强迫症中怀疑的一项调查。
An investigation of doubt in obsessive-compulsive disorder.
作者信息
Samuels Jack, Bienvenu O Joseph, Krasnow Janice, Wang Ying, Grados Marco A, Cullen Bernadette, Goes Fernando S, Maher Brion, Greenberg Benjamin D, McLaughlin Nicole C, Rasmussen Steven A, Fyer Abby J, Knowles James A, Nestadt Paul, McCracken James T, Piacentini John, Geller Dan, Pauls David L, Stewart S Evelyn, Murphy Dennis L, Shugart Yin-Yao, Kamath Vidya, Bakker Arnold, Riddle Mark A, Nestadt Gerald
机构信息
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Compr Psychiatry. 2017 May;75:117-124. doi: 10.1016/j.comppsych.2017.03.004. Epub 2017 Mar 12.
BACKGROUND
Clinicians have long considered doubt to be a fundamental characteristic of obsessive-compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed.
METHODS
Participants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response.
RESULTS
The severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive-compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt.
CONCLUSIONS
Doubt is associated with important clinical features of OCD, including impairment and cognitive-behavioral treatment response.
背景
长期以来，临床医生一直认为怀疑是强迫症（OCD）的一个基本特征。然而，强迫症中怀疑的临床相关性尚未得到探讨。
方法
参与者包括1182名患有强迫症的成年人，他们参与了强迫症的家庭和遗传学研究。我们使用了一种怀疑严重程度的临床测量方法，分为无、轻度、中度、重度或极重度。我们评估了怀疑与强迫症临床特征、轴I障碍、人格和人格障碍维度、损害以及治疗反应之间的关系。
结果
怀疑的严重程度与强迫症症状的发病年龄呈负相关。怀疑与检查症状的数量密切相关，在较小程度上与污染/清洁和囤积症状的数量相关。怀疑还与复发性重度抑郁症和广泛性焦虑症的终生患病率、回避型、依赖型和强迫型人格障碍特质的数量以及神经质和内向性有关。此外，即使在调整了强迫症严重程度和怀疑的其他相关因素后，怀疑仍与整体损害和对认知行为治疗（CBT）的不良反应密切相关。
结论
怀疑与强迫症的重要临床特征有关，包括损害和认知行为治疗反应。
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