Arkin Institute for Mental Health, Amsterdam, The Netherlands.
Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands.
Eur Arch Psychiatry Clin Neurosci. 2019 Mar;269(2):257-268. doi: 10.1007/s00406-018-0898-y. Epub 2018 May 29.
Little is known about the co-prevalence of obsessive compulsive symptoms (OCS) and motor symptoms in patients with psychotic disorders. Cross-sectional associations between OCS and motor symptoms were assessed at baseline and at 3 years follow-up in patients (n = 726) with psychotic disorders and in their unaffected siblings (n = 761) from the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study. Furthermore, longitudinal associations between changes in OCS and motor symptoms were evaluated. At baseline, OCS was not associated with any motor symptom (akathisia, dyskinesia, parkinsonism or dystonia) in patients. At follow-up, patients with OCS reported significantly more akathisia. Dividing the patients into four groups-no OCS, OCS remission with OCS only at baseline, OCS de novo with OCS only at follow-up and a persistent OCS group-revealed that the OCS de novo group already reported more akathisia at baseline compared to the no-OCS group. At follow-up, both the OCS de novo and the persistent OCS group reported more akathisia. These results remained significant after correcting for relevant confounders clozapine, GAF score, PANSS-negative score and IQ. Motor symptoms at baseline were significantly associated with OCS at follow-up, but not the other way around. In siblings, OCS at baseline was associated with akathisia, but this association was lost at follow-up. Results suggest that motor symptoms might precede co-occurring OCS in patients with psychotic disorders. However, no inference can be made about causality, and further prospective research is needed to investigate this assumption.
目前对于精神障碍患者中强迫症状（OCS）和运动症状的共同患病率知之甚少。在荷兰遗传风险和精神分裂症结局（GROUP）研究中，对 726 名精神障碍患者及其未受影响的兄弟姐妹（n=761）进行了横断面研究，评估了基线时 OCS 与运动症状之间的关联，并在 3 年随访时评估了 OCS 和运动症状之间的纵向关联。此外，还评估了 OCS 变化与运动症状之间的纵向关联。基线时，OCS 与患者的任何运动症状（静坐不能、运动障碍、帕金森病或肌张力障碍）均无关。在随访时，有 OCS 的患者报告了更多的静坐不能。将患者分为四个组-无 OCS、仅基线时有 OCS 的 OCS 缓解、仅随访时有 OCS 的 OCS 新发和持续 OCS 组-结果显示，与无 OCS 组相比，OCS 新发组在基线时已经报告了更多的静坐不能。在随访时，OCS 新发组和持续 OCS 组都报告了更多的静坐不能。在校正了氯氮平、GAF 评分、PANSS 阴性评分和 IQ 等相关混杂因素后，这些结果仍然具有统计学意义。基线时的运动症状与随访时的 OCS 显著相关，但反之则不然。在兄弟姐妹中，基线时的 OCS 与静坐不能有关，但在随访时这种关联消失了。结果表明，运动症状可能先于精神障碍患者共病 OCS。然而，不能对因果关系做出推断，需要进一步的前瞻性研究来验证这一假设。
