8-17 岁强迫症患儿及青少年家庭容纳度和父母心理困扰的临床意义。
Clinical significance of family accommodation and parental psychological distress in a sample of children and adolescents with obsessive-compulsive disorder aged 8-17 years old.
机构信息
Department of Neuroscience, Child and Adolescent Neuropsychiatry Unit, Children Hospital Bambino Gesù, Viale Ferdinando Baldelli, 41, 00146, Rome, Italy.
Department of Dynamic and Clinic Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via dei Marsi, 78, 00185, Rome, Italy.
出版信息
Ital J Pediatr. 2020 Nov 10;46(1):167. doi: 10.1186/s13052-020-00932-2.
BACKGROUND
Family Accommodation (FA) refers to the involvement of family members (especially parents) in the compulsive behaviors of children and adolescents with Obsessive-Compulsive Disorder (e.g. modifying family routines or facilitating avoidance of obsessive-compulsive triggers). Many studies have examined the high prevalence of FA in this clinical population; however, less is known about its clinical significance and relationship to the individual psychological distress of parents. In our study, we investigated the clinical significance of FA examining its relationship with obsessive-compulsive symptomatology, functioning, anxiety and depressive symptoms in a clinical sample (n = 51) of children and adolescents with Obsessive-Compulsive Disorder (OCD) aged 8-17 years old and their parents, included to examine their individual psychological distress.
METHODS
The sample was divided into two groups: the High Accommodation group (n = 36) and the Low Accommodation group (n = 15).
RESULTS
Results demonstrated that children and adolescents in the OCD High Accommodation group reported major functional impairment in global (p = .001313), social (p = .000334) and role (p = .000334) domains, and higher depressive symptoms than the Low Accommodation group. Both fathers and mothers from the High Accommodation group reported a higher level of individual psychological distress compared to mothers and fathers from the Low Accommodation group (p = .040365).
CONCLUSIONS
The findings of this study show that FA is common in children and adolescents with OCD and it could cause not only an impairment of the patient's global, social and role functioning but also a high level of individual psychological distress in the single parent. The presence of FA should therefore be carefully investigated and considered in planning assessment and treatment of OCD in children and adolescents.
背景
家庭顺应（FA）是指家庭成员（尤其是父母）参与到患有强迫症（OCD）的儿童和青少年的强迫行为中，例如改变家庭日常生活规律或帮助避免强迫触发因素。许多研究都考察了 FA 在这一临床群体中的高发生率；然而，人们对其临床意义及其与父母个体心理困扰的关系知之甚少。在我们的研究中，我们通过考察 FA 与 OCD 患儿和青少年的强迫症状、功能、焦虑和抑郁症状的关系，研究了 FA 的临床意义，该研究纳入了 51 名 8-17 岁的 OCD 患儿和青少年及其父母，以考察他们的个体心理困扰。
方法
该样本被分为两组：高顺应组（n=36）和低顺应组（n=15）。
结果
结果表明，OCD 高顺应组的儿童和青少年在整体（p=0.001313）、社会（p=0.000334）和角色（p=0.000334）功能领域报告了严重的功能障碍，且抑郁症状较严重。高顺应组的父亲和母亲比低顺应组的母亲和父亲报告了更高水平的个体心理困扰（p=0.040365）。
结论
本研究结果表明，FA 在 OCD 儿童和青少年中很常见，它不仅会导致患者整体、社会和角色功能受损，还会导致单亲个体心理困扰水平较高。因此，在评估和治疗儿童和青少年 OCD 时，应仔细调查和考虑 FA 的存在。
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