Storch Eric A, Small Brent J, McGuire Joseph F, Murphy Tanya K, Wilhelm Sabine, Geller Daniel A
1 Department of Pediatrics, University of South Florida , St. Petersburg, Florida.
2 Department of Health Policy and Management, University of South Florida , St. Petersburg, Florida.
J Child Adolesc Psychopharmacol. 2018 Mar;28(2):104-110. doi: 10.1089/cap.2017.0091. Epub 2017 Sep 14.
The study examined clinical correlates of quality of life (QoL), impact of treatment on QoL, and predictors of QoL change among children with obsessive-compulsive disorder (OCD).
One hundred forty-two children with primary OCD who were enrolled as part of a larger clinical trial participated. Children were administered a structured diagnostic interview, as well as clinician-administered measures of OCD and depression symptom severity. Children and parents completed reports of QoL, as well as measures of impairment and internalizing and externalizing symptoms. Youth received 10 sessions of family-based cognitive-behavioral therapy (CBT).
At baseline, QoL was inversely related to obsessive-compulsive symptom severity, impairment, externalizing and internalizing symptoms, and severity of depression symptoms according to children and parents. After CBT, QoL improved according to parent ratings, but not child ratings. None of the predictors examined were associated with changes in QoL scores over time. Impairment, and externalizing and internalizing symptoms predicted QoL after accounting for OCD symptom severity. After accounting for OCD symptoms, externalizing symptoms inversely predicted changes in QoL.
These data suggest that QoL is related to more severe clinical presentation and improves with evidence-based treatment, but QoL improvements may be inversely related to externalizing symptomology.
本研究探讨了强迫症(OCD)患儿生活质量(QoL)的临床相关因素、治疗对生活质量的影响以及生活质量变化的预测因素。
142名原发性强迫症患儿参与了一项更大规模临床试验。对患儿进行了结构化诊断访谈,以及由临床医生实施的强迫症和抑郁症状严重程度测量。患儿和家长完成了生活质量报告,以及功能损害、内化和外化症状的测量。青少年接受了10次基于家庭的认知行为疗法(CBT)。
在基线时,根据患儿和家长的报告,生活质量与强迫症状严重程度、功能损害、外化和内化症状以及抑郁症状严重程度呈负相关。经过CBT治疗后,根据家长评分,生活质量有所改善,但患儿评分未改善。所检查的预测因素均与生活质量评分随时间的变化无关。在考虑强迫症症状严重程度后,功能损害、外化和内化症状可预测生活质量。在考虑强迫症症状后,外化症状与生活质量变化呈负相关。
这些数据表明,生活质量与更严重的临床表现相关,并且循证治疗可改善生活质量,但生活质量的改善可能与外化症状呈负相关。