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智商水平与强迫症的治疗:荟萃分析

Intelligence quotient level and treatment of obsessive-compulsive disorders: Meta-analyses.

作者信息

Hu Lidan, Hao Youguo, Liu Shudong, Kang Hongying, Qin Li, Zeng Zhen, Abdelrahim Mohamed E A, Tan Youguo

机构信息

General Medicine Ward, Gele Mountain Hospital of Chongqing Mental Health Center, Chongqing, Chongqing 400036, PR China.

Department of Rehabilitation, Shanghai Putuo People's Hospital, Shanghai, Shanghai 200060, PR China.

出版信息

Med Hypotheses. 2020 Nov;144:109995. doi: 10.1016/j.mehy.2020.109995. Epub 2020 Jun 13.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) is a highly heterogeneous mental disorder that could affect mental capacity and requires different treatment methods. The purpose of this meta-analysis study was to evaluate the OCD subjects' intelligence quotient (IQ) and the effect of different treatments on OCD.

METHODS

Through a systematic literature search up to December-2019, 108-studies were identified, with 8049-subjects with 6719-OCD subjects. The studies identified were 45 reporting IQs in OCD and 38 reporting comparisons between selective-serotonin reuptake-inhibitors (SSRIs) to placebo in the treatment of OCD, 9 reporting comparison between SSRIs to each other, 8 reporting comparison between cognitive-behavioral therapy (CBT) to placebo and 8 reporting comparison between CBT to SSRIs. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated comparison was made according to the study content using a continuous method with a random or fixed-effects model.

RESULTS

Subjects with OCD had significantly lower IQ (OR, -3.74; 95% CI, -4.83 to -2.64) than normal subjects. SSRIs (OR, -4.09; 95% CI, -4.87 to -3.30) and CBT (OR, -15.13; 95% CI, -19.27 to -10.99) had better effect than placebo in OCD treatment. No significant difference were found between different types of SSRIs (OR, -0.42; 95% CI, -1.32-0.49) or between CBT and SSRIs (OR, -1.99; 95% CI, -4.20 to 0.22) with non-significant better values favoring CBT.

CONCLUSIONS

The IQ of the OCD subjects was significantly lower than in normal subjects. The SSRIs and the CBT had a significant effect on treating OCD. Different SSRIs are similar in their effect on OCD. More studies are required to separate between CBT and SSRIs' insignificant differences.

摘要

背景

强迫症(OCD)是一种高度异质性的精神障碍,会影响心理能力,需要不同的治疗方法。本荟萃分析研究的目的是评估强迫症患者的智商(IQ)以及不同治疗方法对强迫症的影响。

方法

通过系统的文献检索,截至2019年12月,共识别出108项研究,涉及8049名受试者,其中6719名强迫症患者。所识别的研究中,45项报告了强迫症患者的智商,38项报告了选择性5-羟色胺再摄取抑制剂(SSRIs)与安慰剂治疗强迫症的比较,9项报告了不同SSRIs之间的比较,8项报告了认知行为疗法(CBT)与安慰剂的比较,8项报告了CBT与SSRIs的比较。计算比值比(OR)及其95%置信区间(CIs),并根据研究内容采用连续方法,使用随机或固定效应模型进行比较。

结果

强迫症患者的智商显著低于正常受试者(OR,-3.74;95%CI,-4.83至-2.64)。SSRIs(OR,-4.09;95%CI,-4.87至-3.30)和CBT(OR,-15.13;95%CI,-19.27至-10.99)在强迫症治疗中比安慰剂效果更好。不同类型的SSRIs之间(OR,-0.42;95%CI,-1.32至0.49)或CBT与SSRIs之间(OR,-1.99;95%CI,-4.20至0.22)未发现显著差异,虽有非显著的更好值倾向于CBT。

结论

强迫症患者的智商显著低于正常受试者。SSRIs和CBT对治疗强迫症有显著效果。不同的SSRIs对强迫症的治疗效果相似。需要更多研究来区分CBT与SSRIs之间的非显著差异。

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