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儿童强迫症的领悟水平与临床及家族特征之间的关系

Relationship between insight level and clinical and familial features in pediatric obsessive-compulsive disorder.

作者信息

Miniksar Dilsad Yildiz, Oz Busra, Ozdemir Mikail, Yuksel Tugba

机构信息

Department of Child and Adolescent Psychiatry, Yozgat Bozok University Faculty of Medicine, Yozgat, Turkiye.

The current affiliation of the author: Gaziantep Provincial Health Directorate, Gaziantep, Turkiye.

出版信息

North Clin Istanb. 2023 Jun 5;10(3):289-297. doi: 10.14744/nci.2021.91979. eCollection 2023.

Abstract

OBJECTIVE

The aim of this study was to explore the relationship between insight level and clinical and familial psychiatric features of children with obsessive-compulsive disorder (OCD).

METHODS

Children's Yale-Brown Obsessive-Compulsive Scale-Symptom Checklist, 11 item of the Children's Yale-Brown Obsessive-Compulsive Scale, Wechsler Intelligence Scale for Children Revised Form, Affective Disorders and Schizophrenia for School Aged Children Present and Lifetime Version 1.0, and Structured Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders-IV Axis I Disorders were applied to 92 pediatric OCD patients.

RESULTS

In this study, the prevalence of OCD in the first children of the family was high (41.3%), and low insight was significantly related with concomitant intellectual disability (p=0.003). The level of insight was high in patients with comorbid OCD spectrum disorders (p<0.001). Attention deficit and hyperactivity disorder (ADHD) was the most common psychiatric diagnosis accompanying OCD (19.5%). Among the obsession-compulsion subscales, the symmetry/hoarding was higher in males (p=0.046). OCD patients with a family history of major depressive disorder (MDD) had high ADHD comorbidity rates (p=0.038). In OCD patients, whose family had psychiatric disorders besides MDD and anxiety disorders, the diagnosis rate of intellectual disability was higher than other diagnoses (p<0.001).

CONCLUSION

The sociodemographic, clinical, and familial features of pediatric OCD patients cannot be adequately clarified if the patient has limited insight. Therefore, the insight of children with OCD should be considered a range or continuity.

摘要

目的

本研究旨在探讨强迫症(OCD)患儿的自知力水平与临床及家族精神疾病特征之间的关系。

方法

对92例儿科OCD患者应用儿童耶鲁-布朗强迫症量表症状清单、儿童耶鲁-布朗强迫症量表的11个项目、韦氏儿童智力量表修订版、学龄儿童情感障碍和精神分裂症现患率及终生患病率版本1.0,以及精神障碍诊断与统计手册第四版轴I障碍结构化诊断访谈。

结果

在本研究中,家族中第一个孩子患OCD的患病率较高(41.3%),自知力低下与合并智力残疾显著相关(p = 0.003)。合并OCD谱系障碍的患者自知力水平较高(p < 0.001)。注意缺陷多动障碍(ADHD)是OCD最常见的伴发精神疾病诊断(19.5%)。在强迫观念-强迫行为分量表中,对称性/囤积行为在男性中更高(p = 0.046)。有重度抑郁症(MDD)家族史的OCD患者ADHD共病率较高(p = 0.038)。在OCD患者中,其家族除MDD和焦虑症外还有精神疾病的,智力残疾的诊断率高于其他诊断(p < 0.001)。

结论

如果患者自知力有限,儿科OCD患者的社会人口学、临床和家族特征就无法得到充分阐明。因此,应将OCD患儿的自知力视为一个范围或连续体。

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本文引用的文献

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Hoarding in Children and Adolescents with Obsessive-Compulsive Disorder.患有强迫症的儿童和青少年的囤积行为
J Obsessive Compuls Relat Disord. 2014 Oct 1;3(4):325-331. doi: 10.1016/j.jocrd.2014.08.001.
8
Neuropsychological correlates of insight in obsessive-compulsive disorder.强迫症患者洞察力的神经心理学相关性。
Acta Psychiatr Scand. 2012 Aug;126(2):106-14. doi: 10.1111/j.1600-0447.2012.01845.x. Epub 2012 Feb 29.

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