Gordon Olivia M, Salkovskis Paul M, Bream Victoria
Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK.
University of Bath,UK.
Behav Cogn Psychother. 2016 Jul;44(4):444-59. doi: 10.1017/S1352465815000582.
It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders.
The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD.
92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders.
At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD.
The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.
一般认为,共病的人格障碍可能会干扰基于认知行为疗法(CBT)对轴I障碍的治疗,因为人格障碍被视为具有倾向性,因此与轴I精神障碍相比,被认为更不易改变。
本研究旨在调查共病的强迫症(OCD)和强迫型人格障碍(OCPD)对强迫症认知行为治疗的影响。
92名被诊断为强迫症的个体参与了本研究。数据来自于在一家焦虑症专科治疗中心进行初始评估时以及认知行为治疗后的测量。
在评估时,患有强迫症和强迫型人格障碍的参与者总体强迫症症状严重程度更高,与没有强迫型人格障碍的参与者相比,怀疑、整理和囤积症状也更严重;然而,患有共病强迫症和强迫型人格障碍的参与者在强迫症严重程度、检查和整理方面的治疗效果比没有强迫型人格障碍的参与者更好。患有强迫症和强迫型人格障碍的个体在初始评估时检查、整理和总体强迫症严重程度水平更高;然而,在治疗后,他们的得分与没有强迫型人格障碍的个体相似。
根据关于轴I和轴II共病的研究以及轴II障碍对轴I障碍治疗的影响,对这些发现的意义进行了讨论。