Altintaş Ebru, Taşkintuna Nilgün
Department of Psychiatry, Başkent University, Faculty of Medicine, Adana, Turkey.
Department of Psychiatry, Başkent University, Faculty of Medicine, Ankara, Turkey.
Noro Psikiyatr Ars. 2015 Dec;52(4):346-353. doi: 10.5152/npa.2015.7657. Epub 2015 Dec 1.
Major depressive disorder (MDD) is the most frequent comorbid psychiatric condition associated with obsessive-compulsive disorder (OCD). This study aimed to evaluate the prevalence of current depression in OCD, differences in socio-demographic and clinical characteristics, and obsessive-compulsive symptoms between OCD patients with and without depression. Additionally, factors associated with comorbid depression were investigated in our study.
In total, 140 OCD patients, of which 63 were OCD patients with MDD (OCD+MDD, n=63) and 77 were OCD patients without depression (OCD-MDD, n=77) were included in the study. All patients were diagnosed with OCD using the Structured Clinical Interview for DSM-IV. The Yale-Brown Obsessive-Compulsive Scale, Beck Anxiety Scale, and Beck Depression Scale were administered to all patients. After the socio-demographic and clinical variables and scales were accomplished, the OCD patients divided into two groups as OCD with or without depression and we compared their mean scores of the variables and scales. Univariate analyses were followed by logistic regression.
There were no significant differences in age, gender, marital status, period without treatment, profession, medical and family history, and social support between the two groups. Anxiety, depression, and obsession and compulsion scores were significantly higher in the OCD+MDD group. The avoidance, insight, instability, and retardation scores of the OCD+MDD group were also significantly higher than those of the OCD-MDD group.
Our study suggests that many factors are strongly associated with depression in OCD. Positive correlations between poor insight, severity of obsession and compulsion, and stressful life events during the last six months increased the risk of depression in OCD. Our study suggests that high level of avoidance, instability and retardation, history of suicidal attempt, and delayed treatment are other notable factors associated with the development of depression in OCD.
重度抑郁症（MDD）是与强迫症（OCD）相关的最常见的共病精神疾病。本研究旨在评估强迫症患者中当前抑郁症的患病率、社会人口统计学和临床特征的差异，以及有抑郁症和无抑郁症的强迫症患者之间的强迫症状。此外，本研究还调查了与共病抑郁症相关的因素。
本研究共纳入140例强迫症患者，其中63例为合并重度抑郁症的强迫症患者（OCD+MDD，n=63），77例为无抑郁症的强迫症患者（OCD-MDD，n=77）。所有患者均使用《精神疾病诊断与统计手册第四版》的结构化临床访谈被诊断为强迫症。对所有患者进行耶鲁-布朗强迫症量表、贝克焦虑量表和贝克抑郁量表评估。在完成社会人口统计学和临床变量及量表评估后，将强迫症患者分为有抑郁症和无抑郁症两组，并比较他们在变量和量表上的平均得分。单因素分析后进行逻辑回归。
两组在年龄、性别、婚姻状况、未治疗时间、职业、病史和家族史以及社会支持方面无显著差异。OCD+MDD组的焦虑、抑郁以及强迫观念和强迫行为得分显著更高。OCD+MDD组的回避、洞察力、不稳定性和迟缓得分也显著高于OCD-MDD组。
我们的研究表明，许多因素与强迫症中的抑郁症密切相关。洞察力差、强迫观念和强迫行为的严重程度以及过去六个月内的应激性生活事件之间的正相关增加了强迫症患者患抑郁症的风险。我们的研究表明，高度的回避、不稳定性和迟缓、自杀未遂史以及延迟治疗是与强迫症中抑郁症发展相关的其他显著因素。
