Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906, USA.
Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906, USA; Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA.
Psychiatry Res. 2017 Dec;258:78-82. doi: 10.1016/j.psychres.2017.09.042. Epub 2017 Sep 19.
Research has suggested that the co-occurrence of PTSD in individuals with OCD is associated with more severe symptoms and less responsivity to empirically supported treatment as compared to individuals with OCD and no history of PTSD. However, much of this work has been limited by non-empirical case report design, cross-sectional and retrospective analyses, or small sample sizes. The current study extended this research by comparing the clinical characteristics of individuals with OCD with and without a lifetime PTSD diagnosis in a large, naturalistic, longitudinal sample over the course of seven years. At baseline, individuals with comorbid lifetime PTSD reported significantly more severe symptoms of OCD (including symptom levels and insight), lower quality of life, and higher rates of comorbid lifetime mood and substance use disorders than participants without lifetime PTSD. Further, individuals with comorbid OCD and lifetime PTSD reported significantly more severe OCD symptoms over the course of seven years than those without lifetime PTSD. These results are largely consistent with the existing literature and support the need to consider PTSD symptoms in the assessment and treatment of OCD.
研究表明,与没有创伤后应激障碍病史的强迫症患者相比,强迫症患者同时存在创伤后应激障碍与更严重的症状和对经验支持的治疗反应性较差有关。然而,这项工作的大部分内容受到非实证病例报告设计、横断面和回顾性分析或小样本量的限制。本研究通过在七年的时间内,在一个大型自然主义的纵向样本中比较有和没有终生创伤后应激障碍诊断的强迫症患者的临床特征,扩展了这一研究。在基线时,伴有共病终生创伤后应激障碍的个体报告强迫症的症状(包括症状水平和洞察力)明显更严重,生活质量更低,同时患有终生心境和物质使用障碍的比例也更高,而没有终生创伤后应激障碍的参与者则没有。此外,在七年的时间里,伴有共病强迫症和终生创伤后应激障碍的个体报告的强迫症症状明显比没有终生创伤后应激障碍的个体更严重。这些结果与现有文献基本一致,支持在强迫症的评估和治疗中需要考虑创伤后应激障碍症状。