Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Nord J Psychiatry. 2023 Aug;77(6):574-580. doi: 10.1080/08039488.2023.2191991. Epub 2023 Apr 8.
Obsessive thoughts and compulsive behavior and their related disorder Obsessive-Compulsive Disorder (OCD) commonly occur in the general population. Clinical populations indicate a high level of stability, although there are few longitudinal studies in the general population. The recommended drug treatments are SSRIs/TCAs. However, there are few long-term follow up studies. The goal of this study was to 1) examine the occurrence and stability of obsessions, compulsions, and OCD in a longitudinal population-based survey, 2) investigate the use of SSRI and TCA and the potential effect on symptoms.
A ten-year longitudinal general population in Stockholm was used (2000 and 2010, = 5650) Obsessional washing, checking, intrusive unpleasant thoughts and the level of suffering due to these symptoms were measured by self-report. Information on use of SSRIs and TCAs by these individuals was obtained from registers. Stability was examined using contingency tables and multinomial logistic regression.
At baseline, 2.1, 11.7 and 11.9% reported obsessional washing, checking and intrusive thoughts. A total of 5% reported considerable suffering from these (i.e. OCD). Based on psychiatric interview only 0.4% had OCD. Ten years later a quarter of OCD cases were still classified as having OCD, one quarter reported any obsessive or compulsive symptom and half were classified as symptom-free. Treatment receipt was low and controlling for medication did not change the stability.
Obsessive thoughts and compulsive behavior are common and stable. While this group is potentially undertreated, there is no indication that those treated display a different pattern of recovery.
强迫观念和强迫行为及其相关障碍强迫症（OCD）在普通人群中很常见。临床人群表明其具有较高的稳定性，尽管在普通人群中进行的纵向研究较少。推荐的药物治疗是 SSRIs/TCAs。然而，长期随访研究很少。本研究的目的是：1）在纵向人群研究中检查强迫观念、强迫行为和 OCD 的发生和稳定性，2）研究 SSRI 和 TCA 的使用情况及其对症状的潜在影响。
我们使用了斯德哥尔摩的一个十年纵向一般人群（2000 年和 2010 年，共 5650 人），通过自我报告来衡量强迫性洗涤、检查、侵入性不愉快想法以及这些症状所带来的痛苦程度。通过登记册获取这些个体使用 SSRI 和 TCA 的信息。使用列联表和多项逻辑回归来检查稳定性。
在基线时，2.1%、11.7%和 11.9%报告有强迫性洗涤、检查和侵入性思维。共有 5%报告因这些症状而遭受严重困扰（即 OCD）。根据精神科访谈，只有 0.4%患有 OCD。十年后，四分之一的 OCD 病例仍被归类为患有 OCD，四分之一报告有任何强迫或强迫症状，一半被归类为无症状。治疗的接受率较低，且药物治疗并不能改变稳定性。
强迫观念和强迫行为很常见且稳定。尽管这群人可能未得到充分治疗，但没有迹象表明接受治疗的人恢复模式不同。
