to be offered different psychopharmacological treatment options.
识别强迫症（OCD）患者的同质亚组可能对改善有效治疗方案具有重要意义。有人提出，强迫观念可分为两种亚型，即原发性和反应性强迫观念。尽管已经表明原发性强迫观念患者对治疗的反应可能较差，但尚无研究探讨强迫症患者的不同亚型在心理药物治疗选择上是否存在不同需求。
研究原发性（A-OCD）和反应性（R-OCD）亚型强迫症患者的临床特征和治疗差异。
比较两个强迫症亚组（A-OCD组n = 50，R-OCD组n = 130）的人口统计学和临床参数。计算性别、治疗选择、共病情况、强迫症严重程度和治疗反应的比值比。进行多变量分层回归分析，以确定治疗选择、强迫症严重程度和治疗反应的任何预测因素。
我们的结果表明，除了心理药物治疗需求外，A-OCD组和R-OCD组在一些人口统计学和临床变量上也存在差异。发现A-OCD组患者使用非典型抗精神病药物的可能性是R-OCD组的2.3倍。两种强迫观念亚型组在联合治疗或强迫症症状从基线水平改善方面的几率没有差异。
原发性和反应性强迫观念亚型可能需要提供不同的心理药物治疗选择。
