Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Arkin Institute for Mental Health, Amsterdam, The Netherlands.
Psychiatry Res. 2017 Aug;254:48-53. doi: 10.1016/j.psychres.2017.04.030. Epub 2017 Apr 19.
Various studies reported remarkably high prevalence rates of obsessive-compulsive symptoms (OCS) in patients with a psychotic disorder. Little is known about the pathogenesis of this co-occurrence. The current study aimed to investigate the contribution of shared underlying risk factors, such as childhood trauma and neuroticism, to the onset and course of OCS in patients with psychosis. Data were retrieved from 161 patients with psychosis included in the 'Genetic Risk and Outcome in Psychosis' project. Patients completed measures of OCS and psychotic symptoms at study entrance and three years later. Additionally, childhood maltreatment and neuroticism were assessed. Between-group comparisons revealed increased neuroticism and positive symptoms in patients who reported comorbid OCS compared to OCS-free patients. Subsequent mediation analyses suggested a small effect of childhood abuse on comorbid OCS severity at baseline, which was mediated by positive symptom severity. Additionally, results showed a mediating effect of neuroticism as well as a moderating effect of positive symptoms on the course of OCS severity over time. OCS severity in patients with psychosis might thus be associated with common vulnerability factors, such as childhood abuse and neuroticism. Furthermore, the severity of positive symptoms might be associated with more severe or persistent comorbid OCS.
多项研究报告称，精神障碍患者的强迫症状（OCS）患病率极高。对于这种共病的发病机制知之甚少。本研究旨在探讨共同潜在风险因素（如儿童期创伤和神经质）对精神病患者 OCS 的发生和病程的影响。该研究的数据来自“精神病的遗传风险和结果”项目中纳入的 161 名精神病患者。患者在研究开始时和三年后完成了 OCS 和精神病症状的测量。此外，还评估了儿童期虐待和神经质。与无 OCS 的患者相比，报告伴有 OCS 的患者的神经质和阳性症状增加。随后的中介分析表明，儿童期虐待对基线时伴有 OCS 严重程度有较小的影响，这是由阳性症状严重程度介导的。此外，结果还显示神经质具有中介作用，阳性症状具有调节作用，它们均对 OCS 严重程度随时间的变化具有调节作用。因此，精神病患者的 OCS 严重程度可能与常见的易感性因素（如儿童期创伤和神经质）有关。此外，阳性症状的严重程度可能与更严重或持续的伴发 OCS 有关。
