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注意缺陷多动障碍对强迫症患者的影响。

The impact of attention deficit hyperactivity disorder in obsessive-compulsive disorder subjects.

机构信息

Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.

Department od Psychiatry, Porto Alegre Health Science Federal University, Porto Alegre, Brazil.

出版信息

Depress Anxiety. 2019 Jun;36(6):533-542. doi: 10.1002/da.22898. Epub 2019 Apr 16.

Abstract

BACKGROUND

Recent findings suggest an association between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Thus, we evaluated the clinical associated features of ADHD in a large sample of adult OCD patients.

METHODS

A cross-sectional study including 955 adult patients with OCD from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinical characteristics in adult OCD patients with and without comorbid ADHD were compared using Fisher's exact test, t-tests or Mann-Whitney tests. Bivariate analyses were followed by logistic regression analysis to identify clinical characteristics independently associated with ADHD comorbidity.

RESULTS

The lifetime prevalence of ADHD in adult OCD patients was 13.7%. The current results indicate that OCD + ADHD patients were more severe, had an earlier onset of the obsessive-compulsive symptoms, a higher history of rheumatic fever, with higher frequencies of sensory phenomena and comorbidity with Tourette syndrome. They also had an increased risk for academic impairment and suicide attempts.

CONCLUSION

Adult OCD patients with ADHD present some specific clinical features and may represent a special subgroup of adult OCD. Future studies should focus on the development of interventions more tailored to the phenotype of this subgroup of patients.

摘要

背景

最近的研究结果表明,注意缺陷多动障碍(ADHD)与强迫症(OCD)之间存在关联。因此,我们评估了 ADHD 在一大组成年 OCD 患者中的临床相关特征。

方法

一项横断面研究纳入了来自巴西强迫症谱系障碍研究联合会(C-TOC)的 955 名成年 OCD 患者。使用 Fisher 确切检验、t 检验或 Mann-Whitney 检验比较成年 OCD 患者伴 ADHD 与不伴 ADHD 的临床特征。进行二元分析后,采用逻辑回归分析识别与 ADHD 共病相关的临床特征。

结果

成年 OCD 患者的 ADHD 终生患病率为 13.7%。目前的结果表明,OCD+ADHD 患者的病情更严重,强迫症症状的发病更早,风湿热病史更高,感觉现象的发生频率更高,且与抽动秽语综合征共病。他们也有更高的学业受损和自杀企图的风险。

结论

患有 ADHD 的成年 OCD 患者表现出一些特定的临床特征,可能代表成年 OCD 的一个特殊亚组。未来的研究应重点关注针对该亚组患者表型的干预措施的开发。

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