Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Brazil; Department of Psychiatry and Mental Health, Universidade Federal Fluminense (MSM-UFF), Brazil.
Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Brazil; Department of Psychiatry and Mental Health, Universidade Federal Fluminense (MSM-UFF), Brazil; School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Australia; D'Or Institute for Research and Education (IDOR), Brazil.
Compr Psychiatry. 2018 Nov;87:25-31. doi: 10.1016/j.comppsych.2018.08.012. Epub 2018 Aug 25.
The goal of this study was to compare the clinical and functional status and the trauma-related characteristics of PTSD patients with comorbid OCD whose onset predated the index traumatic event (pre-traumatic OCD) with those of PTSD patient whose comorbid OCD only emerged after the exposure to the traumatic event (post-traumatic OCD).
Sixty-three individuals with PTSD and comorbid OCD were evaluated with the Structured Clinical Interview for DSM-IV AXIS I Disorders and completed the Posttraumatic Stress Disorder Checklist - Civilian Version, the Beck Depression Inventory, the Beck Anxiety Inventory, the Trauma History Questionnaire and the 36-Item Short-Form Health Survey.
A history of childhood abuse was significantly more frequent among PTSD patients with pre-traumatic OCD (45.2%) than among their counterparts with post-traumatic OCD (16%). PTSD patients with pre-traumatic OCD had higher rates of psychiatric comorbidity in general and showed a lower functional health status in a physical domain (SF-36 Role Limitation due to Physical Health). In contrast, PTSD patients with post-traumatic OCD had a decreased functional health status in a psychological domain (SF-36 Emotional Well Being). The effect sizes were in the medium to large range.
A history of child abuse may be an important, but often neglected, factor accounting for clinical, functional, and trauma-related differences between pre-traumatic and posttraumatic OCD in PTSD patients.
本研究旨在比较创伤前强迫症（即创伤前发生的强迫症，其发病先于创伤事件）和创伤后强迫症（即创伤后发生的强迫症，其发病继发于创伤事件）共病 PTSD 患者的临床和功能状态以及与创伤相关的特征。
对 63 名共病 PTSD 和强迫症的个体进行 DSM-IV AXIS I 障碍结构临床访谈，并完成创伤后应激障碍检查表-平民版、贝克抑郁量表、贝克焦虑量表、创伤史问卷和 36 项简短健康调查问卷。
创伤前强迫症的 PTSD 患者（45.2%）有童年期虐待史的比例显著高于创伤后强迫症患者（16%）。创伤前强迫症的 PTSD 患者总体上有更高的精神共病率，且在身体领域（SF-36 因身体健康导致的角色限制）的功能健康状况较低。相比之下，创伤后强迫症的 PTSD 患者在心理领域（SF-36 情绪健康）的功能健康状况较差。效应大小处于中等至较大范围。
童年期虐待史可能是一个重要但常被忽视的因素，可解释 PTSD 患者中创伤前和创伤后强迫症之间的临床、功能和与创伤相关的差异。
