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强迫症中抑郁和强迫症状的关系:来自一项大型自然随访研究的结果。

The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study.

机构信息

Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands.

Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.

出版信息

J Affect Disord. 2016 Oct;203:241-247. doi: 10.1016/j.jad.2016.06.009. Epub 2016 Jun 6.

Abstract

OBJECTIVE

Despite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients.

METHOD

We used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design.

RESULTS

The association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results.

LIMITATIONS

There may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study.

CONCLUSION

The present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD.

摘要

目的

尽管强迫症(OCD)患者常出现抑郁症状,但人们对疾病过程中抑郁和强迫症状之间的相互影响知之甚少。本研究旨在探讨 OCD 患者中强迫和抑郁症状的纵向关系。

方法

我们使用荷兰强迫症协会(NOCDA)研究的基线和 1 年随访数据。在 276 名终生诊断为强迫症的患者中,在基线和 1 年随访时使用贝克抑郁量表(BDI)和耶鲁-布朗强迫症症状量表(Y-BOCS)评估抑郁和强迫症状。使用交叉滞后面板设计研究关系。

结果

基线时抑郁症状严重程度与随访时强迫症状严重程度之间的关联具有统计学意义(β=0.244,p<0.001),而基线时强迫症状严重程度与随访时抑郁症状严重程度之间的关联不具有统计学意义(β=0.097,p=0.060)。在伴有和不伴有当前共病重性抑郁障碍(MDD)的亚组以及首发为 MDD 与首发为 OCD 的亚组中重复分析,结果相同。

局限性

本研究未评估可能同时影响抑郁和强迫症状的其他因素。

结论

本研究表明,无论当前是否诊断为 MDD,以及 OCD 和 MDD 的发病顺序如何,抑郁症状与 OCD 患者的强迫症状病程之间存在关系。

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