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血清素再摄取抑制剂治疗初治强迫症的自然转归

Naturalistic outcome of medication-naïve obsessive compulsive disorder treated with serotonin reuptake inhibitors.

作者信息

Thamby Abel, Balachander Srinivas, Ali Syed Farooq, Arumugham Shyam Sundar, Ts Jaisoorya, Narayanaswamy Janardhanan C, Janardhan Reddy Y C

机构信息

Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.

Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.

出版信息

Asian J Psychiatr. 2021 Jun;60:102642. doi: 10.1016/j.ajp.2021.102642. Epub 2021 Apr 6.

Abstract

OBJECTIVE

The data on the course of obsessive compulsive disorder (OCD) is mostly derived from studying chronic, severely ill patients with varying degree of treatment resistance. We studied the course and outcome of OCD patients who were medication-naïve at initial assessment compared to those who were medicated.

MATERIAL AND METHODS

We analyzed the clinical chart data of all patients with a primary diagnosis of OCD attending a speciality OCD clinic in India during a specified period and compared outcome between medication-naïve (n = 75) and medicated (n = 117) patients.

RESULTS

The mean time to remission was shorter in the medication-naïve [18.99 months (95 % CI: 14.61-23.37)] compared to medicated [33.91 months (95 % CI: 27.55-40.28)] patients. The survival distribution of the two groups was significantly different as per the log-rank test (χ2 = 5.76, p = 0.02). In the Cox proportional hazards regression, medication-naïve status predicted time to remission. Overall, the rate of remission was the same in both groups (57 %).

CONCLUSIONS

Medication-naïve OCD patients seem to remit faster than the previously treated patients. Future prospective naturalistic studies can compare the outcome of medication naïve OCD patients treated with medications and CBT.

摘要

目的

强迫症(OCD)病程的数据大多来自对慢性、重症且具有不同程度治疗抵抗性的患者的研究。我们研究了初始评估时未接受药物治疗的OCD患者与接受过药物治疗的患者的病程及转归情况。

材料与方法

我们分析了在特定时期到印度一家OCD专科诊所就诊、初步诊断为OCD的所有患者的临床病历数据,并比较了未接受药物治疗的患者(n = 75)和接受过药物治疗的患者(n = 117)的转归情况。

结果

未接受药物治疗的患者达到缓解的平均时间[18.99个月(95%置信区间:14.61 - 23.37)]比接受过药物治疗的患者[33.91个月(95%置信区间:27.55 - 40.28)]短。根据对数秩检验,两组的生存分布有显著差异(χ2 = 5.76,p = 0.02)。在Cox比例风险回归分析中,未接受药物治疗的状态可预测达到缓解的时间。总体而言,两组的缓解率相同(57%)。

结论

未接受药物治疗的OCD患者似乎比先前接受过治疗的患者缓解得更快。未来的前瞻性自然主义研究可以比较未接受药物治疗的OCD患者接受药物治疗和认知行为疗法(CBT)后的转归情况。

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