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日本强迫症患者的十年随访研究。

Ten-year follow-up study of Japanese patients with obsessive-compulsive disorder.

机构信息

Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan.

Special Education Course, Faculty of Education, Mie University, Tsu, Japan.

出版信息

Psychiatry Clin Neurosci. 2018 Jul;72(7):502-512. doi: 10.1111/pcn.12661. Epub 2018 May 21.

Abstract

AIM

Obsessive-compulsive disorder (OCD) is a well-known chronic illness. This study retrospectively investigated 10-year outcomes and associated clinical factors in Japanese OCD patients. We focused on the impact of several sociocultural factors, including medical expenses and insurance systems specific to each country, on the differences or biases in follow-up procedures of OCD.

METHODS

Seventy-nine patients diagnosed with OCD who received a standardized combination of treatments for 10 continuous years were divided into three groups according to their improvement rates on the Yale-Brown Obsessive-Compulsive Scale after 10 years of treatment.

RESULTS

A survival analysis revealed that the rate of patients achieving full remission increased every year. Following 10 years of treatment, 56% of OCD patients experienced 'full remission' for at least 1 year. Consequently, 48% exhibited full remission, and 37% exhibited partial remission at the end-point of this study. We identified several factors that were predictive of poorer outcomes, including lower Global Assessment of Functioning Scale scores and the presence of hoarding symptoms or involvement behaviors. In addition, improvement rates after 1 year significantly predicted better 10-year outcomes.

CONCLUSION

Our findings highlight the transcultural nature of long-term outcomes of OCD treatment, which appear to be independent of sociocultural differences.

摘要

目的

强迫症(OCD)是一种众所周知的慢性疾病。本研究回顾性调查了日本 OCD 患者的 10 年结局和相关临床因素。我们专注于几个社会文化因素的影响,包括每个国家特有的医疗费用和保险制度,这些因素对 OCD 的随访程序的差异或偏见产生影响。

方法

79 名被诊断为 OCD 的患者接受了 10 年连续的标准化联合治疗,根据他们在治疗 10 年后耶鲁-布朗强迫症量表上的改善率,将他们分为三组。

结果

生存分析显示,完全缓解的患者比例逐年增加。经过 10 年的治疗,56%的 OCD 患者至少有 1 年达到“完全缓解”。因此,在研究结束时,48%的患者达到完全缓解,37%的患者达到部分缓解。我们发现了几个预测预后较差的因素,包括较低的总体功能评估量表评分和存在囤积症状或参与行为。此外,1 年后的改善率显著预测了更好的 10 年结局。

结论

我们的研究结果强调了 OCD 治疗长期结局的跨文化性质,这些结局似乎与社会文化差异无关。

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