Nordahl Håkon, Havnen Audun, Hansen Bjarne, Öst Lars-Göran, Kvale Gerd
Haukeland University Hospital, OCD-team, Bergen, Norway.
Department of Clinical Psychology, University of Bergen, Norway.
Scand J Psychol. 2018 Apr;59(2):186-191. doi: 10.1111/sjop.12417. Epub 2017 Dec 15.
Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment.
研究表明,强迫症(OCD)患者经常伴有睡眠困难,而这些困难往往未得到临床识别和诊断。关于共病的睡眠困难是否会损害强迫症的治疗效果以及强迫症治疗后睡眠困难是否会改变,相关研究有限。36名强迫症患者连续四天接受了集中暴露治疗,治疗以小组形式进行,并在三个不同时间点(治疗前、治疗后和6个月随访)使用强迫症、抑郁症状和睡眠障碍的测量方法进行评估。该样本的特点是与其他精神疾病的共病率很高。在治疗前,近70%的患者报告有表明原发性失眠的睡眠困难。结果显示,患者的强迫症症状大幅减轻,治疗后评估的睡眠障碍也有显著改善,且这些改善在随访时得以维持。睡眠障碍并未损害治疗效果,相反,治疗前睡眠障碍程度较高的患者在治疗后强迫症症状的改善情况更好。结果表明,大多数强迫症样本存在睡眠障碍,且在未进行特定睡眠干预的情况下,对强迫症进行充分治疗后,这些睡眠障碍会显著减轻。然而,一部分患者在治疗后仍有失眠的残留症状。