Malhotra Dr Sonia, Borade Dr Pankaj B, Sharma Dr Pradeep, Satija Dr Yogesh
Department of Psychiatry, S.M.S. Medical College, Jaipur, India.
Department of Psychiatry, S.M.S. Medical College, Jaipur, India.
Asian J Psychiatr. 2017 Feb;25:6-12. doi: 10.1016/j.ajp.2016.06.020. Epub 2016 Sep 28.
Obsessive Compulsive Disorder (OCD) is one of the most common psychiatric disorders, with lifetime prevalence of 2%-3% and is known to lie on a spectrum continuous with Schizophrenia and other affective psychosis. Neurological Soft Signs (NSS) have been reported to be higher in both Schizophrenia and affective psychosis, like bipolar disorder, and their first degree relatives but in OCD, the results have been inconsistent. It remains unclear if NSS occur at even higher rates in individuals who have a co-morbidity for OCD and either schizophrenia or bipolar disorder, as it might be expected if a broader neurodevelopmental hit underlies the pathophysiology of both OCD and these disorders.
To assess and compare NSS in patients of OCD, OCD with Psychotic spectrum disorders (OCD-PSD), first degree relatives of OCD (FDR of OCD) and healthy controls.
90 subjects each were recruited in four groups- OCD, OCD-PSD, FDR of OCD and healthy controls, as per the pre-defined inclusion and exclusion criteria for each group. Diagnosis was made as per ICD-10 criteria and Cambridge Neurological Inventory, Part-2 was applied.
This study found statistically significant difference between the severity of NSS among these groups. There was also a significant difference in presence of NSS in OCD with PSD group and OCD group. A greater abnormality of NSS in FDR of OCD compared to healthy controls was found. This difference in proportions and severity of NSS between groups points towards an underlying common neurobiological and etiopathological underpinning between OCD with and without comorbid PSDs and their first degree relatives.
强迫症(OCD)是最常见的精神疾病之一,终生患病率为2%-3%,已知与精神分裂症和其他情感性精神病处于连续谱系中。据报道,精神分裂症和情感性精神病(如双相情感障碍)及其一级亲属的神经软体征(NSS)发生率较高,但在强迫症中,结果并不一致。目前尚不清楚强迫症合并精神分裂症或双相情感障碍的个体中NSS的发生率是否更高,因为如果强迫症和这些疾病的病理生理学有更广泛的神经发育损伤,那么情况可能就是如此。
评估和比较强迫症患者、伴有精神病性谱系障碍的强迫症患者(OCD-PSD)、强迫症患者的一级亲属(OCD的FDR)和健康对照者的NSS。
根据每组预先定义的纳入和排除标准,每组招募90名受试者——强迫症患者、OCD-PSD患者、OCD的FDR和健康对照者。根据ICD-10标准进行诊断,并应用剑桥神经学量表第2部分。
本研究发现这些组之间NSS严重程度存在统计学显著差异。OCD伴PSD组和强迫症组在NSS的存在方面也存在显著差异。与健康对照者相比,OCD的FDR中NSS的异常更明显。各组之间NSS比例和严重程度的差异表明,伴有和不伴有共病PSD的强迫症患者及其一级亲属之间存在潜在的共同神经生物学和病因学基础。