CITKOWSKA-KISIELEWSKA, RUTKOWSKI, MIELIMĄKA, SOBAŃSKI, AND DEMBIŃSKA: Department of Psychotherapy, Jagiellonian University Medical College, Krakow, Poland.
J Psychiatr Pract. 2020 Mar;26(2):101-119. doi: 10.1097/PRA.0000000000000451.
Because of the heterogeneity of obsessive-compulsive disorders (OCDs) and their co-occurrence with anxiety disorders, we investigated the prevalence, severity, and correlations between obsessive and compulsive symptoms reported by patients diagnosed with OCD or generalized anxiety disorder (GAD).
A retrospective study was conducted in 2 groups of patients: 76 patients diagnosed with OCD [F42 according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10)], and 186 patients diagnosed with GAD (F41.1 according to ICD-10), who had presented for therapy at the day ward. The Symptom Questionnaire "O," based on the Symptom Checklist 90-Revised (SCL-90-R) questionnaire, was used to assess obsessive, compulsive, and anxiety symptoms. The analysis took into account the impact of sex and the presence or absence of cognitive dysfunction (as assessed using the Bender Benton Visual Retention and Bender-Gestalt tests) on the associations being investigated.
We observed that obsessive and compulsive symptoms were more prevalent and more strongly expressed in the group with OCD than in the group with GAD. However, almost all patients with GAD (94%) confirmed the presence of some obsessive-compulsive symptoms. The study revealed differences in correlations with obsessions and compulsions between the OCD and GAD groups. In the group with OCD, no significant correlation between the severity of obsessions and compulsions was identified, whereas in the group with GAD, a significant positive correlation was found between the severity of those symptoms. In both the GAD and OCD groups, a greater intensity of obsessive-compulsive symptoms was accompanied by an increase in the severity of anxiety symptoms (with this effect noted to a greater extent with obsessions than compulsions).
The study revealed that patients with GAD often have coexisting obsessive-compulsive symptoms, which may not be identified during routine psychiatric examination. Obsessive-compulsive symptoms observed in patients with GAD may show a different structure than obsessive-compulsive symptoms in patients with OCD. The results of this study suggest that compulsions are more specific for the diagnosis of OCD than obsessions. Compulsions, such as counting related to the need for order and symmetry, may be associated with some cognitive dysfunctions and male sex, a finding that requires further research.
由于强迫症（OCD）的异质性及其与焦虑障碍的共病，我们研究了诊断为强迫症或广泛性焦虑症（GAD）的患者报告的强迫和强迫症状的患病率、严重程度和相关性。
对两组患者进行了回顾性研究：76 名被诊断为强迫症的患者[根据国际疾病分类第 10 版（ICD-10）为 F42]，以及 186 名被诊断为 GAD 的患者（根据 ICD-10 为 F41.1），他们在日间病房接受治疗。使用症状问卷“O”，基于症状清单 90-修订版（SCL-90-R）问卷，评估强迫、强迫和焦虑症状。分析考虑了性别和认知功能障碍（使用 Bender Benton 视觉保留和 Bender-Gestalt 测试评估）对正在研究的关联的影响。
我们观察到，强迫症患者的强迫和强迫症状比 GAD 患者更为普遍且更为强烈。然而，几乎所有 GAD 患者（94%）都确认存在一些强迫症状。研究揭示了 OCD 和 GAD 组之间与强迫和强迫相关的差异。在 OCD 组中，没有发现强迫和强迫严重程度之间存在显著相关性，而在 GAD 组中，发现这些症状的严重程度之间存在显著正相关。在 GAD 和 OCD 组中，强迫症状的强度越大，焦虑症状的严重程度也越高（这种影响在强迫症状中比在强迫症状中更为明显）。
研究表明，GAD 患者经常存在共存的强迫症状，这些症状在常规精神检查中可能无法识别。GAD 患者中观察到的强迫症状的结构可能与 OCD 患者中的强迫症状不同。本研究结果表明，与强迫相比，强迫更能特异性诊断 OCD。与需要秩序和对称有关的计数等强迫可能与某些认知功能障碍和男性性别有关，这一发现需要进一步研究。
