Fontenelle Leonardo F, Destrée Louise, Brierley Mary-Ellen, Thompson Emma M, Yücel Murat, Lee Rico, Albertella Lucy, Chamberlain Sam R
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia.
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ).
CNS Spectr. 2021 Apr 12;27(4):1-10. doi: 10.1017/S109285292100033X.
The extent to which obsessive-compulsive and related disorders (OCRDs) are impulsive, compulsive, or both requires further investigation. We investigated the existence of different clusters in an online nonclinical sample and in which groups DSM-5 OCRDs and other related psychopathological symptoms are best placed.
Seven hundred and seventy-four adult participants completed online questionnaires including the Cambridge-Chicago Compulsivity Trait Scale (CHI-T), the Barratt Impulsiveness Scale (BIS-15), and a series of DSM-5 OCRDs symptom severity and other psychopathological measures. We used K-means cluster analysis using CHI-T and BIS responses to test three and four factor solutions. Next, we investigated whether different OCRDs symptoms predicted cluster membership using a multinomial regression model.
The best solution identified one "healthy" and three "clinical" clusters (ie, one predominantly "compulsive" group, one predominantly "impulsive" group, and one "mixed"-"compulsive and impulsive group"). A multinomial regression model found obsessive-compulsive, body dysmorphic, and schizotypal symptoms to be associated with the "mixed" and the "compulsive" clusters, and hoarding and emotional symptoms to be related, on a trend level, to the "impulsive" cluster. Additional analysis showed cognitive-perceptual schizotypal symptoms to be associated with the "mixed" but not the "compulsive" group.
Our findings suggest that obsessive-compulsive disorder; body dysmorphic disorder and schizotypal symptoms can be mapped across the "compulsive" and "mixed" clusters of the compulsive-impulsive spectrum. Although there was a trend toward hoarding being associated with the "impulsive" group, trichotillomania, and skin picking disorder symptoms did not clearly fit to the demarcated clusters.
强迫及相关障碍（OCRD）在多大程度上具有冲动性、强迫性或两者兼具，仍需进一步研究。我们调查了在线非临床样本中不同聚类的存在情况，以及《精神疾病诊断与统计手册》第五版（DSM-5）中的OCRD和其他相关精神病理症状最适合归为哪些组。
774名成年参与者完成了在线问卷，包括剑桥-芝加哥强迫特质量表（CHI-T）、巴拉特冲动量表（BIS-15），以及一系列DSM-5 OCRD症状严重程度和其他精神病理测量指标。我们使用K均值聚类分析，根据CHI-T和BIS的回答来检验三因素和四因素解决方案。接下来，我们使用多项回归模型研究不同的OCRD症状是否能预测聚类归属。
最佳解决方案确定了一个“健康”聚类和三个“临床”聚类（即一个主要为“强迫性”的组、一个主要为“冲动性”的组和一个“混合性”——“强迫性和冲动性”组）。多项回归模型发现，强迫、躯体变形和分裂型症状与“混合性”和“强迫性”聚类相关，囤积和情绪症状在趋势水平上与“冲动性”聚类相关。进一步分析表明，认知-感知分裂型症状与“混合性”组相关，但与“强迫性”组无关。
我们的研究结果表明，强迫症、躯体变形障碍和分裂型症状可以映射到强迫-冲动谱系的“强迫性”和“混合性”聚类中。虽然囤积行为有与“冲动性”组相关的趋势，但拔毛癖和皮肤搔抓障碍症状并不明显符合划定的聚类。
