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难治性强迫症患者经γ 腹侧神经核切开术后的人格测量。

Personality measures after gamma ventral capsulotomy in intractable OCD.

机构信息

Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2018 Feb 2;81:161-168. doi: 10.1016/j.pnpbp.2017.10.023. Epub 2017 Nov 1.

Abstract

BACKGROUND

Neurosurgeries such as gamma ventral capsulotomy (GVC) are an option for otherwise intractable obsessive-compulsive disorder (OCD) patients. In general, clinical and neuropsychological status both improve after GVC. However, its consequences on personality traits are not well-studied. The objective of this study was to investigate personality changes after one year of GVC in intractable OCD patients.

METHODS

The personality assessment was conducted using the Revised NEO Personality Inventory (NEO PI-R) and Cloninger's Temperament and Character Inventory (TCI) in 14 intractable OCD patients before and one year after GVC. Comparisons of personality features between treatment responders (n=5) and non-responders (n=9) were performed. Multiple linear regression was also used for predicting changes in clinical and global functioning variables.

RESULTS

Overall, no deleterious effect was found in personality after GVC. Responders had a reduction in neuroticism (p=0.043) and an increase in extraversion (p=0.043). No significant changes were observed in non-responders. Increases in novelty seeking and self-directedness, and decreases in persistence and cooperativiness predicted OCD symptom improvement. Similary, improvement in functioning was also predicted by hgher novelty seeking and self-directedness after GVC, whereas better functioning was also associated with lower reward dependence and cooperativeness after surgery.

CONCLUSIONS

The pattern of changes in personality traits after GVC was generally towards that observed in nonclinical population, and does not raise safety concerns.

摘要

背景

神经外科手术,如伽马神经束切断术(GVC),是治疗其他方法无效的强迫症(OCD)患者的一种选择。一般来说,GVC 后患者的临床和神经心理学状态都会改善。然而,其对人格特质的影响尚未得到充分研究。本研究旨在探讨 GVC 后一年对难治性 OCD 患者人格的影响。

方法

在 GVC 前后,使用修订版 NEO 人格量表(NEO PI-R)和 Cloninger 的气质与性格量表(TCI)对 14 名难治性 OCD 患者进行人格评估。比较了治疗应答者(n=5)和非应答者(n=9)的人格特征。还使用多元线性回归来预测临床和总体功能变量的变化。

结果

总体而言,GVC 后人格没有不良影响。应答者的神经质(p=0.043)降低,外向性(p=0.043)增加。非应答者则无明显变化。对新奇寻求、自我导向的增加,以及坚持性和合作性的降低,可以预测 OCD 症状的改善。同样,GVC 后新奇寻求和自我导向的增加也可以预测功能的改善,而手术后功能的改善也与奖赏依赖和合作性的降低有关。

结论

GVC 后人格特征的变化模式总体上与非临床人群相似,不会引起安全性问题。

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