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对患者使用咖啡因作为治疗难治性强迫症的一种治疗选择。

Using caffeine on the patients as therapeutic option against treatment-resistant obsessive-compulsive disorder.

作者信息

Shams Jamal, Soufi Elahe Samadi, Zahiroddin Alireza, Shekarriz-Foumani Reza

机构信息

Behavioral Sciences Research Center, Imam Hossein Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Behavioral Sciences Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Family Med Prim Care. 2019 May;8(5):1741-1747. doi: 10.4103/jfmpc.jfmpc_93_19.

Abstract

INTRODUCTION

Obsessive-compulsive disorder (OCD) is one of the most common and debilitating diseases. Approximately 40-30% of these patients are resistant to treatment, which auxiliary drugs are used to treat these patients. One of these drugs is caffeine, which is capable of affecting adenosine receptors and interfering with its release and serotonin reuptake. Considering the limitations of previous studies in this area, including lack of control group, this double-blind study compared the effectiveness of caffeine in the management of patients with treatment-resistant OCD in comparison with placebo group.

MATERIALS AND METHODS

62 patients who referred to the psychiatric clinic of Imam Hossein Hospital in Tehran from 2017 to 2018 were enrolled in the study. According to the psychiatrist's interview, patients with OCD were selected randomly in two groups including caffeine and placebo, after having met the criteria for inclusion and obtaining informed consent. Patients were followed for 8 weeks and compared in terms of the severity of OCD before and after intervention using YBOCS questionnaire.

RESULTS

The two groups of treatment and control were similar in terms of study variables (gender, age, education, age, comorbidity). The mean Yale-Brown Obsessive Compulsive Scale (Y-BOCS) in the treatment and control groups before intervention were determined to be 27.16 and 25.4, respectively, which changed to 24 and 27.23 after medication intervention, which exhibited a decrease of about 3 points (12%) in the treatment group, and was statistically significant based on linear regression analysis ( = 0.009). Considering other variables, the effect of caffeine was still statistically significant in the two groups.

CONCLUSION

Based on the findings of our study, caffeine can reduce the severity of the symptoms of OCD and serve as an auxiliary treatment for OCD.

摘要

引言

强迫症(OCD)是最常见且使人衰弱的疾病之一。这些患者中约有40%-30%对治疗有抵抗性,需使用辅助药物来治疗这些患者。其中一种药物是咖啡因,它能够影响腺苷受体并干扰其释放以及5-羟色胺再摄取。鉴于该领域以往研究存在局限性,包括缺乏对照组,本双盲研究将咖啡因与安慰剂组相比较,以评估咖啡因对难治性强迫症患者的治疗效果。

材料与方法

2017年至2018年转诊至德黑兰伊玛目侯赛因医院精神科诊所的62例患者纳入本研究。根据精神科医生的访谈,在符合纳入标准并获得知情同意后,将强迫症患者随机分为咖啡因组和安慰剂组。对患者进行为期8周的随访,并使用耶鲁布朗强迫症量表(YBOCS)问卷比较干预前后强迫症的严重程度。

结果

治疗组和对照组在研究变量(性别、年龄、教育程度、年龄、合并症)方面相似。干预前治疗组和对照组的耶鲁布朗强迫症量表(Y-BOCS)平均分分别为27.16和25.4,药物干预后分别变为24和27.23,治疗组下降了约3分(12%),基于线性回归分析具有统计学意义(P = 0.009)。考虑其他变量,咖啡因在两组中的效果仍具有统计学意义。

结论

基于我们的研究结果,咖啡因可减轻强迫症症状的严重程度,可作为强迫症的辅助治疗方法。

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